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Domestic violence and emotional abuse: out in the open

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Domestic violence is more common than expected Domestic violence is more common than expected

Domestic violence damages lives every day in England, and many of us, in our clinical practice, have seen the physical, emotional and psychological impacts on people enduring and witnessing violence. It is not just physical violence, but also the use of control, coercion and threats, emotional, sexual, financial or psychological abuse. The knock on effects of this, predominantly the physical and psychological health implications, cost the health care system a staggering £1.3 billion a year. The cost to the economy through social care, sickness absence and productivity losses are even greater.

In England and Wales, two women every week die as a result of domestic violence, and many more suffer physical and mental harm. The very nature of what nurses do puts them in a strong position to support people who reach out for help. Healthcare professionals are one of very few groups who people enduring violence, and those perpetrating, reach out to for help. Nurses have unique opportunities to be alone with patients, separate from their partner, just through their day to day work, creating an opportunity for individuals to disclose. Community nurses in particular are able to witness evidence that most others can't by visits to the home.

When patients reach out for help it is our duty as clinicians to take action. Like child protection, we don't expect every nurse to be an expert, but we do expect them to have basic knowledge of the practical steps to access specialist support, and provide advice and pathways out of violence.

It's important to remember that domestic violence affects clinicians as people as well. Some of the individuals enduring violence and perpetrating may well be nurses. As it stands, domestic violence is a hidden workplace issue. Bringing discussions of domestic violence into the workplace is a crucial step in providing routes to safety for people enduring violence. Fundamental domestic violence affects all of us in some way. Nurses, as line managers and clinicians, have a key role in enabling discussions in the workplace.

To coincide with the 16 Days of Action campaign against domestic violence (25th November to 10th December), PHE has launched a Violence toolkit for businesses – a step by step guide for businesses on how they can tackle domestic violence and raise awareness of an issue that impacts health, wellbeing, and absence and turn over in the workplace. We're keen to see this being used in primary care and community trusts, as well as providers of care. The toolkit, commissioned by PHE and developed by The Corporate Alliance, provides practical tools and resources to help businesses take action over the 16 Days, from raising awareness internally using posters and internal communications messaging, to being visible daily through social media, blogs and podcasts. It also provides briefings for members of staff on how to address the issue.

The Department of Health handbook for healthcare professionals on domestic abuse is being re-launched on the 25th November and PHE is working with AVA to launch an e-learning resource which supports this. Many organisations like Women's Aid, Refuge and CAADA offer more in-depth training and support for professionals, and local authorities can provide information on local support services.


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