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What does it take to be an Outreach worker?

 

In this short video, our Head of Learning and Accreditation Jo Morrish explains how the role of Outreach worker can be different to that of an Idva in terms of the type of support offered to victims and survivors of domestic abuse. 

 

 

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By Kate

Why a Gendered Approach to Supporting Women Experiencing Homelessness with Histories of Violence is Vital

Lisa Raftery is the London Development Manager at Homeless Link. In this blog she talks about the specific needs of women experiencing homelessness, and why a gender neutral approach often fails to support women. For an audio version of this blog, scroll to the bottom of the page or visit our Soundcloud profile

“Women experiencing homelessness” conjures up many different images of women: women with children in refuge accommodation, living in homeless shelters, sofa-surfing, exchanging sex for a bed or sleeping rough on the streets.  

These women, regardless of their exact situation, usually have one thing in common: violence. Estimates range between 44% - 89% of women who are homeless have also experienced violence either during or prior to becoming homeless. Violence during childhood and/or adulthood plays a significant role  in how a woman is affected by homelessness. We also know, from St Mungo’s Rebuilding Shattered Lives report and work by AGENDA that these same women also report a range of other adverse childhood experiences that often extend well into adulthood. 

With such wide experiences of violence and abuse contributing to women’s homelessness, many women also go on to develop mental health issues, PTSD and substance dependency falling into the multiple and complex needs category.  Currently around 30% of people accessing homelessness services are women, and recent figures show that it’s just 12% for those sleeping rough. We know however that women sleep rough differently to men and will often be in “hidden” homeless situations, and therefore will not show up on official statistics. Yet, despite women’s unique and complex experience of homelessness, very few homelessness services are gender specific and responsive to women’s multiple disadvantages and needs. 

Given the reduction in gender specialist services and limited refuge spaces for women with complex needs, we must ask how many of these women are able to access the support they need? How can we evidence the need for gender specialist support to be systematically available to all women regardless of their level of need? And how do we recognise and respond to individual factors - such as violence and mental health, as well as structural factors - such as poverty, inequality and welfare cuts, which combine to contribute to women’s homelessness and put women more at risk? 

Lana and Claire’s story highlights how the current system fails women with histories of abuse and subsequent complex needs. Through Expert Link they are able to share their experiences in the video below:  

Lana and Claire’s respective stories highlight the failings of the current system to recognise the gendered nature of the abuse they have suffered, and how the effects of this abuse can manifest in multiple and complex needs such as substance misuse and mental health issues. Claire talks about how despite being provided accommodation due to her alcohol dependency, she was also evicted for that very same dependency. What could services have done differently to better support Claire? Fighting for and achieving gender equality is the most powerful way to ensure women are lifted out of poverty, and suffer less abuse, mental ill health, and homelessness. What more can services working with women experiencing homelessness and policy makers do alongside this to improve the support for women and prevent other women from becoming homeless?  

Four key areas to consider: 

  • A cross-sector, multi-agency response: Women’s services need to be linked in with homelessness services and vice versa. If you are a women’s centre or specialist VAWG service get in touch with your local homelessness services working with women and develop a relationship. A great example of this partnership approach is Brighton Women’s Centre and Worthing Churches Homelessness Project, where the homelessness project provide the accommodation and the Women’s Centre provide the gender specialist support.  

  • Gender specific support: Men and women’s needs differ hugely, as do their routes into homelessness and it is clear that generic gender neutral support is not effective in supporting women experiencing violence and homelessness. Women need gender specialist support, and this needs to include both funding and skilling up of frontline practitioners. 

  • Trauma informed approaches: Understanding what has happened to women instead of asking what is wrong with women, recognising why a woman is using substances and providing trauma informed responses to empower her with alternative coping strategies and the support she needs.  

  • Safe and secure housing: A report by Gudrun Burnet from the Domestic Abuse and Housing Alliance (DAHA) highlights that safe secure housing is critical for women fleeing violence to rebuild control and emotional safety. 

