Domestic and sexual violence: Impacts on health

Question 1

Define GBV.

Answer 1

Any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women (although domestic abuse can also affect men, and can occur in same sex relatinships), including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life

Question 2

Is Gender Based violence exclusively by men against women ?

Answer 2

No, committed primarily but not exclusively against women by men

Question 3

Identify some examples of acts which are considered GBV.

Answer 3

♦ Domestic abuse
♦ Rape and Sexual Assault 
♦ Childhood Sexual Abuse 
♦ Stalking and Harassment 
♦ Commercial Sexual Exploitation
♦ Harmful traditional practices- FGM, Forced Marriage and Honor-based violence

Question 4

What is the cost of domestic abuse to the NHS ?

Answer 4

£1.73 billion

Question 5

What number of women every week seek medical treatment for injuries sustained in the home ?

Answer 5

Approx. 100, 000 women every week seek medical treatment for injuries sustained in the home.

Question 6

What proportion of women, and men, are affected by domestic abuse ?

Answer 6

• 1 in 3 women, 1 in 6 men

Question 7

What proportion of children live with domestic abuse ?

Answer 7

1 in 5

Question 8

What group is most vulnerable to domestic abuse ?

Answer 8

Women between the ages of 16 and 19 years and those who are pregnant are most at risk (Women’s Aid 2012)

(Women are at highest risk of domestic homicide whist pregnant or post-partum)

Question 9

How many women, and men, die of domestic abuse ?

Answer 9

2 women every week

30 men every year

Question 10

What is the average length of time a woman endures violence ?

Answer 10

Average length of time a woman endures violence –7 years

Question 11

What is the largest cause of morbidity worldwide in women aged 19 -44 ?

Answer 11

Domestic Abuse

Question 12

Define Toxic Trio.

Answer 12

Describe the issues of domestic abuse, mental ill-health and substance (alcohol and/or drugs) misuse which have been identified as common features of families where harm to children and adults has occurred.

Question 13

Identify examples of types of violence against women in different life stages.

Answer 13

Pre-birth: Sex-selective abortion
Infancy: Female infanticide, Neglect
Childhood: Child abuse, FGM
Adolescence: Forced prostitution, Rape
Reproductive Age: Honor Killing, Homicide
Elderly: Elder/widow abuse, Economic abuse

Question 14

Identify and describe any legislations in the UK addressing GBV.

Answer 14

Domestic Abuse (Scotland) Act 2018

• This Act creates an offence with respect to the engaging by a person in a course of behaviour which is abusive towards that person’s partner or ex-partner.
• The new law covers not only spouses, civil partners and cohabitants but also people in intimate personal relationships who do not live together.
• As well as physical abuse, it will cover other forms of psychological abuse and coercive and controlling behaviour that cannot be easily prosecuted under the existing law.

Question 15

What is the fifetime prevalence rates of domestic abuse for women ?

Answer 15

25%

Question 16

What proportion of women who experience DA are assaulted for the 1st time whilst pregnant ?

Answer 16

1/3

Question 17

Who carries most acts of rape or sexual assault ?

Answer 17

Most cases of rape or sexual assault are carried out by someone known to the victim

Question 18

What proportion of women have been victim of rape ? of women ?

Answer 18

Approx. 1 in 20 women have been victims of rape

3% of men

Question 19

What proportion of reported rapes result in conviction ?

Answer 19

6%

Question 20

True or False: Unlike other crimes, victims of rape and sexual assault are often held responsible for sexual violence.

Answer 20

True

Question 21

Define Stalking/ Harassment. Identify actions which may be interpreted as such.

Answer 21

Intentional behaviour, involving more than one incident, which causes fear, upset or annoyance to the victim

 Surveillance
 Unwanted phone calls and text messages
 Unwanted gifts and cards
 “Cyber” stalking
 Threatening emails, letters, calls or texts to family and friends
 Damage to property

Question 22

Identify harmful traditional practices.

Answer 22

 Female Genital Mutilation (FGM)
 “Honour” based violence
 Forced Marriage
 Dowry related abuse

Question 23

Identify examples of Commercial sexual exploitation.

Answer 23

• Prostitution
• Trafficking
• Pornography
• Lapdancing, pole-dancing, stripping
• Saunas, brothels, massage parlours

All of the above have links to organised crime, child exploitation and human trafficking

Question 24

What proportion of men, and women, have experienced childhood sexual abuse ?

Answer 24

 1:4 women have experienced CSA

 1:5 men have experienced CSA

Question 25

What proportion of child sexual abusers are men ?

Answer 25

Men are the abusers in about 90% of cases regardless whether the child is a boy or girl

Question 26

Identify impacts of GBV on health.

Answer 26

♦ Physical Health
- Injuries, disability, impaired immunity

♦ Mental Health
- PTSD, anxiety, phobias, depression, addictions

♦ Reproductive Health
- STIs, infertility, miscarriage, pregnancy complications, poor birth outcomes

Question 27

Describe the role of medical practitioners in preventing GBV and supporting victims.

Answer 27

• Communication
• Gut Reaction
• Listen to what is not being said rather than what is
• If Unsure “Ask”
• Education
• We need to become more aware of patients and their behaviours
• Be aware of external resources
• The importance of taking individual responsibility for self
• Make informed choices and decisions regarding care

Always use the patients reactions as a way forward towards being trauma informed. To promote Holistic Psychological Care can be key.

Question 28

Identify public health approaches to the elimination of GBV.

Answer 28

♠ Educational programmes to address entrenched societal attitudes and beliefs which reinforce gender inequality
♠ National campaigns to raise awareness of GBV and promote support services
♠ National campaigns to encourage non-abusing men to challenge sexist behaviours and attitudes which reinforce gender inequality (The White Ribbon Campaign)
♠ Ensure health services are responsive to those affected by all forms of GBV and offer appropriate care and support.

Question 29

Identify principles of good practice wrt GBV.

Answer 29

• The safety of any victim and children is paramount
• Treat people with respect and dignity at all times: listen
and avoid being judgmental
• Only ask an individual about abuse if they are alone, the only exception being a professional interpreter
• Document your findings accurately and fully
• Recognise the skills and contributions of other agencies
• Keep yourself and your colleagues safe