Domestic Abuse

Question 1

Define domestic abuse.

Answer 1

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.
The abuse can include
Psychological
Physical
Sexual
Financial
Emotional

Question 2

What are the impacts of domestic abuse on health?

Answer 2

1. Traumatic injuries following assault
   Eg Fractures, miscarriages, facial injuries, bruises, haemorrhages
2. Somatic problems/chronic illness consequent on living with abuse
   Eg Headaches, IBS, chronic pain, low birth weight, premature delivery
3. Psychological or psychosocial problems secondary to the abuse
   Eg PTSD, attempted suicide, substance misuse, depression, anxiety, eating disorders

Question 3

What are the ‘Don’ts’ during a consultation when you suspect a pt is a victim of domestic abuse?

Answer 3

Don’t:
Assume someone else will take care of things. You may be his/her only contact
Ask about domestic abuse in front of family members, including children
Tell them what to do. Aim to empower them to make safe and informed choices

Question 4

How are the risk levels of domestic abuse assessed?

Answer 4

DASH Risk Assessment Tool

Standard- Current evidence does not indicate likelihood of causing serious harm
Medium- There are identifiable indicators of risk of serious harm. Offender has potential to cause serious harm but unlikely unless change in circumstances
High- There are identifiable indicators of imminent risk of serious harm. Dynamic, could happen at any time and impact would be serious

Question 5

What should you do based on the risk levels of domestic abuse?

Answer 5

Standard/medium risk- Give contact details for domestic abuse services

High risk- Refer to Multi Agency Risk Assessment Conference (MARAC) / Independent Domestic Violence Advocacy (IDVA) wherever possible with consent, can be done via helpline as well. Can break confidentiality for high risk cases if patient does not consent

Question 6

What is a domestic homicide review?

Answer 6

Review of circumstances in which the death of a person aged 16 or over has/appears to have resulted from violence, abuse or neglect by:
A relative/person with an intimate relationship
A member of the same household