Background: Health services are often the first point of professional contact for people who have experienced domestic violence and abuse. We report on the evaluation of a multi-site, hospital-based advocacy intervention for survivors of domestic violence and abuse. Independent Domestic Violence Advisors (IDVAs), who provide survivors with support around safety, criminal justice, and health and wellbeing, were located in five hospitals in England between 2012 and 2015 in emergency departments and maternity services. We present views about IDVAs' approaches to tackling domestic violence and abuse, how the IDVA service worked in practice, and factors that hindered and facilitated engagement with survivors. Methods: We adopted a convenience sampling approach and invited participation from all who offered to take part within the study timeframe. Sixty-four healthcare professionals, IDVAs, IDVA service managers, and commissioners at all sites were interviewed. Interviews were analysed using a thematic approach: familiarising ourselves with the data through repeated readings and noting initial ideas; generating initial codes through double coding notable features of the data across the dataset; collating codes into potential themes; and reviewing themes to ensure they captured the essence of the data. Results: Two key themes emerged. The first was Hospital-based IDVAs fulfil several crucial roles. This theme highlighted that healthcare professionals thought the hospital-based IDVA service was valuable because it enhanced their skills, knowledge, and confidence in asking about domestic violence and abuse. It enabled them to immediately refer and provide support to patients who might have otherwise been lost along a referral pathway. It also reached survivors who might otherwise have remained hidden. The second theme was Success hinges on a range of structural factors. This theme illustrated the importance of ongoing domestic violence and abuse training for staff, the IDVA having private and dedicated space, and the service being embedded in hospital infrastructure (e.g. featuring it in hospital-wide policies and enabling IDVAs access to medical records). Conclusion: Hospital-based IDVAs offer a unique and valued way to respond to domestic violence and abuse in a healthcare setting. Further work must now be done to explore how to implement the service sustainably.
Young people are more likely to seek help about abusive relationships from friends, rather than adults or professionals, irrespective of gender, age or ethnic group. However, friends may be unequipped to deal with relationship problems and unable to provide adequate emotional or practical support. The aim of this paper is to explore how young people would support friends if they were seeking help or shared experiences of abuse. Qualitative findings drawn from a larger UK mixed-methods study are used to explicate this. Data was gathered using 16 focus groups and one interview with girls, young women and non-binary young people aged 13 to 24 years. Thematic analysis provided six themes pertaining to supporting friends and help-seeking around relationship abuse. Findings showed young people recommended supporting friends in a non-judgemental way to keep conversations open and help them recognise unhealthy behaviours. However, young people confirmed this is a difficult topic and many would feel fearful, helpless and under pressure. Conversations illustrated the need for more awareness of non-physical abuse and resources specifically aimed at young people to enable them to help friends and know where and when to seek professional support. K E Y W O R D S domestic abuse, help seeking, supporting friends, young people Key Practitioner Messages• Young people are disproportionally impacted by domestic abuse.• Young people do not recognise the signs of domestic abuse as it is so normalised in their friendship groups. • Young people are more likely to go to friends to seek support about toxic relationships than adults or professionals. • Young people do not access professionals due to a lack of trust, confidentiality and feeling that they will not be believed. • Approaches to young people who seek support should be supportive, understanding and accepting with guidance, advice and signposting for issues around domestic abuse.
Non-physically abusive acts (underpinned by coercive control) are more prevalent than physical or sexual violence within intimate partner relationships. Yet, little is known about survivors’ help-seeking journeys or the efficacy of existing services in addressing this need. We present findings from a survey of UK-based domestic violence and abuse (DVA) and sexual violence (SV) practitioners (n = 279) exploring experiences of providing care to women with histories of non-physical abuse. Our findings suggest that survivors often seek help for non-physical abuse from specialist DVA and SV services, but wider professional agencies often overlook the severity of this experience of abuse in the absence of physical or sexual violence. The impacts of non-physical abuse on survivors’ health and wellbeing are severe and there are multiple barriers to support, particularly within the criminal justice system. Our findings highlight the urgent need to increase public and professional awareness of non-physical abuse and its consequences for training of wider agencies (for example, police, child protection, legal services) and for sustainable funding that increases long-term support options for survivors and their children.<br /><br />Key messages<br /><ul><li>Survivors of domestic violence and abuse often seek help for non-physical abuse, but professionals can misidentify the severity of this experience.</li><br /><li>The impacts of non-physical abuse on survivors’ health and wellbeing are severe, creating barriers to accessing support.</li><br /><li>There is a need to increase public and professional awareness of non-physical abuse and its consequences.</li></ul>
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