Domestic Abuse disclosure or concerns

Domestic abuse can happen to anyone.  It can happen between people who are in a relationship but it can also happen when a relationship has ended.  It can happen between family members.

Although domestic abuse happens mostly between adults, children and young people can be affected by the abuse that they see and hear, and they can be harmed as part of domestic abuse between adults. Young people may also experience abuse from their own boy/girlfriend.

Domestic abuse can be:

Emotional

  • constantly checking where someone is
  • preventing someone from seeing their friends or family
  • constantly putting a person down
  • using the children to bully
  • Shouting and intimidating behaviour
  • Stalking and harassment

Physical

  • punching, kicking, slapping, pushing
  • strangling or smothering someone
  • threatening to hurt someone
  • not allowing someone to take medication or giving them too much

Sexual

  • making a person do sexual things that they do not want to do
  • rape

Financial

  • not allowing someone to have any money
  • deliberately getting someone into debt
  • making someone give up their job or stopping them from getting a job

Domestic abuse is a repeated pattern of behaviour that is often very controlling. See useful contact numbers below.

If you have concerns that a patient may be suffering from Domestic Abuse:

  • The patient may be presenting to yourself with lots of minor injuries and the reasons for the injuries or illnesses may seem very plausible but you may have some doubts about what you are being told
  • They may present with bruises which are in various stages of healing
  • They may present as saying they are having mental health issues [depression/anxiety] however, the reason for the mental health issue may seem plausible but you may have some doubts about what you are being told
  • They may attend every appointment with their partner, who talks for them or the patient feels they need to be reassured by the partner constantly so they are saying the right thing. Sometimes a partner can present as very caring and attend all appointments with your patient because they are worried about them, however, if in an abusive relationship this is a mechanism of control, to disable them from disclosing the abuse or gaining support.
  • So seek an opportunity to see the patient on their own, so you can ask them 'how are things at home?' this will enable them to answer the question with more ease.

If a patient discloses that they are suffering from Domestic Abuse:

  • Be non-judgmental
  • Believe them
  • Listen to them and ask what they want to do
  • Tell them help and support is available and give them information on the local specialist domestic abuse service if wanted

Reason for the above is to dispel the myth that the perpetrator has kept telling them that 'no one will believe them and no one will want to help them'.

  • Talk to them about how they are coping and can you support them with that medically
  • Acknowledge that everyone has their own coping strategies

Their coping strategy could be why they have come to see you; 'depression, anxiety, increase in alcohol or drug use, misuse of prescription drugs self harm and many more'. If you can support them with their abusive relationship it can reduce the need for them to use a coping strategy and then reduce the visits to yourself for medical help.

Next steps:

Explain that you are wanting to find out what the current risks are so you can offer the most appropriate support and that this form will help you do that.

  • If you have concerns about the welfare of any children or vulnerable adults within the family referrals can be made to Safeguarding Children and Safeguarding Adults services at Lincolnshire County Council
  • Regardless of the result of the DASH offer the patient support from the local Lincolnshire specialist domestic abuse service
    • Boston or South Holland area ring – 01205 318600 or 311272
    • East Lindsey area ring – 01507 609830
    • West Lindsey, Lincoln, South or North Kesteven area ring – 01427 616219 or 01522 510061

  • However, if on completion of the DASH the risk is HIGH, explain to the patient that you need to complete a Multi Agency Risk Assessment Conference [MARAC] Referral form with them, there are leaflets to explain with the patient what MARAC is about available to download on the www.domesticabuselincolnshire.com website.

In an emergency always ring the police on 999.

The 24hr National Domestic Violence number is: 0808 2000 247

Consider immediate safety issues, if it is not safe for the victim to return home. Contact the police and/or specialist domestic abuse agency who can either take positive action to enable the victim to return home or find emergency temporary accommodation e.g. refuge

And lastly consider if you give them a leaflet will it increase the risk from the abuser, if so talk to them about where they can get help and that they can find this information in your reception or by visiting: www.domesticabuselincolnshire.com

Domestic Abuse e-bulletins

See the current and previous Domestic Abuse e-bulletins