The role of healthcare professionals (Social Workers) in helping people experiencing domestic violence and abuse
Introduction and Background
Domestic violence and abuse, often referred to as domestic abuse, is a problem that affects men and women, irrespective of ethnic origin, educational and financial status, and sexual orientation (Robbins and Cook, 2017). There are several definitions of domestic abuse, as well as several terminologies used in its description. In many developed countries, terminologies such as intimate partner violence, spousal violence, or family abuse are common. These terminologies are used to describe broadly the form of abuse and/or violence that may result among people 18 years and over, and is often different from child abuse, and sexual violence and abuse (Rakovec-Felser, 2014).
In the UK, the term domestic violence and abuse is used broadly to refer to abuse taking place within the home. According to the Home Office (2012), the government defines domestic violence in the UK as ‘any incident or pattern of incidents of controlling, coercive or 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. This can encompass but is not limited to the following types of abuse: psychological, physical, sexual, financial, emotional’ (Home Office, 2012, pg. 1). The implication of this definition by the government is that young people aged 16 and 17 years can now be supported by adults’ domestic violence services, as opposed to children services. In order to provide focus for this essay, the government definition will be adopted and will be limited to people aged 16 years and above who are in intimate relationships. In addition, the term domestic abuse will be used to refer to domestic violence and abuse throughout the essay
Domestic abuse has been shown to affect every aspect of the victim’s life, including financial, social, economic and mental components (Femi-Ajao et al., 2018). Furthermore, people who experience domestic violence are likely to have series of health problems, and are likely to miss work, thereby resulting in economic loss to the UK as well as increased financial burden on the NHS (National Institute for Health and Care Excellence, 2014). According to evidence from Office for National Statistics (2017), domestic abuse affects an estimated 1.9 million people aged 16-59 years, with more women than men affected. As indicated, the prevalence rate of domestic abuse is estimated as 6 in 100 adults, at a rate of 7.5% women and 4.3% men, thereby resulting in 1.2 million women and 713,000 men (Office for National Statistics, 2017).
The National Institute for Health and Care Excellence (2014) clearly states that healthcare professionals have a role to play in supporting people affected by domestic abuse, however, existing evidence from Stanley et al. (2010) suggests that social workers are likely to only focus on children and child protection issues, and are less likely to help adults who are victims. Recent evidence from Robbins and Cook (2017) also suggests that people who have experienced domestic violence and have had contact with social workers tend to describe social workers as unhelpful in helping them access the support required for their domestic violence experience. Thus, in this essay, three roles of social workers will be discussed. These are: 1. Identification of victims, 2. Signposting and referral to specialist domestic violence services, and 3. Legal Aid. These three roles will be discussed in the next section of this essay.
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Role of Social Workers
Identification of Victims
With respects to healthcare professionals, identification of victims of domestic abuse has been identified as very important (National Institute for Health and Care Excellence, 2014). Although there is mixed evidence with respects to whether routine screening is necessary for identifying victims of domestic abuse (O’Doherty et al., 2014), it has been empirically established that healthcare professionals need to do more to be involved in identifying people experiencing domestic abuse (O’Doherty et al., 2014). Identification of people experiencing domestic abuse has been suggested as helping to ensure people get the help they need on time, thereby breaking the cycle of abuse (Trevillion et al., 2012). As social workers are likely to be in contact with families who are experiencing trouble in their relationships, there are opportunities that will enhance identification of victims of domestic abuse.
An important part of identification is appropriate response, when people open up about their experience of domestic abuse (Bacchus et al., 2018). Since there are concerns about removal of children and distrust of social workers in supporting adults experiencing domestic abuse (Robbins and Cook, 2017), social workers need to be empathetic in their response to families where there is a problem with domestic abuse. This will help facilitate the development of trust levels required to identify victims.
Signposting and Referral to Specialist Domestic Violence Services
Another important role of social workers is signposting and referral of victims of domestic abuse to specialist services. While it is not expected that social workers should have expertise in providing specialist domestic abuse support, it is necessary for them to be able to refer people they identify to the appropriate agencies that can support them. There are many barriers preventing victims of domestic abuse from seeking help from specialist services (Overstreet and Quinn, 2013); however, it is expected that if a social worker refers them, they would be likely to take up the referral. Some of the barriers faced by victims of domestic abuse include shame and stigma, fear of repercussion, and fear of blame and disbelief (Spencer et al., 2018). Depending on the type of abuse, the gender of the perpetrator, and their social support networks, many victims may be reluctant to seek help from professionals. Thus, with the help of social workers, there is a possibility that victims may be empowered to break the silence and seek the help they need for themselves. Hence, beyond child protection issues, social workers have a role in ensuring that adults experiencing domestic abuse are adequately supported.
Existing evidence from Ellsberg et al. (2008) shows that women victims of domestic abuse experience a wide range of physical and mental health issues. While there is a dearth of research evidence on the impact of domestic abuse on the male victims, evidence from Bacchus et al. (2018) shows that for male victims of domestic abuse, there are significant health impacts from the abusive experience, usually buried under the perception that no one will believe them. However, with referral to specialist services, victims of domestic abuse should be appropriately supported to deal with the situation, and social workers play a pivotal role in this referral process.
