The Indirect Victims
There’s no denying that domestic violence is common in our society but I was shocked to hear that the UK police force receive a phone call on average every minute regarding it.
The definition of domestic violence is:
Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those ages 16 or over who are or have been intimate partners or family members regardless of gender of sexuality.
Women are more likely to experience abuse than men with reports suggesting 1 in 4 women are victims of domestic violence in their life time. It accounts for 16% of violent crime and sadly two women lose their lives at the hands of their partners every week.
Risk factors for domestic violence include young maternal age, poverty, unemployment and alcohol and substance abuse. Alcohol and substance abuse problems may follow the onset of domestic violence as a potential coping mechanism. It is importance to remember however that domestic violence can occur regardless of social background or risk factors.
Sadly children are often the indirect victims. In 2014 there were 56,231 children on the child protection register in the UK. A staggering 75% of these were also affected by domestic violence.
Domestic violence at home can lead to long term social and emotional problems for children including both externalising and internalising behaviours, decreased social skills and even reduced academic performance and IQ. There is also a recognised overlap between those who experience domestic violence and those who experience other forms of child abuse.
The obvious risk is that the attacker may expand their violent behaviour to inflict abuse on children in the household or that the child may get caught in the cross fire of physical violence. Perpetrators may also victimise or threaten children as a way of controlling or punishing their spouse or partner. However even when children are not directly attacked, there are serious emotional consequences of exposure to violence. Studies have shown that children who witness domestic violence are more likely to be exposed to it as adults, both as the victim and the perpetrator.
So why doesn’t she just leave him? This is a question commonly asked. The answer is much more complicated. There are multiple reasons why a mother may endure domestic violence for a long period of time. Following years of abuse, she may be physically and emotionally exhausted. Her self esteem may have hit rock bottom and she may be unsure how she will care for her children without the support of her partner (both physical and financial). She may be experiencing guilt or shame and may genuinely believe that she is staying for the sake of the children as ‘all children need a father’. The process of leaving is not without risk either and may precipitate further significant violence. It is also well recognised that abuse can be ongoing post separation in the form of both verbal, emotional and occasionally physical violence.
As health care workers, we are becoming better at asking about and identifying victims of domestic violence, especially in areas such as midwifery and the accident and emergency department. Once domestic violence has been identified, each case needs to be assessed on an individual basis by people with experience of working with it. The term ‘MARAC’ (multiagency risk assessment conference) is often heard and refers to a multi agency meeting usually led by the police with the aim of sharing information between the relevant agencies to assess the needs of those experiencing domestic violence (including implicated children) to enable appropriate actions to be taken whilst minimising the risk to their safety. If a child is deemed at risk of significant harm, their safety is obviously paramount and urgent child protection proceedings may need to take place. This should ideally be discussed with mother and consent obtained, as your actions may increase the risk for the mother and steps may need to be taken to safeguard her.
For children experiencing domestic violence, there is a great website called ‘The Hideout’ with lots of child friendly useful information. There’s even a section about deleting your search history so that potential perpetrators are not aware of what they’ve been looking at. http://www.thehideout.org.uk
I suppose the main lessons are that it’s very difficult to put yourself directly in the shoes of somebody experiencing domestic violence as such situations are usually very complex. Although the risk to the child in the short term may not be high, there are long term effects associated with continuous exposure to violence and it is important that relevant services are involved early. However management of such situations requires specialist support and the recognition that whilst wading in in our child protection boots, we need to consider safeguarding the vulnerable parent as well.
The Effects of Children’s Exposure to Domestic Violence: A Meta-Analysis and Critique– David A. Wolfe, Claire V. Crooks, Vivien Lee, Alexandra McIntyre-Smith, and Peter G. Jaffe- Clinical Child and Family Psychology Review, Vol. 6, No. 3, September 2003
Domestic violence is associated with environmental suppression of IQ in young children- K. Koenen, T.Moffitt, A.Caspi, A.Taylor. S.Purcell-National Child Traumatic Stress Network, Boston University Medical Center; Institute of Psychiatry, King’s College London; and cUniversity of Wisconsin–Madison