 

For more information about the work of Homeless Link and our work with the sectors to improve support to women experiencing homelessness please contact Lisa Raftery, London Development Manager at lisa.raftery@homelesslink.org.uk  

Lisa Raftery, London Development Manager at Homeless Link has worked in the public and charitable sectors for 15 years firstly in central and local government commissioning a range of services including VAWG, homelessness and health services. Now for the charitable sector at Homeless Link delivering the Pan London Umbrella Support Project (PLUS) funded by London Councils to strengthen the London Homelessness Sector. Lisa is passionate about the issue of women's homelessness and the need for greater recognition and funding of gender specialist services, and through her work aims to encourage greater collaboration between the sectors to better support women experiencing homelessness. 

Homeless Link is the national membership charity for the homelessness and supported housing sectors. We represent over 750 organisations, working to help them improve the support they offer to vulnerable people, and campaigning for policy change that will help end homelessness. We provide training and events, information, resources and one-to-one support on a range of policy and good practice issues, to improve the sustainability and outcomes of frontline services. We also lobby national and local decision makers to develop a favourable policy environment, increase funding, and drive change for the sector. 

For more expert insight and practice tips around homelessness and domestic abuse, visit our Spotlight homepage

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Interview: SafeLives Trainer Briony Williamson on the importance of support workers for young people

 

Briony trainer for young peoples training

Briony has been working in the Learning and Accreditation team at SafeLives for nearly five years, training on our Idva, young people’s practitioner and outreach worker’s courses.

This Autumn she will be delivering Responding to young people affected by domestic abuse: expert level and in this interview she talks about why we need to take young people's relationships seriously. 

 

 

Our recent report Safe Young Lives on young people and domestic abuse highlighted the shocking fact that young people experience the highest rates of domestic abuse of any age group. Why do you think this is?

In part I think it’s because it is in anyone’s first relationship, at whatever age that happens, that they are at the highest risk of abuse. They are still learning what a relationship looks like and inevitably they are very vulnerable to somebody who might be controlling or abusive and mislead them about what a relationship should look like.

Secondly, young people have traditionally been treated as children and the severity of abuse in their relationships – in fact their relationships in general - has been underestimated or not taken seriously. Unfortunately a lot of practitioners’ approaches can reflect that. Things may be dismissed that we know from our work and our research are in fact very serious and mark the risk of harm as very high.

 

What advice in particular would you give to someone working with young people affected by abuse?

I think a common issue is that the vast majority of support workers - and I include myself in this - aren’t young people anymore! In fact, for many of us, when we were young people was quite a while ago, so our frames of reference are very different. A lot of professionals fall down by trying to be cool, by trying to act like they are on the same wavelength as the young person and that they understand exactly what life is like for them. But the reality is that we don’t.

Instead it’s important to learn how it’s possible to work with young people in a way that isn’t patronising or condescending but acknowledges the differences between you. You need to find a way for that young person to relate to you, trust you and work with you. By building that trust and working with them in a really respectful way, you can take steps to improve a young person’s safety. And by helping them understand what a healthy relationship should look like, you can support them to improve their future relationships too.

 

What do you think learners take away from the Responding to young people training?

The first 8 days of a foundation course forms the core training and covers all of the basic skills that we believe any practitioner should have. For example, how we relate to people, how we listen to people, needs and risk assessment, case management and so on. The expert course (and the final four days of the young people’s foundation course) builds on that learning to consider the specific issues relating to young people, for example how to effectively support gang affected young people, identifying and addressing honour-based abuse, FGM and forced marriage.

We talk about child sexual exploitation and we also focus a lot on the use of technology to abuse, which I think is an area of real concern for a lot of practitioners. We often hear people say that they don’t fully understand how the internet and apps can be used by an abusive person to control their partner, so we have built this into all of our training courses.

 

Technology is changing all the time. To what extent does the training reflect this?

The training is as up to date as it can be on the day. There are obviously new apps coming out all the time so we send practitioners away not only with the knowledge of what is available right now but also with access to resources so that they can stay informed beyond that point.

