Behavioural change Flashcards
Definition of domestic abuse
‘Any incident, or pattern of incidents, of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality.’
How does gender affect domestic abuse?
1 in 4 women will experience
1 in 6-7 men
2:1 ratio female:male
What % of trans people have experienced abuse from a partner or ex partner?
80%
emotional, sexual,or physicalabuse from a partner or ex-partner.
Types of domestic abuse
Coercive control
Psychological and/or emotional abuse
Physical or sexual abuse
Financial abuse
Harassment and stalking
Online or digital abuse
What is coercive control? + examples
a pattern of intimidation, degradation, isolation and control with the use or threat of physical or sexual violence
eg Isolation from friends and family
Deprivation of basic needs, such as food
Monitoring victim’s time
Monitoring via online communication tools or spyware
Taking control over aspects of everyday life, such as where victim can go, who they can see, what they can wear and when they can sleep
Depriving access to support services, such as medical services
Humiliating, degrading or dehumanising you
Controlling your finances
Making threats or intimidating victim
LGBT abuse
Threat of disclosure of sexual orientation and gender identity.
Undermining someone’s sense of gender or sexual identity.
Limiting or controlling access to support relevant to coming out and coming to terms with gender and sexual identity.
Withholding medication or preventing treatment needed to express victim’s gender identity (e.g. hormones, surgery).
The abuser might refuse to use correct pronouns and prevent the abused from speaking about their background or identity.
Factors increasing risk of domestic abuse
Large family
Young age
Low educational attainment
Unemployment
Poverty
Drug use
Previous abuse eg as child
Disability
Long term health condition
Low SE class
Factors increasing risk of domestic abuse
Large family
Young age
Low educational attainment
Unemployment
Poverty
Drug use
Previous abuse eg as child
Disability
Long term health condition
Low SE class
Domestic abuse consequences
Increased mental health problems,
Suicide attempts,
Worsening of chronic illness,
Injury,
Substance abuse, anxiety, stress,
Chronic pain
Gynaecological problems.
Pregnancy
How does pregnancy affect domestic abuse?
1/3 of domestic violence starts or gets worse when a woman is pregnant.
>14% of maternal deaths occur in women who have told their health professional they are in an abusive relationship.
Risk of domestic abuse consequences pregnancy
Increase risk of
Miscarriage
Infection
Prem
Low BW
Foetal injury
Stillbirth
Questions to ask around omestic abuse
Do you ever feel frightened of your partner? Do you feel that you are in danger?
Have you been physically hurt by your partner? Has your partner ever threatened to hurt you or someone you care about?
Are there any problems with your partner? Do you ever argue or fight? Do the fights become physical? Are you ever afraid?
Do you feel controlled and isolated by your partner? Does your partner belittle and insult you
Has your partner ever made you have sex when you don’t want to or do other sexual things?
Fram question
“as domestic abuse is common, we ask all our patients about it”. “You may have seen some posters and leaflets outside, we are asking all our patients about domestic abuse”.
“I see that you’re experiencing X symptoms, sometimes when this happens there may be problems in your life at home. How are things at home”.
What to do if patient discloses domestic abuse?
Thank the patient for telling you. Validate the patient’s feelings. Let them know that they are not responsible for the abuse
Ask of they are safe now and if there are children involved
Let the patient know that abuse is something that you are concerned about the abuse and it can impact on their health
Explain that this is why you would like to offer some help and/or some information but will not force them to do anything they do not want to
if there is an immediate threat to the patient or staff, notify security and/or the Police
Risk assessment for domestic abuse
DASHH
Domestic abuse, stalking, harrrassment and honour check lsit
27 Qs to assess risk to victom
Low medium or high risk
https://www.dashriskchecklist.co.uk/
Risk factors for serious harm
Victim’s perception of risk of harm
Separation (and child contact)
Pregnancy/new birth (under 18 months old)
Escalation
Community issues/isolation
Stalking
Sexual assault
Strangulation
Credible threats to kill
Use of weapons
Controlling and/or excessive jealous behaviour
Child abuse
Animal/pets abuse
Alcohol/drugs/mental health
Suicide-homicide
