The experience of health and welfare workers in identifying and responding to domestic abuse among military personnel in the UK

Abstract

Background Awareness of domestic violence and abuse (DVA) as a problem among military personnel (serving and veterans) has grown in recent years, and there is a need for research to inform improvements in the identification of and response to DVA in this population. This study aimed to explore the experience of health and welfare professionals in identifying and responding to DVA among the UK military population (serving personnel and veterans). Methods Thirty-five semi-structured telephone interviews were conducted with health and welfare staff who work with serving UK military personnel and veterans. Interviews were analysed using thematic analysis. Results Three superordinate themes were identified: i) patterns of DVA observed by health and welfare workers (perceived gender differences in DVA experiences and role of mental health and alcohol); (ii) barriers to identification of and response to DVA (attitudinal/knowledge-based barriers and practical barriers), and iii) resource issues (training needs and access to services). Participants discussed how factors such as a culture of hypermasculinity, under-reporting of DVA, the perception of DVA as a “private matter” among military personnel, and lack of knowledge and awareness of emotional abuse and coercive controlling behaviour as abuse constitute barriers to identification and management of DVA. Healthcare providers highlighted the need for more integrated working between civilian and military services, to increase access to support and provide effective care to both victims and perpetrators. Furthermore, healthcare and welfare staff reflected on their training needs in the screening and management of DVA to improve practice. Conclusions There is a need for increased awareness of DVA, particularly of non-physical forms of abuse, and of male victimisation in the military. Standardised protocols for DVA management and systematic training are required to promote a consistent and appropriate response to DVA. There is a particular training need among healthcare and first-line welfare staff, who are largely relied upon to identify cases of DVA in the military. Employing DVA advocates within military and civilian healthcare settings may be useful in improving DVA awareness, management and access to specialist support.

Help-seeking for Intimate Partner Violence and Abuse: Experiences of Civilian Partners of UK Military Personnel

“…Participants also identified a lack of support for those attempting to resolve their relationship difficulties and remain with their partners, marking this group as particularly vulnerable to not receiving appropriate interventions. These problems were related to a wider lack of awareness and understanding of IPVA within services as has been extensively reported in civilian populations (Keeling & Fisher, 2015 ; Ramachandran et al, 2013 ; Rose et al, 2011 ; Sparrow et al, 2020 ; Sprague et al, 2012 ).…”

“…Victim-survivors of IPVA who want to remain with their partners was highlighted as another under-supported group. We know from civilian research that this is not an uncommon problem (Sparrow et al, 2020 ) and needs to be considered as a priority given emerging evidence in support of working with some couples to improve relationship functioning (Taft et al, 2016 ).…”

“…This does not appear as part of the MOD Domestic Abuse Strategy ( 2018 ), and we would urge services to consider such provision to facilitate disclosure and help-seeking. Also, the use of Domestic Abuse Advocates, independent of the military, who have specialist skills in the assessment and management of IPVA is a strategy not yet implemented by the UK military as in civilian settings (Feder et al, 2011 ; Malpass et al, 2014 ), but has been recommended by UK military health and welfare workers in previous research by this group (Sparrow et al, 2020 ). Criticisms of both the military and the civilian justice systems also need to be addressed (see Theme 3, subthemes 3 ‘ Police and the criminal justice system ’ and 4 ‘ Military / civilian divide ’).…”

“…Financial dependency and isolation may be a particular barrier for the civilian partners of military personnel, as frequent military-related relocations have been found to disrupt spouses’ social networks and ability to maintain employment (Blakely et al, 2014 ; Gribble et al, 2019 ) and the military may provide housing and other welfare support (Sparrow et al, 2020 ), which they would lose if the relationship ended. Adding further weight to previous study findings of help-seeking for IPVA in the military community, these barriers were especially heightened for FCO participants, whose circumstances, such as a reliance on their (ex)partner both financially and for the right to remain in the country, as well as their isolation from their own communities, impaired their ability to seek help (Gray, 2016 ; Sparrow et al, 2020 ). These factors may be of heightened significance in the context of the Covid-19 pandemic due to local lockdown rules and social distancing, international border closures or travel limitations and the potential for financial instability and job loss.…”

“The real pandemic’s been there forever”: qualitative perspectives of domestic and family violence workforce in Australia during COVID-19

“…This study used a relatively large sample size compared to similar studies where samples varied from 16 to 40 [ 26 , 43 – 46 ]. This enabled us to collect rich information about the diverse experiences of DFV workforce across Australia.…”