It’s the same with substance use. We can train you on this one day but whatever substance is the current ‘in’ thing will probably be different next month, so we aim to send practitioners out knowing the current information and also where they can find updates on a regular basis to keep themselves up to date.

 

You’re clearly very passionate about ensuring young people get the support they need. Can you explain why you believe it to be so important?

Since working with SafeLives, my main focus has been on the Idva programme but I’ve also worked on projects like the young people’s practitioner training and it’s made it really clear to me that this is where our work needs to start.

If we’re going to end domestic abuse, we have to start at the beginning. And in fact the beginning is even before these young people, but in this instance we are talking about young adults who, from when they start their first relationships in their teens, are starting a pattern that could run throughout the rest of their lives. So if we can work with them at this early stage, help them address the risks in their relationships, talk about what a healthy relationship is and explain what they should be able to expect, then we can begin to break that cycle. 

And that’s why this course is so important to me because although Idva work is crucial, it cannot change anything in isolation and  we need roles like young people’s support workers and outreach workers because they really can change lives.

 

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By Kate

Reflections on the role of the Hospital Idva

Kathy Bonney is Head of Safeguarding at East Lancashire Hospitals NHS Trust. In this blog post, she discusses the impact of having an Idva embedded within the hospital Safeguarding team.

Domestic Abuse and Safeguarding 

The Care Act 2014 came into force in April 2015 and defined adult safeguarding as 'working with adults with care and support needs to keep them safe from abuse or neglect'. It sets out a clear legal framework for how local authorities and other health and social care agencies should protect adults at risk of abuse or neglect.

Within the Act the list of recognised categories of abuse was expanded to include three additional types of abuse, one of which is domestic abuse. Domestic abuse is now recognised as the jurisdiction of Safeguarding Adult Boards across the country.

Health and Domestic Abuse

In addition to direct injuries sustained as a result of domestic abuse, there is good evidence to support the fact that women who are abused by their partners can suffer significant physical and mental health problems.

If we examine the reasons for attendance at hospital for those women who have experienced domestic abuse (who are known to us) we can see a picture of poor health including chest pain, recurrent infections, bowel complaints, anxiety and depression.

Within East Lancashire Hospitals NHS Trust, and other Trusts like ours, we have the opportunity to reach thousands of women who have experienced domestic abuse; they use our services every single day. With over 500 people coming through our emergency department and urgent care centres each day, over 1000 in-patient beds across our 5 hospitals, plus maternity services, hundreds of out-patient appointments, day case procedures and community appointments, we are likely to meet women who have experienced domestic abuse. We also employ over 7500 staff, many of whom could also be experiencing domestic abuse.

The Hospital Idva

East Lancashire Hospitals NHS Trust was in a fortunate position to be supported by the local provider of domestic abuse services. This started a few years ago as part of the IRIS project; bringing Idvas in to health, predominantly placed within the emergency department.

Integrating the Hospital Idva into our Safeguarding team enabled us to raise awareness of domestic abuse across our clinical services, which led to staff recognising the signs of Domestic abuse in their patients. The opportunity for patients to disclose domestic abuse was available, and the Hospital Idva became involved with the daily ward routines, including attending board rounds to assist staff in identifying patients at risk, and improving their knowledge and understanding of domestic abuse.

Most importantly, patients were afforded the opportunity for risk assessment, advice and initial safety planning before they left their hospital bed. We have also had patients who have been discharged from our hospital straight into a refuge, and we have had a few patients who were discharged to another life, simply taking the clothes and belongings they had with them in hospital to start a new life free from abuse elsewhere.

The Hospital Idva position lends itself perfectly to the 'One Chance Rule'. Many of the patients who we have supported have not been known to the police or other services; they have simply taken an opportunity to seek help and support whilst in our care. We have also had patients who may have denied they were experiencing domestic abuse, and those who have disclosed but do not wish to accept the help and support available. These patients may return to our Trust through another pathway, such as though our maternity services, and it may be at a later stage that these patients are ready to accept the specialist help they need.

