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Domestic and family violence (DFV) resources to support the health workforce

Queensland Health's DFV Toolkit of resources for health workers

The health system is often a first point of contact for people who have experienced DFV.

Queensland Health's DFV Toolkit of resources for health workers was developed in 2016 to help health workers to use sensitive inquiry to safely and appropriately recognise, respond, and refer to suspicions and disclosures of domestic and family violence. If you scroll through this page you will find online and face-to-face training modules, guidelines, factsheets and clinical tools for a range of health workers, including first responders and those working in hospitals and health services.

The toolkit was revised in 2019 to include updated statistics, references and information about government priorities and emerging themes in contemporary human services practice. Updates include further information about:

  • COVID-19 and DFV (see factsheet and safety planning checklist)
  • coercive control and reproductive coercion as types of DFV
  • the impact of systemic issues on the risk and incidence of DFV
  • the use of trauma-sensitive care
  • using a 'human rights lens' to respond to issues of diversity.

COVID-19 and DFV

For people experiencing DFV, being at home is not always a safe place. We know that the incidence of DFV has increased during the COVID-19 pandemic period. Measures introduced to reduce the spread of COVID-19 such as changes to access to support services, social restrictions, home schooling and self-isolation and quarantine requirements, as well as the stress caused by the economic impacts such as unemployment, have increased the risk of DFV.

Health services may become the most accessible support services for people experiencing DFV during the COVID-19 pandemic. When treating and/or discharging patients, it is imperative that health professionals assess patient's safety at home and provide safe, appropriate and timely responses to presentations of DFV. Safety planning now needs to take into account the impacts of the COVID-19 pandemic.

Read the DFV COVID-19 Factsheet (PDF 289 kB) for guidance on how to recognise, respond, and refer safely and appropriately to suspicions and disclosures of DFV within the context of COVID-19. The Factsheet includes a Safety Planning Checklist which considers the complexity of safety planning within the context of potential impacts and restrictions resulting from COVID-19.

DFV services will be accessible throughout the pandemic period. For information about availability and any changes to the mode of service delivery read Operation of domestic and family violence services during the pandemic period (PDF 270 kB).

Training resources to support clinicians

Strengthening the health system response to violence against women

One in three women throughout the world will experience physical and/or sexual violence by a partner or sexual violence by a non-partner. This violence has a wide range of short- and long-term health consequences. The health system is a place where women who have experienced violence can go in order to receive services and support for their physical and mental health needs.

Video transcript

One in three women experience violence at the hands of their husband or partner, that's over 800 million women worldwide.

These women can feel trapped, afraid, their lives are often restricted. Those who consider leaving often fear ending up penniless or losing their children.

Over time their confidence slips away, making a life without violence seem a distant memory.

The abuse can lead to injuries as well as serious physical and mental health problems, in some cases even death. Many women contract sexually transmitted infections or have unwanted pregnancies and when pregnant have a greater risk of miscarriage or of having a premature or low birth weight baby.

They can experience depression, anxiety and other mental health problems or become addicted to drugs and alcohol.

It can be hard to know who to trust or where to turn but there is a place they can go; a visit to a local clinic is often one of the few opportunities women have to go out alone and it's important for doctors and nurses to make sure this isn't a missed opportunity.

When doctors, nurses and midwives listen with compassion, survivors are more likely to share their story. When they ask the right questions they can uncover what is really happening and challenge cultural attitudes that say it's okay for a husband to hit his wife.

They can reassure women that it's not their fault and can work with women to help them stay safe and where necessary connect them with other services that can provide, for example, shelter, psychological support, legal services, and financial opportunities.

More women can find their way to live without violence when changes are implemented across healthcare and other systems. Changes such as private rooms for consultations, training that enables doctors and nurses to respond better to women's needs and raising awareness of the harmful consequences of violence for women and children and how to prevent it.

Making these changes helps foster a culture where violence is unacceptable and where women have the courage to speak out. Imagine if that could happen to each and every one of those 800 million women.

Text:

Health care providers should:

RAISE awareness
LEARN more about the issue
LISTEN with care and empathy
LINK women to other services
SPEAK OUT to end and respond to violence

Governments should:

CHALLENGE social norms that accept violence against women
PROVIDE timely access to health services
ENSURE training of all health providers
STRENGTHEN evidence and data collection
STOP VIOLENCE AGAINST WOMEN AND GIRLS

For more information see:

http://who.int/reproductivehealth/topics/violence/en/

The Queensland Ambulance Service (QAS) and the Queensland Police Service (QPS) are often the frontline first responders to incidents of domestic and family violence. In recognition of this QAS and QPS collaborated in the development of the training video below to be used to raise health worker awareness of the challenges faced by first responders.

