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Domestic abuse and health

Domestic Violence and Abuse (DVA) is a common breach of human rights. It affects individuals and has far-reaching consequences for families, children, communities and society as a whole. The extent of the problem is shocking and intolerable. DVA is a major public health problem with devastating health consequences and enormous costs to the NHS and is a challenge to health care services in the UK and internationally.

DVA is the systematic use of power and control. It includes emotional and psychological abuse, physical abuse, sexual violence, stalking and harassment, intimidation and humiliation, manipulation, threatening behaviour, financial control, isolation and entrapment. The context of fear is an important element in the understanding of domestic violence as a pattern of coercive control.

Domestic violence is a pattern of behaviour, rather than a one-off incident. Click here for more information on DVA

The NHS spends more time dealing with the impact of violence against women and children than almost any other agency and is often the first point of contact for women who have experienced violence. The health service can play an essential role in responding to and helping prevent further DVA by intervening early, providing treatment and information and referring patients to specialist services. The health service is in a unique position to help people who experience DVA to get the support they need. Click here for more information on DVA and health

As a matter of normal humanitarian principles, core values, social responsibility and its basic mission to make people healthier, the NHS has a critical role to play in relation to violence against women and children. (Feder G et al, Report from the Domestic Violence Subgroup, Department of Health 2010)

The cost of DVA to the health service is £1.7 billion per year with the major costs being to GPs and hospitals. This does not include mental health costs, estimated at an additional £176 million [1]. Click here for more information on costs.

The prevalence of DVA is substantially higher in a general practice population [2] than that found in the wider population. Eighty percent of women in a violent relationship seek help from health services [3], usually general practice, at least once, and this may be their first or only contact with professionals. There is extensive contact between women and primary care clinicians with 90% of all female patients consulting their GP over a five year period [4]. This contrasts starkly with its virtual invisibility within general practice, where in fact the majority of women experiencing DVA and its associated effects are not identified. Click here for more information on DVA and general practice.

The GPs' response to women and children who can be isolated and fearful as a result of their experiences is critical to their future well-being. The initial reaction of the person they tell and the follow-up within and beyond the NHS can have a profound effect on their ability to re-establish their life, health and well-being. (Feder G et al, Report from the Domestic Violence Subgroup, Department of Health 2010)

  1. Walby S. The cost of domestic violence: update 2009, Lancaster University
  2. Roberts G et al. Intimate partner abuse and health professionals: New approaches to DV, 2005
  3. Department of Health: DV: A health response, 2000
  4. Wisner, CL et al. Intimate partner violence against women: do victims cost haelth plans more? 1999