Only recently a patient attending a gynaecology clinic appointment asked for help; she had been informed what was available during previous contact with our services, and she had made her mind up to ask for the support when she came to the hospital again; 'enough is enough' she said to the clinic nurse. 

Staff and Domestic Abuse

As a consequence of promoting the Hospital Idva role across our clinical services we found our staff began to refer themselves to us for specific advice and support in relation to domestic abuse. This simply grew – the more staff became aware of the Idva and her role, the more referrals we received. Staff were supported either by the Hospital Idva directly, or their local domestic abuse services.

Our own safeguarding team members, including myself, also engaged with individual staff members who chose to have ongoing support following initial assessment, safety planning and specialist support from the domestic abuse services. We learned so much;  staff had lots of episodes of short-term sickness, listed as 'back pain', 'stomach ache', diarrhoea and vomiting', and other minor conditions that simply disguised the truth that they were experiencing domestic abuse.

Patterns of sickness emerged, such as frequent days off on a Monday and Tuesday. Managers had been critical of these staff, never thinking for a moment that they may have bruises to hide following a weekend of drunken abuse. We have been privileged to support individual staff who have trusted us to ensure their story is sensitively told, and this has led to a greater understanding of domestic abuse amongst managers and HR Business Partners.

The support has been unbelievable within our Trust, from the Board members to our car park managers who willingly reserve safe car parking spaces for staff at risk. A special mention has to be given to our Occupational Health and Well Being service who have introduced Routine Enquiry of domestic abuse for all staff who access their service. Finally, we now have a cohort of people who have experienced domestic abuse and received support. In turn they are able to offer peer support to other staff, and this has been of great value to all involved. 

The Hospital Idva going forward

There have been many changes in relation to investment in services for domestic abuse. We now find ourselves, an Acute Hospital Trust, with limited access to an Idva. It would be wonderful to introduce Routine Enquiry across all in-patient services, but it is essential that we are able to meet the needs of those patients who disclose domestic abuse. As part of our safeguarding role, and high on the safeguarding agenda, we would like to strengthen the support in hospital for those who are experiencing domestic abuse.

We welcome the opportunity to prove that having Hospital Idvas working closely with Hospital Safeguarding Teams will not only increase the numbers of people disclosing abuse – and receiving support – but will ultimately improve the long term health outcomes of many hundreds of people.

We're calling for every hospital to have an Idva. Read about our Cry for Health research.

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Thinking intersectionality: forced marriage and 'honour'-based violence as forms of violence against women and girls in a context of structural inequality

Lia Latchford is a Development Co-ordinator at Imkaan. Imkaan is the only UK based, national second tier women’s organisation dedicated to addressing violence against Black and ‘minority ethnic’ (BME) women and girls.  The organisation works at local, national and international levels, and in partnership with a range of organisations, to improve policy and practice responses to BME women and girls. Imkaan works with its members to represent the expertise and perspectives of frontline, specialist and dedicated BME women’s organisations that work to prevent and respond to violence against women and girls.

The UN defines violence against women and girls as “any act of gender-based violence that is directed against a woman because she is a woman or that affects women disproportionately” (UN General Assembly, 2006, pp.12).  While forced marriage and ‘honour-based’ violence can and do affect men and boys, it is well evidenced that women and girls are disproportionately targeted, impacted and encountered by agencies following these forms of violence (Home Office & Foreign and Commonwealth Office 2017; Swegman 2016).  As such, Imkaan views these issues as gendered, and as forms of violence against women and girls that exist as a cause and consequence of their unequal status in the UK and globally.

In the UK, women and girls of all ethnicities experience routine abuse, control and victimisation based on their gender.  However, when forms of violence disproportionately impact Black and ‘minority ethnic’ (BME) women and girls, there is a tendency in policy, practice and media discourse to ‘otherise’ these issues and frame them as cultural phenomena rather than as occurring in the context of gender inequality (Imkaan & Rights of Women 2016a). Such discourse is based on simplistic and essentialist notions of culture and religion which can result in inadequate, discriminatory and racist practice (Imkaan & Rights of Women 2016b). 

