Today, we publish our research ‘A Cry for Health’ – a rallying cry to every hospital in England and Wales to have specialist domestic abuse support onsite. In this article, Diana Barran, SafeLives' CEO, explains why improving domestic abuse services in healthcare settings is such an important way to support victims.
Our call to every hospital in England and Wales to embed domestic abuse support onsite comes after years of research. Women and children living with abuse have been waiting for much much longer.
Domestic abuse is a public health epidemic and health must be part of the solution. We must meet victims where they are. We know four of five victims do not call the police. We have to go to them: where they feel supported, where they feel safe and free from stigma.
We must have Independent Domestic Violence Advisors (Idvas) in hospitals across the country.
Our research shows very starkly that domestic abuse victims in hospital experience multiple vulnerabilities. The levels of physical and sexual abuse as well as coercive and controlling behaviour are frankly shocking. Two thirds of victims in hospital disclose serious mental health issues, including half with PTSD and nearly half have self-harmed or attempted suicide. We also found that half of the victims who disclose in hospital are still with their partner.
By failing to ask the question in hospital – they are being discharged back into the arms of the perpetrator who put them there. Only to inevitably return weeks later. This cycle of abuse could be stopped - if we have had specialist professionals to ask the question and provide support, right then, right there.
And of course many of these victims have children – children who are growing up in households that are filled with fear. Everything we know about the development of children’s brains tells us that these are exactly the children who need our help. And their mothers are just women who understandably do not want to call the police. It only takes each of us to think for just one second how hard that must be, and how long we might all wait before calling the police on a family member. On the father of our children. We mustn’t wait until victims call the police because they are scared for their lives. We must find ways to ask them first. And Idvas in hospitals could help us do just that.
More broadly, our research shows that this is also an issue for staff working in hospitals. Our best estimate is that over 50,000 NHS employees (44,000 women and 6,000 men) are victims of domestic abuse. We need help in hospitals for staff as well as patients. With domestic abuse – there is no ‘us’ and ‘them’. Only us.
Sometimes our enthusiasm and passion for the cause can blur our judgement about what is possible. But I cannot think of another time where I have felt more personally excited about the potential for change. We have absolute focus that this is a common sense vision that can be achieved. There is nothing simple about addressing domestic abuse, but improving support in hospitals for victims at their most vulnerable seems like a pretty good step in the right direction.
We think it will cost just £100,000 per hospital to unlock the capacity of the clinical staff and for specialist domestic abuse professionals to be onsite. When we know that domestic abuse costs the NHS £1.76 billion – that is put into perspective.
There is a book by Roddy Doyle, The Woman Who Walked Into Doors, and I would like to just include a short extract from Paula – the heroine of the story who represents so many thousands of heroines up and down the country.
In this extract, Paula is in A&E after another assault from her husband Charlo. She puts it better than I can.
“Someone once told me that we never remember pain. Once it’s gone, it’s gone. A nurse. She told me just before the doctor put my arm back in its socket. She was being nice. She’d seen me before.
I fell down the stairs again, I told her. Sorry.
No questions asked. What about the burns on my hand? The missing hair? The teeth? I waited to be asked. Ask me. Ask me. I’d tell her. I’d tell them everything….Ask me about it.
In the hospital.
Please ask me.
In the clinic.
Ask me, ask me, ask me….
I would get worked up waiting. I believed it was a matter of luck. Maybe this time. A nurse would look at me and know. A doctor would look past his nose. He’d ask the question. He’d ask the right question and I’d answer and it would be over. One question. One question. I’d answer.
I’d tell them everything if they asked.”