GP Sensitive Issues

Question 1

Mental health presentations of domestic violence

Answer 1

Anxiety, depression
Drug/alcohol
Eating disorders
Suicide
PTSD
Frequent attendance

Question 2

Barriers to disclosure

Answer 2

Shame
Fear of abuser
Abuse is normal
Fear of judgement
Partner present
Perception that GP can't help

Question 3

GP’s barriers to deal with partner violence?

Answer 3

Time
Skills

Beleive it’s not common
Offending patient
Private
Belief it won’t change anything.

Question 4

Some screening questions about domestic violence

Answer 4

How are things at home?
Any tension? What happens when argue?
Are you afraid of your partner?
Any physical threatening or hurt.

HARK

Question 5

What is HARK?

Answer 5

Humiliation
Afraid
Rape
Kick

Question 6

Questions to follow up on funneling for domestic violence

Answer 6

Do you feel able to tell me what happens when your partner gets upset with you?
I’m getting the feeling that when they get upset, this affects you.

Sometimes when ppl get upset, they can lash out. Is that happening to you?

Counter the normalization of violence. It’s NOT normal to experience violence.

Question 7

Things you must ask if detect domestic violence?

Answer 7

Safety - safe to go home?
Any children involved?

-Any weapons?
-abuse escalating?
-

Question 8

Summary of management and safety plan for domestic violence.

Answer 8

Ask respond non-judge tally
Beleive them
Ensure confidentiality unless kids violence
Assess current state
don't offEr couple counselling

Safety plan: spare keys/cars, money, birth certificate, passports, signal for Neighbour to call police.

Question 9

How to ask sensitive questions?

Answer 9

Prepare them - preface them
Give them the reason why.
Ask permission
Normalize