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We only do bones here

Why London needs a whole-health approach to domestic abuse.

‘We only do bones here’ maps the domestic abuse response within health settings in the capital and makes recommendations for the most effective means of securing a whole-health response which truly meets the needs of all victims and survivors of domestic abuse.

It builds on the findings of the Pathfinder Project, which sought to embed a ‘Whole Health’ approach to domestic abuse in eight sites across England.

This report focuses specifically on London’s provision of health-based domestic abuse services. It combines the experience of survivors who accessed healthcare services through a dedicated survey with observations from frontline specialist services and other stakeholders who engaged in two roundtables held in December 2020 and January 2021.

When I went to A&E the doctor told me we only do bones here, not that ‘relationship mental health stuff’. But didn’t offer to refer me to somewhere that did.

Survivor

Key findings

  • Domestic abuse in the capital continues to cause significant harm
  • There are significant gaps in the provision of health-based domestic abuse services which need sustainable funding
  • Survivors have experienced a lack of understanding, awareness and support from the health system, perpetuating the impact on their physical and mental health

It concludes with recommendations for London’s policymakers and commissioners.

    Survivors told us

  • 98%

    said the abuse had affected their mental health

    while over three-quarters (76%) reported having suicidal thoughts due to the abuse

  • 86%

    said they suffered physical health issues because of the harm

  • 39%

    experienced abuse when they were pregnant

  • 76%

    said health professionals did not ask 'is everything OK at home' or ask them if they had experienced domestic abuse

Further research and reading

Whole Health London

A three-year project on a whole health approach to transform the health response to victims and perpetrators of domestic abuse across the capital.

Pathfinder

A national project to transform healthcare's response to domestic violence and abuse by ensuring a coordinated and consistent approach across the health system.

Psychological violence report

This report explores the daily experiences of people living with psychological abuse and the tactics used to threaten and control by those perpetrating the abuse.