Routine questions about domestic abuse are not being asked, charity warns

A ‘postcode lottery’ means as few as 3% of patients are asked about domestic abuse by mental health services – despite official guidelines suggesting every person should be questioned.

New figures show that 15 NHS mental health trusts do not have a ‘routine enquiry’ policy about domestic abuse.

Agenda, a women’s rights charity, sent freedom of information (FoI) requests to 58 mental health NHS trusts.

Of the 42 who replied, 25 said they did have a policy, 15 said they did not and two trusts said they could not share their policies because they were being updated.

This means more than a third of the trusts which replied are not following National Institute for Health and Care Excellence (NICE) guidelines.

One trust responded that only 3% of patients were asked about domestic abuse, according to the report.

Guidelines state that health managers should ensure trained staff working in mental health should “ask service users whether they have experienced domestic violence and abuse”.

It adds: “This should be a routine part of good clinical practice, even where there are no indicators of such violence and abuse.”

The figures come after Sky News revealed that more than half of front-line healthcare staff say they do not feel able to identify a domestic abuse victim.

Chlo is a campaigner and survivor who was in her teens when she first started to experience domestic abuse.

She said: “I was in mental health services when it started, but no one talked to me about my relationship or picked up the warning signs. It was the police that first suggested what I was experiencing was domestic abuse.

“It hadn’t even occurred to me that’s what it was until then, I didn’t know about emotional abuse or coercive control. After that, I was referred to victim support and eventually he was convicted.”

According to Agenda’s August report Ask and Take Action, 38% of women who have a mental health problem have experienced domestic abuse.

Earlier this year, researchers found that women who experience domestic abuse are three times more likely to develop a serious mental illness.

Around one in 20 women and one in 100 men in England have experienced extensive physical and sexual violence and abuse during their lifetime.

The charity is calling for a statutory duty on public authorities to ensure staff are trained to ask about domestic abuse. It also wants to ensure when support is rolled out, that it takes into account the trauma the individual has experienced.

Its call, which also demands that sufficient funding is made available, is backed by a number of other organisations, including SafeLives, Women’s Aid and Against Violence and Abuse (AVA).

Baroness Hilary Armstrong, chair of the national commission on domestic and sexual violence, who has worked with many victims of abuse, said: “Time and again the signs of abuse were not picked up by professionals, and too often women were bounced around or even turned away from services.

“We need concerted action across public services so that trained staff are able to identify survivors and respond accordingly, ensuring they get support.”

Jemima Olchawski, chief executive of Agenda, said: “Women who have experienced domestic abuse come into contact with a wide range of services – both while they are facing abuse and in the years that follow.

“It’s clear that existing guidance isn’t enough to ensure women are given the chance to share their experiences – a change in the law is needed to make sure we’re not missing opportunities to help.”

Donna Covey, chief executive of AVA, said: “The only way to break this cycle of silence is to make sure that wherever a woman goes for help, she meets practitioners who are able to ask about abuse with skill and compassion.”

The FoIs were sent by the charity in February this year. Agenda asked Trusts to provide copies or links to policies they were referring to in their response where possible. 

(c) Sky News 2019: Routine questions about domestic abuse are not being asked, charity warns