Leading Colleges including RCPsych and the Royal College of Obstetricians and Gynaecologists (RCOG) have launched a campaign aimed at encouraging healthcare professionals to work collaboratively and tackle domestic violence towards women and girls.
The two Colleges, endorsed by the Royal College of Midwives (RCM), have today launched a campaign aimed at encouraging healthcare professionals to put aside any prejudices and keep an open mind when identifying women and girls affected by domestic violence.
The ‘All the women we won’t miss’ campaign – launched in time for the UN’s 16 Days of Activism Against Gender-Based Violence – urges colleagues to work collaboratively to tackle the crisis and includes a set of steps healthcare workers can take to spot the signs of violence and direct women to places of safety and support.
While domestic abuse also impacts men and boys, women and girls are disproportionately affected with 1.6 million women in England and Wales experiencing domestic abuse last year (ONS).
Only one in five survivors will call the police, but 80 per cent seek help from health services. Women suffering violence often visit maternity and gynaecology services, as well as mental health services, which is why it’s vital healthcare professionals can recognise the signs and safely support.
Sadly, we know from data published that during the first three months of the pandemic, of the 16 pregnant or postnatal pregnant and postnatal women who died, four women died by suicide and two due to domestic violence.
The steps for health professionals include:
- Be open-minded and don’t make assumptions.
Violence can affect any woman from any age group, any community, any background, and any ethnicity.
- Find innovative ways to help women disclose.
Help reduce fears of disclosure by creating safe places and introduce innovative ways to encourage disclosure.
Consultations over the phone or online have particular challenges.
It’s important to make sure that the woman you are in contact with is alone and safe before speaking with them.
- Identify pathways of support.
Know what support is available in your local area so that you can easily and quickly direct women to them if needed.
- Ensure safe reporting and referral.
Have telephone numbers to hand for help, especially for those in immediate danger and in need of a place of safety.
Accurately record any details, including potential patterns as well as health-related concerns, to avoid missed opportunities in the future.
Try to arrange another appointment with the woman at a suitable time and follow up.
In a related initiative today the RCM and RCOG have issued a call to end the ‘scourge’ of domestic abuse in the UK, which affects a quarter of women and is more likely to begin and worsen during pregnancy. The two Colleges are putting forward several recommendations to tackle this terrible problem and have published guidance for midwives and other health professionals.
Pushing forward their recommendations, the Colleges call for sustainable funding for specialist training for health professionals and funded specialist mental health support for survivors. They also say all health services need to commit strategically to respond to domestic abuse, and for health settings to have independent Domestic Abuse Advisors.
Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said: “Healthcare professionals can play a crucial role in tackling a crisis which has spiralled during the pandemic.
“What’s even more important is that healthcare professionals keep an open mind when speaking to patients and don’t overlook anyone because they don’t ‘look’ like someone experiencing abuse. Abuse can happen to anyone.
“The pandemic has meant that many appointments are now done by video call or over the phone, making it more difficult for healthcare professionals to spot the signs of domestic violence or provide a safe space for women to discuss what’s happening to them. That’s why now, more than ever before, we urgently need action to address domestic abuse.”
Dr Adrian James, President of the Royal College of Psychiatrists (RCPsych) said: “Tragically, as a result of COVID-19, the entire medical profession observed an increase in abuse cases reported. The repercussions of this can be felt across communities, with survivors struggling with isolation, inability to work, lack of participation in regular activities and limited capacity to care for themselves and others. It is more important than ever to be vigilant and support survivors who may be facing increased risk of violence as well as increased difficulty to access support.
“Experiencing violence is extremely traumatic and is likely to heavily impact mental and physical health. Patients who are survivors of abuse are more likely to report somatic symptoms related to panic, depression, substance misuse, suicidal thoughts, chronic pain, and genitourinary disorders. However, violence against women is more than a health issue; it is a violation of human rights and bodily integrity.
“We must take a public health approach to overcome gender violence and call on government to provide funding to improve preventative responses across all medical specialities. We must ensure that our patients feel safe, pursue trauma informed care and continue to provide appropriate referral and support.”
Gill Walton, Chief Executive of the Royal College of Midwives, said: “Pregnant women have been especially vulnerable to domestic violence and abuse during this pandemic, they need to be more than just another grim statistic. Midwives are in a unique position to support pregnant women to access the help and support they need. While the pandemic has made that more challenging in some circumstances, we are calling on maternity colleagues to work collaboratively to identify and support women at risk, and on the UK governments to ensure services are properly and sustainably funded so that women can keep themselves and their baby safe.”