Domestic and family violence: The leading preventable contributor to death, disability and illness in women aged 15 - 44 years

Domestic violence is often the reason people seek assistance from a health service. Anyone can become a victim, however women and children are more likely to experience domestic and family violence perpetrated by men.

It is a complex issue which includes behaviours that control or dominate a person, causing them to fear for their own (or someone else’s) safety. It can include physical, psychological, financial or sexual abuse and other controlling behaviours.

Exposure to violence can lead to poorer overall physical health for women compared with those who have not experienced violence and it increases the risk of women developing a range of health problems, even after the relationship has ended.

Domestic violence occurs in all types of intimate partnership regardless of class, culture, sexuality or gender. Those at an increased vulnerability include women with a disability, Aboriginal and Torres Strait Islander women, women from a culturally and linguistically diverse background and pregnant women.

Key statistics for violence against women

According to the 2012 ABS Personal Safety Survey

  • One in six Australian women have experienced physical or sexual violence from a current or former partner
  • One in four Australian women have experienced emotional abuse by a current or former partner
  • 89 women were killed by their current or former partner between 2008 – 2010. This equates to nearly one woman every week.
  • An estimated 26% of the 237,100 women who had experienced current partner violence had never told anyone about the violence by their current partner.

Allied health providers may be the first professionals to notice or suspect domestic family violence.

Some of the issues patients present with that may be indicators for domestic violence include:

  • severe or repeated spinal or cranial misalignment (to chiropractors or osteopaths)
  • evidence of eye trauma, or repeated replacements of broken prescription products (to optometrists)
  • bruising or musculoskeletal injuries (to physiotherapists or massage therapists)
  • tiredness, fatigue or chronic stress (to herbalists or naturopaths)
  • feeling anxious/depressed (to herbalists or naturopaths)
  • weight loss and other nutritional disorders (to nutritionists or dietitians)
  • explanation inconsistent with injury or minimises injuries and/or pain (to physiotherapists or massage therapists).

Other indicators include:

  • wearing concealing clothing
  • unwanted pregnancy or STI through coerced sex
  • alcohol or drug abuse
  • low self-esteem
  • socially isolated
  • suicidal thoughts/attempts
  • seldom/never makes decision without referring to partner
  • frequent absences from work
  • substantial delay before seeking treatment
  • repeat after hours presentations at ED
  • reference to partner’s anger or temper
  • submissive/withdrawn

Allied health workers are well placed to identify a risk of domestic violence and to take action to intervene early. More than one in five women make their first disclosure of domestic violence to a health professional. The health worker’s role includes offering non-judgemental support, assessing a patient’s current safety, providing information on resources and legal options, reporting to police or community services if injuries are serious or there are concerns that children are at serious risk, and documenting the account in the patient’s medical records.

For more information on how to ask about domestic violence and best practice responses visit HealthPathways Sydney. Women experiencing domestic violence and professionals working in the domestic violence space can also gain support by calling 1800 RESPECT (National Sexual Assault and Domestic Violence Counselling Service) or 1800 656 463 (NSW Domestic Violence Line).

For information about the federal and state government recently announced funding packages to improve support and services for women and children at high risk of or experiencing violence visit the NSW Government website or the Australian Government website.

Article submitted by Renee Lovell, Manager Women's Health, Community Health, SLHD