Standing together against domestic violence

Children & Health

Standing Together has long recognised that any response to domestic violence must incorporate work around children and health, and in January 2010 a full time Children and Health Coordinator was appointed. The recognition of the importance of these areas was further emphasised by the Maternity Project, which started in January 2011. Whilst the Children and Health Coordinator works in Hammersmith and Fulham only, the Health and Maternity Project Coordinator works across multiple boroughs to help maternity services coordinate their response to domestic violence.

Children and Young People

Domestic Violence can have a huge impact on children, affecting their physical, emotional, and psychological wellbeing. The Department of Health estimates that every year 750,000 children experience domestic violence, but given the low levels of reporting it is likely the true figure is even higher. Locally 65% of child protection conferences have domestic violence as a factor, and 295 children had a parent assessed as being at very high risk of serious harm or death. The shared responsibility for safeguarding children means that it is imperative that any response to domestic violence integrates effective responses to children, and that Children’s Services are a strongly engaged members of the partnership.

All adults have a responsibility to safeguard children and professionals must follow thier agency‘s Child Protection Policy, referring children to Children’s Services when appropriate. If a disclosure of domestic violence is made by someone with a child under 12 months old (including unborn children), there is a statutory requirement to refer to Children’s Services. If a child is older than 12 months (whether present at the incident or not), Child Protection Policies must be consulted and followed.

A flowchart of local domestic violence agencies for those working with children and young people has been produced.

Health

Domestic violence affects the nation’s health on a daily basis. It can be the cause of multiple health problems which may include any of the following:

• Broken bones

• Dislocation

• Sexually transmitted diseases

• Urinary Tract Infections

• Mental health issues

• Gynaecological health problems

• Stillbirth

• Miscarriage

• Death.

The long term nature of some of these problems mean that the NHS may continue to treat the after-effects of domestic violence long after someone has stopped experiencing the abuse on an everyday level. It is in the best interests of NHS staff to get the response to domestic violence right. In addition to the human cost and the time it takes up, domestic violence is expensive. In her examination of the cost of domestic violence to the UK economy, Sylvia Walby found that the cost to the NHS was £1.7bn in one year alone.

Survivors of domestic violence often become very isolated, with strict limitations on where they can go and who they can talk to. It could be that the local GP, health visitor or mental health professional is the only person that a survivor is allowed to talk to alone. A health professional may be the first, and only, person a survivor discloses domestic violence to. To be most safe and effective, health professionals must not only treat the immediate injury/illness in front of them, but also try to get to the underlying cause. Once a disclosure is made, referrals can be made to agencies that can provide support and advice to the patient as appropriate.

For information on domestic violence agencies that health professionals can refer to, take a look at this flowchart.

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Children and Health Operational Group

This work is supported by the Children and Health Operational Group, which meets three times a year to monitor work around these areas. The group works to an action plan, which in turn links in with the overarching borough Action Plan to respond safely and effectively to domestic violence.