This toolkit provides busy practitioners with an easily navigable resource to ensure excellence in safeguarding practice in Primary Care.
We are awaiting a review before updating this resource. Please use with caution.
"Domestic abuse can seriously harm children and young people. Witnessing domestic abuse is child abuse, and teenagers can suffer domestic abuse in their relationships."
One in four women and one in six men will experience domestic abuse in their lifetime.
Anyone can be a victim of domestic abuse, regardless of gender, age, ethnicity, socio-economic status, sexuality or background.
For detailed and specific guidance on recording domestic abuse information (including MARAC – Multi Agency Risk Assessment Conference) in the patient record, go to Section 3 of this toolkit.
This is an excellent resource for all health professionals. We advocate that all GPs/GP trainees consult this document directly for learning and guidance. The relevant pages in this document are:
- Pages 6 -12: How to use the resource. This sets out the prevalence, context, cost and legal aspects of domestic abuse
- Pages 28 - 46: Practitioners responding to victims. This sets out Health Professionals' responsibilities; early identification of domestic abuse; sensitive enquiry and asking about domestic abuse; multi agency assessment; how to respond well to particular groups, for example, children, older adults; interventions; gathering and recording information; confidentiality and information sharing
- Pages 51 – 54: Health Professionals responding to perpetrators of domestic abuse
- Pages 25 - 26: Supporting staff who experience domestic abuse
Abuse in teenage relationships
Domestic abuse is not limited to adults; there is an increasing awareness of domestic violence within teen relationships.
A 2009 study by NSPCC found that up to three-quarters of teenage girls and up to half of teenage boys reported emotional, physical and/or sexual violence in their intimate partner relationships, with girls experiencing more severe violence.1
Further information can be accessed from the hideout website created by Women's Aid for children and young people who are experiencing domestic abuse:
- A study showed that 32% of students in one secondary school were currently experiencing some form of domestic abuse (Alexander et al., 2005)
- A US study showed that 7 out of 10 teenagers have experienced abusive/controlling behaviour from a partner (Teen Dating Relationships Survey, 2008)
- The same study said that 11% of the teenagers studied had experienced physical abuse in a relationship (Teen Dating Relationships Survey, 2008)
- What do young people think about abusive behaviour in relationships?
- 36% of boys think that they might personally hit a woman or force her to have sex (Burton et al., 1998)
- 78% of men and 53% of women think that women and girls are 'often' or 'sometimes' to blame for the violence perpetrated against them (Burton et al,. 1998)
- One in two boys and one in three girls think there are some circumstances when it is ok to hit a woman or force her to have sex (Burton et al., 1998)
- 19% of young women and 34% of young men do not think that being forced to have sex is rape (Regan & Kelly, 2001)
Technology and unhealthy teenage relationships
Young people's lives can be consumed by mobile phones, social media, sharing information online, lack of privacy or increased surveillance by peers or partners and it's easy to see how the abusive use of technology could become normalised.
Mobile technology is increasingly a part of young people's lives and it's important that adults must understand how young people use it and how it could be a medium for abuse. Further information and resources can be found on the NSPCC website.
MARAC (Multi-agency Risk Assessment Conference)
A Marac is a regular local meeting to discuss how to help victims at high risk of murder or serious harm. A domestic abuse specialist (Idva), police, children's social services, health and other relevant agencies all sit around the same table. They discuss safety measures and ways to help the victim. The meeting is confidential.
Together, the meeting writes an action plan for each victim. They work best when everyone involved understands their roles and the right processes to follow.
For further information visit SafeLives.
Groups of victims of domestic abuse who may be 'hidden' from services or who may face additional barriers to accessing services
SafeLives have a series of Spotlights on groups of domestic abuse victims who may be 'hidden' from services or who may face additional barriers to services:
- Domestic abuse and mental health
- LGBT+ people and domestic abuse
- Homelessness and domestic abuse
- 'Honour'-based violence and forced marriage
- Young people and domestic abuse
- Disabled people and domestic abuse
- Older people and domestic abuse
Adolescent to Parent Violence
Child on Parent Violence (CPV) or Adolescent to Parent Violence and Abuse (APVA) is any behaviour used by a young person to control, dominate or coerce parents. It is intended to threaten and intimidate and puts family safety at risk. Whilst it is normal for adolescents to demonstrate healthy anger, conflict and frustration during their transition from childhood to adulthood, anger should not be confused with violence. Violence is about a range of behaviours including non-physical acts aimed at achieving ongoing control over another person by instilling fear.
Most abused parents have difficulty admitting even to themselves that their child is abusive. They feel ashamed, disappointed and humiliated and blame themselves for the situation, which has led to this imbalance of power. There is also an element of denial where parents convince themselves that their son or daughter's behaviour is part of normal adolescent conduct.
More information here: Reducing the Risk of Domestic Violence: Child on parent violence
This website also has a booklet for parents.
If a parent discloses violence towards them by their child, it is important to examine and document any injuries. Parents should be signposted to local domestic abuse services for support for themselves.
These situations are complex and challenging. It is important that a young person using abusive behaviour towards a parent receives a safeguarding response. A child who is displaying violence towards their parent may also be victims of abuse themselves.
For further information
Information Guide: Adolescent to parent violence and abuse (APVA), Home Office 2015