Video transcript

First Responders

Putting an end to Domestic and Family Violence

(man and woman fighting, man hitting woman with beer bottle, man leaving the house)

The Queensland Ambulance Service, the QAS, and the Queensland Police Service, QPS, are often the frontline first responders to incidents of domestic and family violence in Queensland. In certain cases the QAS attends cases without QPS involvement and vice versa. In many cases the victims of domestic and family violence (DFV) refuse treatment and transport to medical care and remain under the radar of the health system.

(woman walks out of house with blood on her head)

A special government taskforce reported an increase of domestic and family violence in Queensland and made recommendations for the QPS and QAS.

(woman remains standing in front of the house, lights a cigarette and mops head with towel)

Both services will be expected to provide further domestic violence information to the victim with the objective of protecting the victim and ensuring that all presentations to either service is an effective portal to decisive and appropriate action.

(a small child exits the house behind the woman who is still standing at the front of the house, and stands looking at his mother)

The presence of children add to the sensitivity of these cases. Witnessing domestic violence may affect the way in which they behave in their relationships, continuing the cycle of violence. The highly sensitive nature of these cases presents a difficult challenge for emergency service staff.

(camera pans to view woman from above, child not visible)

Either the QPS or the QAS may be called depending on the situation.

(camera pans back and ambulance van pulls up outside of the house, two paramedics exit the van and walk across the yard to the woman)

If the QAS is the initial responding service, a paramedic’s primary responsibility is their own personal safety, and the immediate medical assessment and treatment of the victim, with transport to hospital as required.

(paramedics are in the lounge room treating the woman’s wounds, and then support her into the back of the ambulance van outside)

If a risk assessment returns a high likelihood of immediate danger for any involved parties, including QAS staff, immediate QPS involvement is required.

(paramedic is shown talking into a two-way radio on his collar, then shows female paramedic talking to the woman, then both paramedics talking with the woman)

When speaking to the victim be empathetic and listen carefully. Consider the education and training that you have received and strive to provide the best outcome for the victim. The QPS and QAS may refer the victim to DVConnect. We will cover DVConnect in more detail later in this video.  Prior to providing any suggestions to the victim confirm that they are seeking further domestic violence information and assistance. Ensure the victim is aware that paramedics are not authorised to provide legal advice or directly advocate on the patients behalf.

(woman puts her hand up and turns away from the paramedics and shakes her head multiple times)

Patients in these cases may refuse service. Paramedics should refer to the QAS regulations in regards to patient consent in the clinical environment. Across all emergency services the primary goal is provide the best outcome for the victim while still respecting their right to choose.

(police car pulls up outside of the house)

When the QPS are called for back-up, they will arrive and start their investigation processes with medical assistance as a priority.

(woman shown speaking with the police officer, still outside the house)

The investigative process starts by separating the involved parties to get a version of events.

(police speaking with man in from of the car garage)

The QPS will act accordingly to severity. In these cases, both QAS or QPS are expected to provide further domestic violence related information to the victim.

(women speaking with paramedics outside of front door)

In most cases however the QPS will be the initial responding service.

(women standing alone outside of front door with police officers walking toward her, then a shot of a police officer speaking into the two-way radio in the police vehicle)

In these circumstances if medical assistance is required on scene the QAS will be called. The QPS will conduct an investigation by separating the parties and gaining a version of events. The QPS will act according to their findings.

(police talking to woman, then talking separately to the man)

If the perpetrator of domestic and family violence is under the influence of alcohol or is still threatening the victim or staff, the QPS may detain him or her for up to 8 hours in total.

(man is escorted to the back of the police vehicle)

If domestic violence has occurred, the QPS can detain the perpetrator for up to 4 hours for the purpose of making an application for a domestic violence order.

(Female paramedic talking on the phone in front of the ambulance van)

Both the QPS and QAS, with the victim’s approval may make a referral to DVConnect, Crisis Support Queensland, or recommend other self-sought domestic violence services.

(police speaking with injured woman outside the house)

Emergency services have a special DVConnect dedicated emergency services number.  Once referred DVConnect will contact the victim, to provide assistance.

(image of orange cab, and then injured woman and child getting into the cab)

DVConnect can organise refuge accommodation and transport for the victim along with ongoing assistance tailored to their specific situation, wants and needs.

(Injured woman speaking to paramedics outside of house)

If the victim doesn’t wish for a DVConnect referral, alternative solutions to domestic violence can also be suggested at the QPS or QAS staff member’s discretion.

(Injured woman smoking a cigarette, as child comes out of the front door, and mother hugs and kisses child before he returns back inside)

Domestic and family violence affects women, men, children and families from all sections of society. It requires collective efforts to break the cycle of violence within our communities. It is imperative that responses to domestic and family violence be wide ranging, strategic and integrated so that no one, victim or perpetrator, falls through the gaps.

