Accelerating Detection and Action in Family Violence Cases: Reflections on Clinical Responses

Accelerating Detection and Action in Family Violence Cases: Reflections on Clinical Responses

Despite the Australian government’s attempts to reduce domestic and family violence, systemic impediments remain that reduce the disclosure of coercive, controlling, and violent experiences to primary healthcare providers. Further, the conditions which ignite and exacerbate violence in the home increased during Covid-10 This was acknowledged globally, with many countries introducing intervention points in grocery shops and pharmacies, wherein women used the code word ‘mask 19’ to obtain help. Additionally, many clinics altered their mode of delivery and consultation to online and telehealth options, thus reducing holistic patient examinations.
We undertook a scoping review to examine the current state of evidence regarding reluctance among women victims and survivors to reveal experiences of violence to primary healthcare providers. The review found that women did not trust or believe that GPs could effectively assist them. The women themselves were hesitant in acknowledging they were in abusive relationships. Women instead presented with a range of comorbidities that were either related to, or a direct result of the violence, but were not contextualised or communicated as such. They requested prescription sleep medication with synchronous symptoms of depression, anxiety, and self-harm. Hair breakages, healing of cuts and bruises at different stages, unexplained injuries, anxiety, depression and eating disorders and alcohol dependency were also presented.
Further barriers to improved communication and accelerated responses to these conditions include lack of private space in clinical settings, too many staff in the screening process, the screener not being of the same gender or race, presence of the victim's partner, and age differences between victim and screener. As such, screening in GP centres demonstrated very low or limited data yield overall.
Nuanced reflection, responses, and referrals are needed to facilitate faster life-saving action in clinical and online diagnostic settings while pandemics of violence and Covid-19 continue to threaten human health.

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