Government is “preparing” for further increases in women suffering domestic violence seeking support, according to Minister for Justice Helen McEntee.
Speaking at the publication on Wednesday of a guide for GPs on recognising and responding to domestic violence and abuse (DVA) she said as more women were encouraged to disclose, more would need services.
“It’s certainly something that we are preparing for. Year on year we have increased our funding in the Departments of Justice, of Children, of Health investing in services. But we are very conscious that we need to do much more,” said the Minister.
She welcomed the new “quick reference” guide, developed by the Irish College of General Practitioners (ICGP), and hopes it will “empower” women and men to seek the right supports.
The guide advises GPs to ask “gentle, probing” questions of a woman or man about, for example, how things are at home, or how they are getting on with their partner. This could be “a life-saving intervention”, it says.
The six-page guide explains DVA and coercive control. It states that 15 per cent of women and 6 per cent of men have experienced this behaviour at some stage in their lives and notes that on average victims do not seek help for two to three years.
It sets out circumstances where a woman may be particularly at risk – for example during pregnancy or at times of high stress like homelessness or unemployment – and advises on how to respond to a disclosure of abuse which may be made after several visits and consultations rather than on first being asked.
Nóirín O’Herlihy, director of women’s health with the ICGP who helped develop the guide, said GPs were ideally placed to recognise and support men and women experiencing DVA. Dr O’ Herlihy said a recent British study had found 76 per cent of women and 73 per cent of men would feel comfortable discussing it with their GP.
Identifying the problem
Velma Harkins, a GP based in Banagher, Co Offaly, said it is "sobering" to realise "many of our patients are experiencing this on a daily basis . . . We can do more and we really have to." Since her involvement on writing the guide Dr Harkins said she looks back at past consultations with patients and fears she may have missed signs that they were experiencing DVA.
“As GPs we would always have been aware of domestic violence, aware of it under the surface. But we would not be sure how to approach it. How do you enable people to ask the right question? How do you broach the subject?
“I had a lady who came into me almost every week for 14 years, mainly with minor things before she eventually disclosed . . . It’s not only bruises. Before that, it’s a process that breaks down a person, disempowers them and that’s what the GP’s role has to be – to provide a gentle, empowering and safe space.”
She describes subdued body language, loss of confidence, depression, anxiety, as well as some chronic illnesses like diabetes, cardiovascular disease and digestive disorders as possible indicators of abuse.
“There are subtle signs we haven’t spotted in the past. This is to raise awareness of them; and once you raise awareness then it’s click – it all makes sense. GPs will start spot it.”
Ms McEntee said a “significant part” of her department’s forthcoming strategy on DVA is “in expanding our refuge accommodation. We are also looking at not just the services provided by our own State agencies but also by the community and voluntary sector . . . It will require a lot of money but this is an issue that Government has committed to,” she said.
