Domestic violence and abuse Key contact/author: Teresa Martin, Community Safety Manager, Buckinghamshire County Council

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1 Domestic violence and abuse Key contact/author: Teresa Martin, Community Safety Manager, Buckinghamshire County Council Introduction Domestic Violence and Abuse (DVA) is a top priority for the Buckinghamshire Community Safety Partnerships, and is also an issue for health services due to its wide-ranging health and social consequences. It is a national priority, with government stating that working towards outcomes for victims of DVA should focus on risk reduction and individual justice as most victims do not report to the police i. Violence in intimate relationships can happen to and is committed by both men and women, but women experience the majority of incidents of physical violence which take place in intimate relationships ii. The majority of chronic long term victims are women and female victims are more likely to be abused post-separation than male victims iii. DVA has a major impact upon the health of victims, with women who are experiencing domestic abuse presenting more frequently to the health service and requiring wideranging health interventions. A study found that 80% of women in a violent relationship had sought related help from the health service at least once iv. Women who have experienced violence from a man known to them are v : fifteen times more likely to abuse alcohol nine times more likely to abuse drugs three times more likely to be diagnosed as depressed or psychotic five times more likely to attempt suicide Pregnancy is also a factor with DVA often starting or intensifying during the pregnancy vi and 44% of abused women being assaulted whilst pregnant vii. DVA is associated with increases in rates of miscarriage, low birth weight, premature birth, foetal injury and foetal death viii. It is also a primary indicator of child protection needs, with Every Child Matters recognising DVA as a cause of vulnerability which has a negative outcome on children s ability to achieve their full potential across the five identified outcomes. Women fleeing DVA are most likely to attend A&E because of the 24-hour access and the anonymity that A&E provides ix. Abuse victims may present not just with injuries, but with a range of other health concerns such as chest pain and irritable bowel syndrome x. Research by the Women s Institute found that 52% of rural women and 56% of urban women said they have experienced DVA. The researchers noted that urban and rural women had very similar experiences of violence, except that rural women were more likely to have weapons used against them and that they were more likely to present to health professionals. Commissioning services for domestic violence represents value for money and data confirms the need for DVA provision. Any decrease in funding for DVA services would impact negatively on outcomes for victims and their children, as well as increasing costs

2 for agencies. The IDVA service has become a vital and integral service for high risk victims and is accessible to both female and male victims of DVA Areas requiring additional work include engaging with victims and communities at a local level, including those who are harder to reach; work with children and young people, training for professionals and improved working between commissioners from different agencies. Research should also be considered into best practice in how to break the cycle of inter-generational links and how best to support emerging agendas such as Families First and Tackling Disadvantage. Need in the population current and future DVA can be experienced by anybody. However, research has repeatedly concluded that the vast majority of DVA victims are women and children. Research has also found that women are more likely to experience repeated and severe and/or lifethreatening forms of violence and sexual abuse, and for women the abuse is more likely to carry on post-separation. DVA is a pattern of abusive and controlling behaviour and may be experienced regardless of ethnicity, religion, class, age, gender, sexuality, disability or lifestyle. It can occur in a range of relationships, and may involve other family members (including children). It can also include issues such as female genital mutilation, honour-based violence and forced marriage. Following a recent government consultation, the definition of domestic violence and abuse is being widened from March 2013 to include coercive control and to cover those aged 16 and 17. Including victims aged is particularly important given that intimate partner relationships and even marriages before the age of 18 are not uncommon, and that the British Crime Survey shows year olds are the age group most likely to suffer abuse from a partner. The biggest risk factor of experiencing domestic abuse is gender. There are, however, a number of factors which contribute to the risk level being increased, including separation, pregnancy, escalation, isolation, stalking and strangulation. Mental health and substance misuse issues, whilst not the cause of DVA, may be contributory factors and may increase the risk of harm of serious injury or death. Numbers affected in Buckinghamshire; percentage of population affected Approximately 60% of all Violence Against the Person (VAP) which occurred during the period 1 August 2011 to 31 July 2012 were assaults. According to the police database (CEDAR), as at 28 August 2012 this equates to 2,978 assaults across Buckinghamshire, with nearly 40% (1139) of these domestic related. As a comparison, the next most prevalent offence type for VAP is public order. These make up around 18% of all VAP offences and according to CEDAR as at 28 August 2012, this equates to 698 offences across Buckinghamshire with only 4% (31) of these domestic related.

