Signs of domestic abuse
The RCN has published a pocket guide on domestic abuse covering all four areas in the UK.
The government’s definition of domestic violence and abuse, published in 2016 by the Home Office, is: ‘any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those 16 years or over who are, or have been, intimate partners or family members, regardless of gender or sexuality.’
Statistics from the charity Living Without Abuse (LWA) suggest that domestic abuse leads to two women being killed each week and 30 men each year. Although it accounts for 16% of violent crime, domestic abuse is still the least likely violent crime to be reported to the police.
In May, the RCN published a pocket guide on domestic abuse. Developed in response to the RCN’s recognition that healthcare professionals need to understand the impact of domestic abuse on patients and colleagues, the publication covers all four countries of the UK. Alongside information on indicators, there is help for nursing and midwifery staff who are concerned about a patient, including key questions to begin a conversation.
Signs and symptoms
Abuse can take many forms, including psychological, physical, sexual, financial, emotional or coercive control. Signs may include injuries where the explanation is vague or implausible; stress, anxiety or depression; alcohol or other substance misuse; self-harming or suicidal tendencies; self-neglect; a lack of opportunity for the person to communicate independently, with a partner talking over or for them; and an unwillingness to give out personal details, such as a telephone number.
According to LWA, around one in four women and one in six men experience domestic abuse in their lifetime, although the figures are likely to be an underestimate, as all types of domestic abuse and violence tend to be under-reported. It can happen to anyone and is not specific to a gender, race, sexual orientation or age. It crosses social and economic boundaries, may begin at any stage in a relationship and can affect teenagers and those in lesbian, gay, bisexual and transgender relationships.
How you can help your patient
Nursing staff should find out more about domestic abuse, seeking an up-to-date understanding of its complexity. While asking patients who you think may be at risk a question such as ‘Do you feel safe at home?’ is a good starting point, this should be done sensitively and in a safe environment. It may mean taking steps to speak to the person on their own. Once the question is asked, healthcare professionals need to feel confident there is support available and that the person will not be in greater danger following disclosure.
Carmel Bagness, RCN professional lead for midwifery and women's health
‘Although domestic abuse is talked about a lot, many healthcare professionals don’t know enough about it. Knowledge varies depending on how much you might come into contact with it, but there isn’t an area of practice where it’s not going to have an impact. Unfortunately, many stereotypical perceptions remain and this guide is about busting some of those myths and giving basic facts. For example, it crosses all boundaries and may happen to anyone, anywhere.
‘Healthcare professionals can play a big role in making people’s lives better. But recognising that someone is in an abusive situation on its own is not enough – they need to know what to do next. It’s also important to think about nursing staff who may be experiencing domestic abuse themselves, potentially making it harder for them to recognise it in others.’
- RCN Domestic Abuse Pocket Guide (May 2017)
- NICE Domestic Violence and Abuse Quality Standard (February 2016)
- Women’s Aid
- Safe Lives
- Living Without Abuse