Domestic violence and abuse

Melanie Goodway IRISi

It was like screaming under water and no-one could hear me, then I was given one-to-one support from my own specialist caseworker, who has been there for me ever since. IRIS helped me to prepare, focus and to look objectively. Through some of the lowest and loneliest points in my life, iris was there, even if it was to help me remember to laugh, which sounds so simple, but it meant everything.
— IRIS service user

What is Domestic Violence and Abuse (DVA)?

DVA is a devasting and prevalent crime worldwide. According to the crime survey of England and Wales, approximately 2 women a week are killed by a current or ex-partner. The UK Femicide report (a report analyzing all deaths of women at the hands of men) shows that 64 women were killed in 2017-18 by a current male partner or previous partner. A further 10 women were killed by their sons and 7 killed by another male family member.

DVA Definition

click here

Who does it affect?

DVA affects people in all areas of society regardless of age, ethnicity or social class. However, we do know that domestic abuse is a gendered crime, disproportionately affecting women. 1 in 4 women will experience domestic abuse across their lifetime, compared to 1 in 6 men. Abuse experienced by women happens more frequently, has a longer-lasting impact, is more violent and more likely to lead to fatality.

Although we know that domestic abuse happens in all walks of life, the experience for women living in poverty can bring additional challenges. If a woman is without adequate independent financial resources, she is at increased risk of harm and abuse both from an abusive partner on whom she is dependent and from third parties identifying an opportunity to exploit her. (Femicide Annual Report, 2017)

Additionally, women in poverty are particularly likely to experience the most extensive violence and abuse in their lives. According to one research report 14% of women in poverty have faced extensive violence and abuse, compared to women not in poverty (6%). (From a sample of 1185 women in poverty and 2884 women not in poverty).

These women also face multiple disadvantage too (e.g. homelessness, mental health, substance misuse) alongside extensive violence and abuse. This leads to a long-standing traumatic impact on their health and well-being.

The impact on health

We know that DVA has a direct impact on both the mental and physical health of those affected. These effects are often longstanding and can continue to affect the survivor long after they leave the abusive relationship.

Women who experience abuse have a 3x times increased risk of experiencing gynaecological problems, including STI’s, UTI’s, discomfort during intercourse and vaginal bleeding. In addition, longstanding heath conditions may get significantly worse and more unmanageable for women exposed to repeat physical and/or emotional abuse.

Without doubt the longest and most enduring heath impact on women who have experienced DVA is on their mental health. Many women subjected to abuse are likely to experience depression, anxiety and/or some degree of PTSD. In fact, abused women are 7 times more likely to experience PTSD.

What can I do?

DVA is everyone’s responsibility and you can help those affected. Have a look at just a few of our suggestions:

  • Understand the barriers victims face and how you may be able to help address these.

  • Highlight and challenge those who perpetuate myths about domestic abuse and help educate them around the reality for victims. See example of this.

  • If you are a health care professional and your area doesn’t yet have IRIS, consider checking out our website or getting in touch for more info about how this could be made possible.

  • Lobby your local MP and council to make sure DVA is a priority within their mandate.

  • Lobby locally for the commissioning of the IRIS programme or similar.  The IRIS programme offers a health care response to DVA within general practice. We know that general practitioners are in a unique position, not only to elicit disclosures of DVA, but also to offer direct referrals into specialist support.

  • Survivors of DVA trust health care professionals with their disclosures and believe their doctor is one of the few people to whom they can disclose. Support your team to routinely ask patients about domestic violence and abuse. Ask more than once if violence or abuse is suspected. Do, however, try to understand what is not helpful, and potentially dangerous, when responding to victims and survivors (see medical power and control wheel).

  • Check out Women’s Aid’s ‘Ask Me’ scheme to see if it is possible to become a champion for DVA within your community.

  • Chose to be an advocate for improving not only the health care response, but national response to DVA victims and survivors.

  • Educate yourself by reading more around the topic – check out the links below!

I’m now convinced that violence against women and children is a major public health problem with long term consequences for women and their families.
— GP engaged in the IRIS project