Recent changes in legislation have shown that social workers have an important role to play in supporting people experiencing domestic abuse. The Legal Aid, Sentencing and Punishment of Offenders Act (LASPO) 2012 (UK Government, 2012) detailed the level of evidence that can be submitted in support of private family law matters. Although the Act mentioned that healthcare professionals are able to provide documentary evidence for legal aid, so that victims can get the legal support they need, it was not clearly stated that such documentary evidence can be provided by social workers. However, recent changes in the law (UK Government, 2017) shows that social workers have now been recognised as being in a position to identify and refer people experiencing domestic violence and are thus able to provide documentary evidence in support of legal aid for victims. As described by Legal Aid Agency (2018), registered social workers are able to provide written confirmation of the authenticity of the abusive experience, provided they have examined the victim themselves.
This change in legislation has had a significant impact on the extent that social workers can now support victims of domestic abuse. As people who are experiencing domestic abuse are likely to be dependent financially on the perpetrator and may not have the financial resources to be able to afford to pay for legal services (Eriksson and Ulmestig, 2017), this role of social workers is very important, especially when there is need to fight for the custody of children, and to criminalise the offense committed by the perpetrator.
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Domestic abuse is a private problem that have major public impacts on the health and wellbeing of the people affected and the entire country. It results in significant health problems that affect the economy, victim’s ability to work and study, as well as the healthcare system. This essay provided an overview of the definition and terminologies of domestic abuse, as part of the background for the ideas presented on the role of social workers in supporting people experiencing domestic violence and abuse.
Three key roles were identified. Firstly, it was identified that social workers have a role in identifying victims of domestic abuse, especially since identification have been shown to help break the cycle of abuse. Secondly, the importance of signposting and referral to specialist domestic abuse services was also discussed, and it was stated that referral from social workers may help victims to seek the help they need. Thirdly, the change in legislation, which has now resulted in social workers being able to provide documentary evidence in support of legal aid was also highlighted. By fulfilling these three roles, social workers are able to help people in dire situations.
List of References:
Bacchus, L. J., Buller, A. M., Ferrari, G., Brzank, P. & Feder, G. (2018) “It’s Always Good to Ask”: A Mixed Methods Study on the Perceived Role of Sexual Health Practitioners Asking Gay and Bisexual Men About Experiences of Domestic Violence and Abuse. Journal of mixed methods research, 12(2), 221-243.
Ellsberg, M., Jansen, H. A., Heise, L., Watts, C. H. & Garcia-Moreno, C. (2008) Intimate partner violence and women's physical and mental health in the WHO multi-country study on women's health and domestic violence: an observational study. The Lancet, 371(9619), 1165-1172.
Eriksson, M. & Ulmestig, R. (2017) “It’s Not All About Money”: Toward a More Comprehensive Understanding of Financial Abuse in the Context of VAW. Journal of interpersonal violence, 0886260517743547.
Femi-Ajao, O., Kendal, S. & Lovell, K. (2018) A qualitative systematic review of published work on disclosure and help-seeking for domestic violence and abuse among women from ethnic minority populations in the UK. Ethnicity & Health, 1-15.
Home Office. (2012) New Definition of Domestic Violence Available at http://www.homeoffice.gov.uk/media-centre/news/domestic-violence-definition Accessed: 15-11-2013.
Legal Aid Agency. (2018) The Legal Aid, Sentencing and Punishment of Offenders Act (LASPO) 2012 - Evidence Requirements for Private Family Law Matters [Online]. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/672143/evidence-requirements-private-family-law-matters-guidance-version-8.pdf: Ministry of Justice. [Accessed 05-06 2018].
National Institute for Health and Care Excellence. (2014) Domestic violence and abuse: how health services, social care and the organisations they work with can respond effectively. Available at: https://www.nice.org.uk/guidance/ph50.
O’Doherty, L. J., Taft, A., Hegarty, K., Ramsay, J., Davidson, L. L. & Feder, G. (2014) Screening women for intimate partner violence in healthcare settings: abridged Cochrane systematic review and meta-analysis. BMJ : British Medical Journal, 348.
Office for National Statistics. (2017) Domestic abuse in England and Wales: year ending March 2017 [Online]. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/bulletins/domesticabuseinenglandandwales/yearendingmarch2017. [Accessed 05-06 2018].
Overstreet, N. M. & Quinn, D. M. (2013) The Intimate Partner Violence Stigmatization Model and Barriers to Help-Seeking. Basic and applied social psychology, 35(1), 109-122.
Rakovec-Felser, Z. (2014) Domestic Violence and Abuse in Intimate Relationship from Public Health Perspective. Health Psychology Research, 2(3), 1821.
Robbins, R. & Cook, K. (2017) ‘Don’t Even Get Us Started on Social Workers’: Domestic Violence, Social Work and Trust—An Anecdote from Research. The British Journal of Social Work, bcx125-bcx125.
Spencer, D., Dodge, A., Ricciardelli, R. & Ballucci, D. (2018) “I Think It’s Re-Victimizing Victims Almost Every Time”: Police Perceptions of Criminal Justice Responses to Sexual Violence. Critical Criminology, 1-21.
Stanley, N., Miller, P., Foster, H. R. & Thomson, G. (2010) Children and families experiencing domestic violence: Police and children's social services' responses: NSPCC.
Trevillion, K., Oram, S., Feder, G. & Howard, L. M. (2012) Experiences of Domestic Violence and Mental Disorders: A Systematic Review and Meta-Analysis. PLoS ONE, 7(12), e51740.
UK Government. (2012) Legal Aid, Sentencing and Punishment of Offenders Act 2012 [Online]. Available at: http://www.legislation.gov.uk/ukpga/2012/10/contents. [Accessed 05-06 2018].
UK Government. (2017) The Civil Legal Aid (Procedure) (Amendment) (No. 2) Regulations 2017 [Online]. Available at: http://www.legislation.gov.uk/uksi/2017/1237/schedule/made [Accessed 05-06 2018].
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