Domestic abuse

There are different types of abuse which can include:

• Psychological abuse - intimidation, insulting, isolation from  friends/family, criticising, forced marriage, threatening to harm children/take away
• Physical abuse – such as hitting, shaking, punching and kicking, starving, burning, tying up, presence of finger or bite marks, suffocation, throwing objects, FGM, strangulation. It should be noted that strangulation is the most common method of intimate partner homicide.
• Sexual abuse – forced sex, prostitution, ignoring religious prohibitions  re: sex, sexual insults, STDs, preventing breastfeeding
• Financial abuse - not letting victim work or forcing them to work against their will,  controlling the finances, withholding money or credit cards, making someone unreasonably account for money spent/petrol used, exploiting assets, withholding basic necessities, deliberately running up debts, gambling
• Emotional abuse – swearing, undermining confidence, racist remarks, eroding independence, calling victim stupid/useless

Statistics

The prevalence and incidence of domestic abuse:

• On average 2 women a week are killed by a male partner or former partner: this constitutes around one-third of all female homicide victims 
• Almost 30 per cent of women and 17 per cent of men in England and Wales have experienced domestic abuse since the age of 16
• An analysis of 10 separate domestic violence prevalence studies by the Council of Europe showed that 1 in 4 European women experience domestic violence over their lifetimes and between 6-10% of women suffer domestic violence in a given year
• In over three-quarters (77%) of incidents of domestic violence the victims were women
• Repeat victimisation accounts for 66% of all incidents of domestic violence and 21% of victims have been victimised three times or more 
• Domestic violence accounts for 1 in 7 (14%) of all violent incidents in England and Wales 
• Domestic abuse costs the tax payer an estimated £3.9bn per year and high risk domestic abuse makes up nearly £2.4bn of this 
• It is estimated that before intervention by a MARAC or IDVA service, it costs nearly £20,000 to support the average high risk victim of domestic abuse over the course of a year 
• 'Rule of thumb' – legal to beat wife with stick/weapon no thicker than husband's thumb
• Estimated- 35 incidents of abuse will take place before seeking help
•  25% of victims never lived with perpetrator
•  DV/Abuse is 16%-25% of all recorded violent crime in UK
•  One incident of DV is reported to Police every minute in UK

• Abuse –The abuse occurs
• Guilt –The abuser will express guilt
• Excuses –The abuser will make excuses for their behaviour
• "Normal" behaviour — The abuser does everything they can to regain control and keep the victim in the relationship. They may act as if nothing has happened, or they may turn on the charm. This peaceful honeymoon phase may give the victim hope that the abuser has really changed this time.
• Fantasy and planning – The abuser begins to fantasize about abusing again. They spend a lot of time thinking about what the victim has done wrong and how they will make them pay. Then they make a plan for turning the fantasy of abuse into reality.
• Set-up – The abuser sets the victim up and puts their plan in motion, creating a situation where they can justify the abuse.

View the Home Office guidance on controlling and coercive behaviour

The profile of  perpetrator

• Demonstrates possessiveness

• Enjoys control and power

• Tendency to justify, deny and minimize their behaviour

• Unrealistic expectations of partners to fulfil their needs

• Express most feelings as anger

• Isolate their partner from friends, family and society

• Need to maintain an over adequate façade that all is well

• Tends to particularly believe in traditional male/female roles

• Alcohol Abuse Varies - 25% abuse only when drunk; 25% when drunk or sober; 25% never drink; 25% are social drinkers & not drunk when abusing

• Socialized into Aggression

• Lacking Self Esteem

• Not Mentally Ill - the proportion of mentally ill battering men is no greater than the proportion of mentally ill people in the population at large

An abuser may be impulsive & quick tempered but is able to demonstrate extra ordinary control when to do so is in his best interest i.e. around people he is trying to impress, the police, co-workers, the court, etc.

Ten facts about domestic abuse in England and Wales

• Each year around 2.1m people suffer some form of domestic abuse -  1.4 million women (8.5% of the population) and 700,000 men (4.5% of the population)  
• Each year more than 100,000 people in the UK are at high and imminent risk of being murdered or seriously injured as a result of domestic abuse
• Women are much more likely than men to be the victims of high risk or severe domestic abuse: 95% of those going to MARAC or accessing an IDVA service are women
• In 2013-14 the police recorded 887,000 domestic abuse incidents in England and Wales 
• Seven women a month are killed by a current or former partner in England and Wales 
• 130,000 children live in homes where there is high-risk domestic abuse
• 62% of children living with domestic abuse are directly harmed by the perpetrator of the abuse, in addition to the harm caused by witnessing the abuse of others
• On average victims experience 50 incidents of domestic abuse before getting effective help
• On average high-risk victims live with domestic abuse for 2.6 years before getting help
• Most victims – 85% - see on average 5 professionals in the year before they finally get effective support

For a victim the physical costs of domestic abuse can be high with 2 women being killed each week, and 30 men being killed each year as a direct result of domestic abuse. Many victims are left with permanent scarring.

Strangulation has only recently been identified as one of the most lethal forms of domestic violence but a north west study found that 56 % of people interviewed had suffered injuries related to strangulation. Serious damage from strangulation can occur after only ten seconds.

Financially the victim may be left with debts that they have been coerced into taking out in their name as well as the costs incurred through moving and re-establishing themselves. Victims often lose their jobs because of absenteeism due to both the effects of injuries, the undermining of employment by the perpetrator and during the process of leaving the relationship, this compounds the financial burden.