Women and girls are also likely to experience multiple forms of violence and abuse that overlap, or intersect, within a broader pattern of control.  This could include physical and sexual violence, stalking, female genital mutilation, trafficking or child abuse, alongside forced marriage for example (Swegman 2016).  In the context of forced marriage, Swegman states:

“For service providers and survivors alike, it is critical to recognise and understand these links and to connect the dots between the mechanisms of power, control, and coercion that may precede a forced marriage, and the forms of abuse that can follow it.  With this increased understanding of historic and related trauma, it is more possible to effectively identify opportunities for safety and healing” (Swegman 2016, p. 2).

Acknowledging that women and girls affected by forced marriage and ‘honour-based’ violence are subjected to multiple forms of VAWG helps to ensure that professionals are more alert to their vulnerabilities and support needs and are better able to respond appropriately. 

For these reasons, an intersectional analysis of forced marriage and ‘honour-based’ violence is useful - to acknowledge and respond to the intersections between different forms of violence and abuse, the intersections between gender inequality and other inequalities across the protected characteristics, and the impact on women and girls’ journeys and experiences.  As an example of how this plays out in reality, last year, the team at Imkaan committed to archiving and amplifying young Black women’s voices created a film focused on racialised sexual harassment, which demonstrates some of the ways in which the intersections between racism, sexism and age impact everyday experiences of harassment.  Young women highlighted that racism could not be separated from their experiences of harassment and spoke about the ways in which racialised gendered stereotypes and racist violence formed part of the harassment against them, as one felt experience.  They also highlighted that, as young BME women, they felt less entitled to space and support following harassment.

Forced marriage and ‘honour-based’ violence require specific skills and awareness from professionals and much of this expertise is held within ‘by and for’ BME women’s specialist organisations that work to provide safety, support, space and social justice to BME women and girls (Larasi & Jones 2017).  In recognition of this specialism, Imkaan has developed a quality assurance framework that is designed to identify and quality-mark the critical support that such organisations provide.

However, it is also important that all agencies working on VAWG are able to respond to forced marriage and ‘honour-based’ violence.  Practically, organisations should ensure that staff members are aware of their safeguarding responsibilities, the multi-agency guidance on forced marriage, and the current civil and criminal legal frameworks in place to respond to these forms of VAWG (Imkaan & Rights of Women 2016a). 

Professionals should also routinely consider how issues of forced marriage and ‘honour-based’ violence are discussed and thought about within their organisations, for example, are these forms of violence integrated into broader VAWG issues or is there anything that needs to change attitudinally within the organisation?  In terms of practice, do needs and risk assessments cover all forms of violence against women and girls, including forced marriage and ‘honour-based’ violence and are there clear referral pathways to specialist organisations to support women’s safety and healing processes (Imkaan & Rights of Women 2016a)?

Responding to forced marriage and ‘honour-based’ violence is an important part of ensuring women and girls freedom, safety and healing and a critical part of addressing violence against women and girls, towards creating an equal society.  In order to do this effectively, understanding these issues as forms of violence against women and girls, that occur in a wider context of inequality, is crucial.  

References

Home Office & Foreign and Commonwealth Office (2017) Forced Marriage Unit Statistics 2016. London: Home Office & Foreign & Commonwealth Office

Imkaan & Rights of Women (2016a) Strengthening responses to forced marriage and female genital mutilation– Good Practice Briefing. London: Ascent

Imkaan & Rights of Women (2016b) Creating a clear pathway for practice: working towards more effective responses to survivors of forced marriage. London: Imkaan & Rights of Women

Larasi, M. & Jones, D. (2017) Tallawah: a briefing paper on black and ‘minority ethnic’ women and girls organising to end violence against us. London: Imkaan

Swegman, C. (2016) The Intersectionality of Forced Marriage with Other Forms of Abuse in the United States. National Resource Center on Domestic Violence

UN General Assembly (2006) In-depth study on all forms of violence against women: report of the Secretary-General, 6 July 2006, A/61/122/Add.1

 

For more research, expert insight and survivor stories, visit our Spotlight homepage.

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