3 As an indication of risk to victims, of the 98 offences in Buckinghamshire where there was a threat to kill, 55% (54) were domestic related. With 40% of all violence offences relating to domestic abuse, it is important for the partners in Buckinghamshire to prioritise this issue. These figures are likely to increase from March 2013 as the new domestic abuse definition comes into place. xi This does not represent those domestic-related offences which have not been reported. At any one time, 10% of the adult female population will be experiencing domestic abuse and almost 70% of those will have children who are being adversely affected. Over 6,070 cases of DVA in Buckinghamshire were reported to police in 2011/12, of which 2,451 were repeat incidents xii. This does not include the vast number of cases which still go unreported - using the Home Office Ready Reckoner tool, it is estimated that 16,504 women and girls aged in Buckinghamshire have been a victim of DVA in the past year. A total of 32,602 incidents of domestic violence were recorded by Thames Valley Police in 2011/2012, with 6,070 of those occurring in Buckinghamshire. There are over 1 million female victims of DVA in England and Wales each year. National data reveals that 1:4 women will be affected by an abusive relationship at some point in their lives after the age of 16. Local research in 2002 replicated this finding for Buckinghamshire. Over 75% of cases presented at Buckinghamshire Children Social Care have domestic violence as a presenting problem for repeat child protection plans. The NSPCC identified DVA being present in two-thirds of Child Protection Cases nationally. Findings from the Home Office Statistical Bulletin Homicides, Firearm Offences and Intimate Violence 2007/09 show that the likelihood of being a victim of any form of domestic abuse may increase with decreasing household income. It goes on to say that women who are at particularly high risk of domestic abuse are those living in households with an income of less than 10,000. This being the case, it is likely that many risk factors associated with DV may be correlated with deprivation. The Index of Multiple Deprivation 2010 reveals that Buckinghamshire has some areas that fall within the 30% most deprived in England and the number of these areas has been increasing since Given the current economic climate and rising unemployment levels, it is likely that greater pressures will be put on families in Buckinghamshire and a resulting increase in DVA and/or high risk DVA will be seen. This in turn will put an increasing burden on the local IDVA service. Domestic abuse can happen within any ethnic group or culture, class, sexuality etc. There is some evidence, however, that some forms of domestic abuse may be more likely to be experienced by particular groups, e.g. those experiencing female genital mutilation, forced marriage and honour-based violence.

4 Past trends The incidence of police reported domestic violence in Buckinghamshire is increasing year on year following concerted campaigns to increase reporting of this issue xiii. Table 1: number of domestic incidents 2006/ / / / /11 Number of domestic incidents Number of repeats The future The population of Buckinghamshire has been increasing each year to 505,300 in 2011 and is predicted to rise to an estimated population of 520,400 by The female population accounts for over 50% of the population. Increases in local population, particularly female, will see a corresponding increase in domestic abuse. It is also likely that following the changes to the relevant definition and improved awareness raising, the number of reported incidents will continue to rise. Evidence of what works/good practice Both the Co-ordinated Community Response Model and Vision for Services for Children and Young People Affected by Domestic Violence recognise the importance of the tiered model of levels of need and intervention, as used within the Department of Health s assessment framework, The most effective intervention for ensuring safe and positive outcomes is usually a package of support that incorporates risk assessment, trained domestic violence support, advocacy and safety planning for the non-abusing parent in conjunction with protection and support for any children. There is now a wealth of evidence which shows that IDVAs provide an invaluable service to victimsof domestic abuse, both in increasing their safety and improving their experience in the court process xiv. There is also empirical evidence that the IDVA approach keeps victims of severe abuse safer, and crucially that the improved safety applies not just to adults but also to their children. xv. A local needs assessment demonstrated the need and effectiveness of the IDVA service in Buckinghamshire. The Local DVA Strategy was developed by taking into account the learning and direction of Government in its Violence Against Women Strategy. It was developed in partnership with key stakeholders and also included focus groups with victims of DVA. Current services in relation to need Support can come from a range of agencies (most of which are able to work with both female and male victims), including police, health, probation, voluntary sector organisations. Locally Women s Aid provide much of the support for victims and their children, including refuge and outreach services and the hosting of the IDVA service. The