£1.2bn is cost to NHS in dealing with physical injuries caused by domestic abuse and the health related costs involved in treating a victim of rape is estimated to be £73,487 per case.

The impact of violence and abuse has been found to have psychological parallels with the impact of torture and imprisonment on hostages.  Victims are 15 times more likely to abuse alcohol, 9 times more likely to abuse illicit drugs, 3 times more likely to be diagnosed with mental health concerns and 5 times more likely to commit suicide.

The impact of domestic abuse on women and their ability to parent

Domestic violence is a complex behaviour; the aim is to control and subdue the partner. Victims are placed in a position over time where they feel isolated and fearful; there are real worries about whether the violence will increase, whether the children will be next, can I leave, where do I go, how do I get money and how will I cope. Ending any relationship is a stressful event, but where there is domestic violence, the decision to do so is extremely difficult.

This is complicated by the fact that victims describe that their self-confidence has been totally eroded both as an individual and a parent, they don't know what to do or say to the children, the emotional effort of day to day parenting can become too exhausting to achieve and your emotional energy and focus is on the perpetrator.

Some victims are so concerned about not being able to manage a separation that they remain in the relationship, or are not able to maintain a separation as violence may continue (or they are manipulated into believing that things will be different) and so make a survival decision to remain.

It is therefore essential that no victim is made to separate from their partner without very careful assessment, planning and support leading up to and after separation. It is not the role of the health professional to provide this very specific and targeted support, the role of the health professional is to support and encourage the practitioner in accessing the most appropriate services.

The impact of domestic abuse on children

The harm that can be caused to children living with domestic violence can be:

Physical: Direct physical or sexual abuse; being caught in the abuse of the mother; being forced to participate in the abuse and emotional control of the mother; trying to intervene to stop the mother being hurt

Emotional: Hearing abusive and threatening language directed at the mother, observing the mother being humiliated and degraded; observing the violence directly or seeing injuries to the mother after the incident and feeling powerless to do anything; hearing their mother shout, scream and plea for help; seeing the police attend; seeing their mother being taken to hospital; being used by the abusive partner to spy on the mother, or being used as pawns to control the mother – particularly when separated and there are contact concerns

Psychological and social: Affecting their ability to form friendships and relationships as they may be withdrawn at school; frequent disruptions to life through moving home and school, sometimes at short notice; disrupting their education and their ability to gain from school; adversely affecting their attachment and relationship with either one or both parents; low self-esteem, increased levels of anxiety, anger and aggression, poor conflict resolution skills, nightmares, hyper-vigilance (e.g. not going to school so they can protect their mother), over-protectiveness and intrusive thoughts; difficulties with alcohol and substance misuse as a coping mechanism.

The impact will vary from child to child however, and will depend on a number of factors:

• severity and nature of the violence

• length of time he/she has been exposed to violence

• child's age, own strengths, resilience and capacity to self-protect

• emotional warmth and support from the mother, siblings and other family members

• Whether the child has regular access to and support from wider extended family, school, support services.

 Unborn Children – pregnancy is a factor which is well associated with domestic violence developing or escalating. Where this is a factor, rates of miscarriage, premature birth, foetal injury and foetal death increase. The mother may be prevented from accessing ante-natal and post-natal care. There is also the danger that the mother's attachment to the unborn child can be affected, particularly if the pregnancy is as a result of rape

The Multi-Agency Risk Assessment Conference (MARAC) is part of a coordinated community response to domestic abuse, which aims to:

• Share information to increase the safety, health and well-being of victims/survivors - adults and their children;

• Determine whether the alleged perpetrator poses a significant risk to any particular individual or to the general community
• Construct jointly and implement a risk management plan that provides professional support to all those at risk and that reduces the risk of harm
• Reduce repeat victimisation
• Improve agency accountability
• Improve support for staff involved in high-risk domestic abuse cases

 The meetings are chaired by the police and there is a core group of agencies that will have input into the majority of cases heard at the MARAC. This includes police, housing, health, social care plus other statutory and third sector organisations.

The information brought by agencies must be relevant and proportionate. It must be in line with the MARAC Information Sharing Protocol (ISP) and relevant legislation and guidance. It is vital that all relevant information is shared at the meeting.

Making a referral to MARAC

The way in which a referral to MARAC is made is slightly different depending on the MARAC meeting that you are referring to, this is governed by the Borough in which the victim lives. Comprehensive guidance including who can help you make the referral, the referral pathway and all relevant forms and documentation can be found here

What is an independent domestic violence advisor?

A definition from Safe Live

The main purpose of independent domestic violence advisors (IDVA) is to address the safety of victims at high risk of harm from intimate partners, ex-partners or family members to secure their safety and the safety of their children.  Serving as a victim's primary point of contact, IDVAs normally work with their clients from the point of crisis to assess the level of risk, discuss the range of suitable options and develop safety plans.

They are pro-active in implementing the plans, which address immediate safety, including practical steps to protect themselves and their children, as well as longer-term solutions. These plans will include actions from the MARAC as well as sanctions and remedies available through the criminal and civil courts, housing options and services available through other organisations. IDVAs support and work over the short- to medium-term to put them on the path to long-term safety.  They receive specialist accredited training and hold a nationally recognised qualification.

Since they work with the highest risk cases, IDVAs are most effective as part of an IDVA service and within a multi-agency framework. The IDVA's role in all multi-agency settings is to keep the client's perspective and safety at the centre of proceedings.

Studies have shown that when high risk clients engage with an IDVA, there are clear and measurable improvements in safety, including a reduction in the escalation and severity of abuse and a reduction or even cessation in repeat incidents of abuse^.

Civil orders