Domestic abuse Flashcards
What is domestic abuse
Any form of physical, verbal, sexual, psychological or financial abuse from a partner/ ex partner
What are the different types of domestic abuse
Situational couple violence-fighting
Coercive and controlling behaviour-violence
Physical
Emotional
Verbal
Sexual
Financial (controlled access to money- difficult to escape)
What is the domestic abuse act 2018
Created a specific criminal offence of domestic abuse
Recognises can be over a period of time
Criminalises coercive and controlling behaviour
What is the prevelenceof domestic abuse in Scotland
Affects 1 in 5 women at some point in their lives and up top 1 in 6 men.
60,000 cases reported annually (however many cases unreported)
Where is the most common place for domestic abuse to take place
In a private residence
What is gender based violence
Violence based against a person on the basis of gender
Reflects and reinforces inequalities between men and women
Eg. Rape and sexual assault, sexual harassment, stalking, coerced marriage, trafficking and sexual exploitation
What is coercive control behaviour
A pattern of behaviour
Aim to isolate victim
Degradation of victim
Micro-regulation of all aspects of life (money, clothes, surveillance)
Abusers are often charming to everyone else which serves to increase the isolation
Who is most at risk of domestic abuse
Age 16-24 (f), 16-19 (m)
Long term illness/ disability
Mental health problems
Pregnancy (elevation during pregnancy)
Elevated risk at time of separation from partner
What are the health consequences
Fatal- suicide, murder
Non fatal- physical harm, reproductive health, mental health, chronic conditions (TMJ etc), health harming behaviours (drinking, smoking, drugs).
How many women were killed by a partner in UK in 2018
80
How many children were murdered by their parents in 2007?
33
What are some effects of physical harm on children?
Anxiety/ depression
Sleeping issues, nightmares
Heightened startle response
Physical symptoms
Behavioural issues
Health harming behaviours
Low sense of self worth/ feel guilty
Truanting
What is ACE
Adverse childhood events
Abuse, neglect, household dysfunction
4 or more- more likely to have medical issues, be involved in violence, binge drink
This is a factor but can be overcome by resilience
How many attempts does it take for someone to leave an abusive relationship?
6-7
How to recognise abuse?
Low self-esteem
Anxiety
Constant communication with partner if not present
If partner present, they may do all the talking
Alcohol
May insist on female clinician
Missed or frequent appointments
Some of these things may be for other reasons
Physical signs of domestic abuse
Repeated injuries
Bruises at different stages of healing
Dental/ maxilofacial injuries, orofacial pain (69% has history of abuse)
TMJ problems (chronic pains)
Facial bruising/ on neck
Unlikely explanation for injury
Delay in seeking help for injury
What are some effects off at attempted strangulation
Can cause infarction in brain
How often does physical abuse occur in domestic abuse
40% of cases
50-90% are facial injuries
Always question facial injuries
What are some barriers to domestic abuse screening?
Patient accompanied
Lack of training, time, knowledge where to refer
Concern about offending patient
Patient’s cultural norms
Which act protects vulnerable adults and allows you to make a referral on their behalf
Adult Support and protection (Scotland) Act 2007
What is the definition of a vulnerable adult?
Adult unable to safeguard their own interest through disability, mental disorder, illness or physical or mental infirmity, and who is at risk of harm or self-harm, including neglect
What is AVDR
Ask
Validate
Document
Refer - signpost, Scottish Domestic Abuse Helpline
Framework to help clinicians to ask about domestic abuse.
Quick and easy.
Limits enquirers involvement to very simple tasks - let patient decide what they would like to do and when.
What are some things you can do in your practice?
Put cards/ posters in toilets/ waiting room
Have staff wear ASC badges
Allow patient to use the phone in the surgery
Link with local domestic abuse agencies and have their materials available
Develop a protocol to allow you to get people on their own if partners are present eg code word.