5 design of the IDVA service took into account the need to ensure support was available to both female and male victims at medium/high risk of DVA and includes provision for male victims. There are two Multi-Agency Risk Assessment Conference (MARACs) in the county, one covering the north and the second the south of Buckinghamshire; as with the IDVA service both females and males may be referred to the MARAC. The Freedom Programme is delivered at various sites across the county and intervention programmes for children who have witnessed DVA are also available. A 121 programme for perpetrators of DVA is available (both male and female), with non-abusing parents also being offered support. Agencies, including Victim Support and Relate, may also be involved with DVA work. A multi-agency training programme is also delivered to help ensure that professionals are aware and better equipped to deal with DVA. In 2011/12 a total of 138 women and 172 children were accommodated in refuges in Buckinghamshire, with a further 268 women and 303 children being refused refuge due to lack of space or needing to be accommodated away from Buckinghamshire. An additional 359 women were worked with on an outreach basis. In the same period, the IDVA service worked with almost 200 clients. Evidence suggests that male victims of DVA have different support needs and that this differs between heterosexual and homosexual men xvi. As with any survivor, it is important for practitioners to find out what support male survivors would like as they often seek practical assistance rather than emotional support, but this may vary. Practitioners working with male victims of domestic violence are encouraged to either call or refer the client to the Men s Advice Line, a national helpline run by Respect and funded by government. In addition, male victims can access support locally from other sources, including Victim Support, Respect, the IDVA and MARAC. Unmet needs and service gaps More work needs to be undertaken to engage with victims and communities at a local level. This should include those who are harder to reach, to ensure that they are getting the services they need. We need to identify groups where there are emerging issues and put in place appropriate support. This will include scoping and implementing support for those in the lesbian, gay, bi-sexual and transgendered communities, those at risk of forced marriage and honour-based violence and young girls at risk of gang-related abuse. Another area of need is around universal healthy relationship advice and support at both primary and secondary school level as well as the wider availability of support for children and young people who have been affected by DVA. This should include early intervention and pre-birth support and intervention and provision for those aged years. The continuation of training for professionals is key to ensuring that victims and their children are identified, protected and supported. This includes training to all professionals in the use of the Domestic Abuse Stalking and Harassment risk assessment tool and Confidential Routine Enquiry. There is a need to increase GPs understanding of DVA and the support services available for those affected.

6 Whilst there are several effective services in Buckinghamshire at present, potential reductions in funding and devolvement of budgets to the Police and Crime Commissioner may impact on the sustainability of current provision and the developments made in relation to a co-ordinated community response. Recommendations for consideration by commissioners Commissioning services for domestic violence represents value for money. DVA costs Britain 23 billion a year xvii, and using population figures from the 2001 Census and the national research, it is estimated that the annual cost to Buckinghamshire in 2004 was 53,546,387 of which 12,903,226 is attributable to costs to health services. This is in addition to the emotional cost of DVA. Data from the police, Women s Aid, MARAC (Multi-Agency Risk Assessment Conference) and the Independent Domestic Violence Advocate (IDVA) service working with high-risk victims demonstrate a need for DV intervention work locally, with research finding that for every 1 spent on the MARAC/IDVA, 6 of public money is saved xviii. The IDVA service has become a vital and integral service to supporting high-risk victims of domestic violence in Buckinghamshire. IDVAs are essential to crisis intervention and safety planning, effective outcomes and repeat referrals to MARAC, homicide prevention and safeguarding children by supporting the non-abusing parent. Any disinvestment in DVA services would have a negative impact on outcomes for victims and children, as well as increased costs for agencies, e.g. increasing costs of safeguarding children, DVA is funded by multiple agencies, and consideration should be given to adopting closer relationships between the commissioners and should aim to increase joint commissioning. Research should be considered into best practice in how to break intergenerational links with domestic violence and how best to support emerging agendas, e.g. Families First and Tackling Disadvantage. i Calling an End to Violence Against Women and Girls Strategy ii Coleman et al, 2007; Walby and Allen, 2004 (both from British Crime Survey); Tjaden and Thoennes, 2000 iii Respect position statement: gender and domestic violence, Ibid (all) iv The effects of women s abuse on health care utilisation and health status: a literature review Women s Health Issues v British Medical Association (1998) Domestic Violence: A Health Care Issue?, London, BMA vi Bewley et al 1997 Violence Against Women, London, RCOG vii Bowker & Maurer (1987) viii Mezey G, Bacchus L, Bewley S (2000) ESRC Domestic Violence and Pregnancy Research Paper ix Tilden and Shepherd (1987) x Conference Report: Domestic Violence A Health Response: Working in a Wider Partnership (2000), Department of Health xi Buckinghamshire Partnership Strategic Assessment 2012 (Strategic Period 1 August July 2012) xii Thames Valley Police Domestic Abuse Scorecard

7 xiii Thames Valley Police Performance Team xiv Includes evaluation a 2004 evaluation undertaken on the two Specialist Domestic Violence Court sites in Gwent and Croydon and Justice with Safety Specialist Domestic Violence Courts Review xv Safety in Numbers (November 2009) xvi Complicated Matters: A toolkit addressing domestic and sexual violence, substance use and mental ill-health, AVA Stella Project xvii Costs of DV Research, Professor Sylvia Walby, University of Leeds, 2004 xviii Saving Lives, Saving Money, 2010

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