BMJ 2014;348:g2203 doi: 10.1136/bmj.g2203 (Published 19 March 2014)

Page 1 of 1

Letters

LETTERS RESPONDING TO DOMESTIC VIOLENCE

Training doctors to respond to domestic violence: more than just communication skills Carley G Yapp foundation year 2 doctor Cheltenham General Hospital, Cheltenham GL53 7AN, UK

Although training to enable doctors to enquire about domestic violence is crucial,1 this is only the first step. Training beyond lessons in communication skills would be needed for a clinician to understand the implications of the disclosure and its impact on the patient’s life, and to identify the patient’s immediate and long term needs. The new National Institute for Health and Care Excellence (NICE) guidance recommends that support should be “tailored to meet people’s needs.”2 The UK is becoming increasingly multicultural, and doctors need to understand that cultures may vary in their attitude towards domestic violence.3 Furthermore, victims may be financially reliant on their abuser and immigration status may depend on that person. In such cases, legal and financial support may be needed as well as emotional support.

Recent research by the World Health Organization found that intimate partner violence had diverse and far reaching health consequences. Physical injuries were the tip of the iceberg, with victims facing an increased risk of a variety of mental health, sexual health, reproductive health problems.4 Such health implications reflect some of the longer term consequences of domestic violence that clinicians should be aware of.

The first recommendation of the new NICE guidance offers constructive advice on service planning,2 and the government has pledged £40m (€47.9m; $66.5m) for “specialist local support services” in a targeted bid to tackle violence against women.5 However, more diverse services are needed, together with training to ensure that they are used appropriately, so that clinicians can respond holistically when a patient has taken the first brave step of disclosing domestic violence. Competing interests: None declared. 1 2

3 4 5

Torjesen I. Doctors need training to respond to domestic violence, NICE guidance says. BMJ 2014;348:g1797. (26 February.) National Institute for Health and Care Excellence. Domestic violence and abuse: how health services, social care and the organisations they work with can respond effectively. NICE public health guidance 50. 2014. www.nice.org.uk/nicemedia/live/14384/66668/ 66668.pdf. Gill A. Voicing the silent fear: South Asian women’s experiences of domestic violence. Howard Journal of Criminal Justice 2004;43:465-83. WHO. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. 2013. www.who.int/ reproductivehealth/publications/violence/9789241564625/en/. Home Office. Ending violence against women and girls in the UK. 2014. www.gov.uk/ government/policies/ending-violence-against-women-and-girls-in-the-uk.

Cite this as: BMJ 2014;348:g2203 © BMJ Publishing Group Ltd 2014

[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions

Subscribe: http://www.bmj.com/subscribe

Training doctors to respond to domestic violence: more than just communication skills.

Training doctors to respond to domestic violence: more than just communication skills. - PDF Download Free
169KB Sizes 0 Downloads 3 Views