Contemporary challenges in responding to domestic violence

The complexity of the intersection between mental health, trauma and domestic violence poses significant challenges for health professionals. Increasing recognition of the limitations of mainstream healthcare systems’ response to domestic violence victims underlies the growing demand for trauma and violence-informed care.

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Emerging models of care are attempting to address structural limitations (e.g., brief consultation times, coordinated service responses), re-conceptualise trauma and radically revise the treatment of women to diminish damage from stigma and paternalistic attitudes.

Promoting violence and trauma-informed care

The collective efforts of survivors of violence, researchers, and clinicians to educate health professionals and advocate for women’s safety are building the momentum needed to enact change! However, such reforms require a system-wide paradigm shift, involving significant structural and funding changes that will not happen overnight. The protracted fight to increase women’s access to appropriate and safe healthcare may lead health professionals to question how they can help women in the here and now?

It is heartening to see that higher numbers of health professionals are participating in training workshops to improve their ability to identify domestic violence and respond to women’s interlinked health and safety needs. But how can health professionals build up a culture of sensitive practice that empowers women when they remain constrained by practice limitations that are inconducive with trauma and violence-informed care?

Bringing violence and trauma-informed care into your practice

Here are 4 ways to bring a culture of sensitive practice to your work with women:

  • Get informed: Understand coercive control and how it can limit women’s thoughts and behaviours even when the partner is not in the room — the best place to start is with the works of Evan Stark
  • Go broader: Position women in their social context to identify the wider operations of power in their lives and understand how they may compound issues and affect access to supports
  • Learn to navigate the trust paradox: Balance trust in women’s fierce capacity to keep themselves safe against the realities of risk and the pitfalls of relied upon support services and systems — learn about women’s experiences navigating health systems
  • Engage in reflexive practice: Recognise that your attitudes and responses can have a profound impact on women’s beliefs and shape future help-seeking — what can you do to minimise the shame, stigma and self-blame that many women feel when disclosing abuse? Listening actively, label violence, establish safety, validate feelings, demonstrate compassion, acknowledge strength, and above all, cultivate a sense of hope.

To learn more about managing domestic violence in practice go to the on-demand recording of eMHPrac Webinar 42.

You can read Victoria's research on Investigating the prevalence of intimate partner violence victimisation in women presenting to the emergency department in suicidal crisis here. 

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Victoria Rasmussen

Victoria is a PhD Researcher in the School of Psychiatry, Faculty of Medicine at UNSW, currently working as a Research Officer at the Black Dog Institute. Victoria’s doctoral research examines the mental health impacts of intimate partner violence with a specific focus on women’s risk of suicide and experiences seeking support in Australian emergency departments. She adopts empirical- and data linkage methodologies to uncover the pathways between victimisation and suicidal thoughts and behaviours and generate clinically useful findings for risk stratification and suicide prevention within health settings.

At the Black Dog Institute, Victoria has coordinated evaluation studies, feasibility/acceptability trials and randomised-controlled trials (RCT) under the broad field of mental health promotion. This builds on her professional research experience contributing to empirical studies in hereditary cancer, genetic disease, and mental health settings in her roles as Study Coordinator at the Peter MacCallum Cancer Centre and Murdoch Children’s Research Institute in Melbourne.

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