|Davina James-Hanman | Violence Against Women Consultant|
So what are the key barriers preventing health and social care from playing their full role within addressing violence against women and girls?
Progress by health and social care providers in addressing violence against women and girls was painfully slow for years, although there are now promising signs of an increasing momentum. Sadly this still seems to be largely limited to specific disciplines within health and to child protection within social care. Within health, maternity services have led the way since the end of the last century, eventually being joined by some A&E departments and later still by some enlightened GP practices and some mental health trusts. However, with the exception of a few projects here and there, there is yet to be any significant commitment from the many other disciplines within health and social care.
The lack of time and capacity in health & social care
The first and most obvious barrier is one of time and capacity. All health professionals are under extreme pressure – especially those in the most crucial points of contact for abused women – both GP’s and A&E – but also across the NHS. This is also true for social care staff who are dealing with ever more referrals and complex cases. And this blog post is not about to argue that this isn’t a real barrier; it is. Who – honestly – wants to open up a “can of worms” that means yet more time is spent at the appointment, there is more paperwork and the potential for extra case conferences or other multi-agency meetings (with the obvious knock-on effect of less time for everyone and everything else)?
The lack of specialist, up-to-date knowledge
A lack of knowledge is another key barrier. Not only the initial layer of understanding about abuse and its dynamics, but also keeping up to date with the ever-changing external landscape of rapidly disappearing specialist services, changes in legal aid rules, benefit changes, housing options and so on. This is a challenge for those who specialise in this area of work, let alone for those for whom it is just a part.
Fear of getting it “wrong” is another major barrier; no-one wants to make things worse and this can sometimes mean that professionals do nothing rather than risk causing further harm.
Overcoming the barriers
But these barriers – whilst understandable and challenging to overcome – are not insurmountable. For years survivors have been telling us that what they want most from professionals is to be believed and to be treated with dignity and respect. Survivors don’t expect professionals to have all the answers or to be able to wave a magic wand; indeed it can be empowering for survivors and professionals to find out the answers together.
And whilst time and capacity is an issue, not dealing with it at the earliest opportunity just makes things worse in the long run. The economic costs of violence against women are huge and much of that cost is the consequence of belated interventions. Left to survive alone, many women develop substance use and mental health issues. Unchecked, violence may increase in severity so that the injuries become broken bones or even death rather than bruising. Children can develop life-long health conditions or struggle to find a place where they feel they belong so may get involved in gangs or have teenage pregnancies.
Thankfully, one of the barriers seems to be diminishing and that is the attitude that “it’s nothing to do with me”. Despite progress taking place, it’s clear that sexual and domestic violence has far reaching and long lasting impacts. If we are to ever effectively address these issues, all parts of public services – and even beyond - need to be involved.
If you were to find your world falling apart, if you were scared to the point where you had to ask for help from a stranger, if you found yourself unable to call any place or person safe – wouldn’t it be your hope that others would treat you with kindness? That they would believe you when you found the courage to tell the truth about your secrets?
I know that professionals in health and social care want to help and want to feel that they make a difference. Violence against women and girls is still an area where big improvements are needed. Here’s your chance.