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Domestic violence and abuse: The role of general practice

The reality in general practice
In east London general practice waiting rooms 41% of women had ever experienced physical violence from a partner or former partner. In total 74% of women had experienced some form of controlling behaviour by their partner and 46% had been threatened. Physical violence from a partner or former partner had been experienced by 17% women within the previous 12 months and 35% had ever felt afraid of their current or former partner. However, only 15% of women had any reference to violence in their medical record.

Specialist DVA service providers rarely receive referrals from primary care and historically general practice has been absent from community domestic violence partnerships. If women do disclose DVA to their GP, there is evidence of an inappropriate, poor quality response. Health care professionals are largely unaware of appropriate interventions and have not received effective training. Creating an environment in which patients are more likely to feel safe enough to discuss DVA will make a real difference for men, women and children.

Women report wanting health services and professionals to have a duty to identify and respond to violence against women and girls, and felt it was more appropriate for health professionals to receive mandatory training to meet their needs effectively than it was for criminal justice professionals

Survivors of DVA trust health care professionals with their disclosures and believe their doctor is one of the few people to whom they can disclose. However many will not disclose abuse without being directly asked. They report wanting to be asked and expect an appropriate response. Clinicians in turn report not knowing how to ask women about DVA, how to respond and where to refer.

  1. Richardson J et al. Identifying domestic violence: cross sectional study in primary care. BMJ 2002; 324(7332): 274 - 278
  2. Women's National Commission. A bitter pill to swallow: Report from WNC focus groups to inform the Department of Health Taskforce on the health aspects of Violence Against Women and Girls. London: Women's National Commission; 2010
  3. Feder GS, Hutson M, Ramsay J, Taket AR. Women exposed to intimate partner violence: expectations and experiences when they encounter health care professionals: a meta-analysis of qualitative studies. Arch Intern Med, 2006; 166(1):22-37.