Domestic abuse
The RCN is committed to raising health care professionals understanding of how domestic abuse impacts on lives
Domestic abuse describes a continuum of behaviour ranging from verbal abuse, threats and intimidation, manipulative behaviour, physical and sexual assault, through to rape and homicide.
It is a complex issue that all health care professionals should have some understanding about. They should be aware of who is affected, how individual victims may present in differing health care settings, how the subject could be approached, and most importantly what professionals can do to help and support victims of abuse.
The term Intimate Partner Violence (IPV) is also often used interchangeably with domestic abuse, as a collective term used to describe domestic abuse, sexual assault and stalking. The term domestic abuse has been used throughout this resource which discusses all types of abuse within a domestic setting and not just between partners or ex partners.
In 2021, the Domestic Abuse Act was published. Along with the Domestic Abuse Act 2021: overarching factsheet.
Domestic abuse statistics
1 in 3 women globally are directly affected by domestic abuse (WHO, 2016)
1 in 6 men will experience domestic abuse in their lifetime (ONS)
1 in 5 children have been exposed to domestic abuse (Radford, 2011)
Domestic violence and abuse:
- is not exclusively male against female
- is not gender, race, sexual orientation, religion, culture or age specific
- children growing up exposed to domestic abuse may suffer a range of behavioural and emotional disturbances. These can also be associated with perpetrating or experiencing violence later in life
- the victim and the perpetrator are known to each other but not necessarily partners. Other family members, children and parents can be the perpetrators
- victims and perpetrators may be among the health care professional community
- it is a major safeguarding issue and all health care professionals have a role in increasing awareness, and being inquiring when confronted with behaviours that raise concerns and alarm.
Definition of domestic violence and abuse
The cross-government definition of domestic violence and abuse is:
“Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality.”
- psychological
- physical
- sexual
- financial
- emotional.
Characteristics of domestic abuse
Domestic abuse is essentially a pattern of behaviour not generally limited to a one-off incident. The key differences between it and other forms of abuse are:
- the survivor and the perpetrator are known to each other
- unlike stranger abuse or violence, domestic abuse takes place largely in private and behind closed doors
- there is often a lack of objective evidence that abuse has taken place
- outsiders may take the view that that domestic abuse is less serious
- the abuse rarely happens once and tends to increase in frequency and severity over time
- the abuser may have a great deal of intimate knowledge about their victim and hurt them in subtle ways that may not be understood by others
- physical injuries can easily be targeted on places on the body where they are unlikely to be seen by others
- it is less likely to be reported to the police.
Five Rs for asking about Domestic Abuse
Safe Lives has published guidance to support health professionals to safely ask patients about domestic abuse (DA) in virtual settings for example on the telephone or online. It sets out five simple steps to help you identify and respond to people who might be at risk. It can be applied in services which use routine enquiry, for example maternity services, as well as services using clinical enquiry, such as general practice. See: Five Rs for asking about Domestic Abuse.
Psychological First Aid
VITA Network’s Dr Laura Wood has recorded a 10-minute introductory video to Psychological First Aid.
Many people have some basic first aid training, to help someone who has been physically hurt, however what about knowing the safe steps to take in supporting someone who’s experienced emotional or psychological harm and distress? Particularly in the settings of severe adversity, after a disaster or in conflict. This short 10-minute video recorded by VITA Network’s Dr Laura Wood is an introduction to Psychological First Aid, showing how to support people to cope, adapt and recover in the aftermath of severe adversity and disaster. This is the latest SafeREFUGE resource.
Professional lead for domestic violence and abuse:
COVID-19 and domestic abuse
Find out more about COVID-19 and domestic abuse
Domestic abuse: professional resources
RCN Position Statement - Domestic Abuse
The RCN is committed to supporting nurses, midwives and healthcare workers to better understand the complexities that surround Domestic Abuse, whether it affects them personally or professionally.
View the position statement.
Cavell Nurses' Trust
Further help can be found at the Cavell Nurses Trust.
The Cavell Nurses’ Trust charity supports UK nurses, midwives and healthcare assistants, both working and retired, when they’re suffering personal or financial hardship often due to illness, disability, older age, domestic abuse and the impact of the coronavirus.