(woman who acted as the victim in the filmed scenario, is sitting in a chair facing directly to the camera, on occasion the camera focuses on severe scars on the woman’s arm )

Hi. My name is Rachel Moore and in 2014 I was a victim of family and domestic violence, along with my 5 children who were also present when my children’s father shot me. I am lucky to be alive. I would like to thank the Queensland Police and the Ambulance Service, along with my 5 brave children, who saved my life that night. I am eternally grateful and have nothing but admiration for the Queensland Police and Ambulance Service Officers and the job that they do. As a victim of domestic and family violence I would like to ask that all police officers and paramedics take each and every case of domestic and family violence seriously, to take action in protecting victims and their families, and to take the necessary action against perpetrators. Victims of domestic and family violence depend heavily on you, our police and ambulance officers, to get the best outcome for victims and their families.

Training

Read the Health workforce domestic and family violence training guideline (PDF 308kB)

Domestic and Family Violence train-the-trainer sessions have been facilitated in HHSs and private health services throughout Queensland.  Health workers and professionals in both the private and public sectors can request to participate in DFV training for the health workforce be delivered by skilled, local trainers. If you would like to find out your local DFV training contact, please email StrategicPolicy@health.qld.gov.au.

Understanding Domestic and Family Violence

The Understanding Domestic and Family Violence training module aims to raise awareness of domestic and family violence among all health workers, and provides guidance on how to respond to a disclosure of domestic and family violence.

It provides information for all health workers, both clinical and non-clinical, in public and private health facilities.

The information is also available in other formats:

Clinical response to Domestic and Family Violence

The Clinical response to Domestic and Family Violence training module aims to support clinicians working in a range of clinical areas (e.g. maternity services, emergency department and mental health) to identify domestic and family violence through a sensitive inquiry model and to respond appropriately.

Train the trainer

These train the trainer resources are targeted towards clinical leads in domestic and family violence from a range of clinical areas.

  • Facilitators guide (revised) (PDF 9.33MB) designed to help trainers in your organisation provide face to face training sessions.
  • Training presentation (revised) (PPT 4.38MB) to support the delivery of the face to face training sessions.

Referral model

A Referral model (revised) (PDF 1.93MB) and flowchart (revised) (PDF 137kB) have been developed to guide clinicians through the process of referring a client to specialist services, in cases where this becomes necessary.

Please also refer to the Domestic and family violence online portal to support Queenslanders experiencing or impacted by domestic and family violence.

The portal facilitates easy access to information and support services from across Queensland Government agencies and selected funded services and caters for people with a range of needs and individual circumstances including women with children, people from Aboriginal and Torres Strait Islander and CALD backgrounds, from rural and regional communities and people in LGBTIQ relationships.

It is a useful resource for friends, family and bystanders who are looking for information on how to support a loved one, friend or colleague. The portal can also be accessed by health workers and clinicians across the state who are looking for local referral options for clients.

Information sharing guidelines

The Domestic and Family Violence Information Sharing Guidelines support the implementation of new information sharing provisions under the Domestic and Family Violence Protection Act 2012. The guidelines support practitioners to share information appropriately with each other in order to appropriately assess and manage domestic and family violence risk, and in a manner consistent with legislative amendments.

A quick-reference DFV Information Sharing Factsheet (PDF 82kB) and Flowchart (PDF 97kB) are also available for use by the health workforce working in busy and complex clinical environments.

Non-lethal strangulation in DFV

Non-lethal strangulation in DFV became a stand-alone criminal offence in Queensland in April 2016. The intent of a stand-alone strangulation offence is primarily to improve justice responses and to increase women’s safety.

A Non-lethal Strangulation in DFV Factsheet (PDF 170kB) and Flowchart (revised) (PDF 235kB) have been developed to provide the health workforce with easy-to-access, evidence-based information for use in busy clinical environments.

Antenatal screening for DFV

The Antenatal screening for domestic and family violence guideline (PDF 303kB) has been developed for Queensland Health professionals involved in providing care to women during the antenatal period. Pregnancy can trigger or intensify the occurrence of domestic and family violence and this guideline supports health professionals to identify and respond to the particular needs of pregnant women at risk or experiencing domestic and family violence. Specific antenatal screening training scenarios (PDF 192kB) and a training video can be used to enhance understanding and implementation of the guideline.

Background

The Taskforce on Domestic and Family Violence in Queensland was established to examine Queensland's domestic and family violence support systems and make recommendations to the Premier on how the system could be improved and future incidents of domestic violence could be prevented. The Not Now Not Ever: Putting an end to Domestic and Family Violence in Queensland report was presented to the Premier in February 2015.

Australia’s National Research Organisation for Women’s Safety (ANROWS) is a Commonwealth-funded not-for-profit company established to deliver relevant and translatable research evidence which drives policy and practice leading to a reduction in the levels of violence against women and their children.

Last updated: 17 September 2020

OurWatch - Lets change the story: Violence Against Women in Australia

Australia has a choice. We can change the story that currently sees a woman murdered every week by a current or former partner. We can choose a future where women and their children live free from violence. Learn more

Find local support

There are specialist domestic and family violence support services available in your local area.

People impacted by domestic and family violence may require financial support and can acces brokerage and emergency crisis payments.