Intended for healthcare professionals

  1. Education
  2. Identifying and...
  3. Identifying and responding to domestic violence and abuse in healthcare settings
Practice Practice Pointer

Identifying and responding to domestic violence and abuse in healthcare settings

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1047 (Published 07 May 2021) Cite this as: BMJ 2021;373:n1047

Linked Opinion

Intimate partner violence as a public health problem
  1. Roxanne Keynejad, clinical research training fellow1,
  2. Natasha Baker, senior clinical research midwife1,
  3. Ursula Lindenberg, founder CEO2,
  4. Katherine Pitt, general practitioner3,
  5. Adrian Boyle, consultant emergency physician4,
  6. Claire Hawcroft, general practitioner and clinical research fellow5
  1. 1Section of Women’s Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
  2. 2VOICES, Bath, UK
  3. 3Wellspring Surgery, Bristol, UK
  4. 4Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  5. 5Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
  1. Correspondence to R Keynejad roxanne.1.keynejad{at}kcl.ac.uk

What you need to know

  • Ask about domestic violence and abuse (DVA) sensitively and respond in a supportive manner, asking the person what they would like to happen, informing them of sources of support, and following up the case in your clinical setting where possible

  • Get support and advice from safeguarding leads when supporting patients with complex DVA and other needs

  • Being well informed about DVA, building links with local support organisations, and addressing barriers to accessing services can improve the care provided to survivors of DVA

Visits to the UK national domestic abuse helpline website increased by 700% in the second quarter of 2020 compared with the first quarter,1 supporting reports from the voluntary sector that domestic violence and abuse (DVA) escalated during the covid-19 pandemic.23 The World Health Organization considers violence against women an “urgent public health priority.”4567 Clinicians play important roles in the multisectoral response to DVA, which has acute, lasting impacts on physical, reproductive, and mental health. Family doctors or general practitioners are often trusted by survivors; they are well placed to listen, offer practical support, and advocate for local commissioning of integrated DVA services within healthcare. Identifying patients experiencing DVA, responding appropriately, and connecting them with specialist support is part of good holistic care.

What is DVA?

Although definitions vary,8 in England and Wales DVA is defined as any incident or pattern of controlling, coercive, or threatening behaviour, violence, or abuse between current or former intimate partners or family members aged 16 or above.9 Much DVA comprises intimate partner violence (IPV), perpetrated by partners and ex-partners. DVA includes psychological, physical, sexual, financial, and other abuse. Examples include insults, humiliation, intimidation and threats (psychological abuse), hitting, kicking, slapping or punching (physical abuse), rape and forced non-penetrative sexual acts (sexual abuse), and controlling or withholding of …

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