Telehealth and domestic and family violence

Guideline number: QH-GDL-497:2022

Effective date: 10 December 2025

Review date: 10 December 2028

Supersedes: 1.0

On this page:

• Purpose
• Scope
• Self-care
• Background
• Intersectional considerations
• Principles
• Approach
• Scheduling Telehealth
• The Telehealth Visit
• Response
• Education and Training
• Information sharing
• Legislation
• Related documents
• Definitions
• Summary of changes

Purpose

This guideline provides best practice recommendations if a health professional recognises or suspects a patient is at risk of or experiencing domestic and family violence (DFV) before, during or after a telehealth appointment. It outlines best practices for the management of disclosures to support all health professionals to appropriately identify and respond to the needs of any person at risk of or experiencing DFV. It is important that staff normalise the reasons that questions are asked about a person’s physical, psychological, and emotional health during a consultation. A script can also be found in the Telehealth and DFV Factsheet.

Scope

DFV can affect anyone and often intersects with the health system. This guideline applies to all Queensland Health employees (permanent, temporary, and casual) and all individuals acting as its agents (including visiting medical officers and other partners, contractors, consultants, volunteers and students or trainees) in the public health sector involved in the provision of health care via telehealth.

Compliance with this guideline is not mandatory, but sound reasoning must exist for departing from the recommended requirements within this guideline.

To respond safely and sensitively to DFV in healthcare settings, it is important to note:

• DFV can impact people of all genders, from all cultures, communities, ages and backgrounds.
• While all genders can be both victim-survivors and persons using violence (PuV), the evidence shows men are significantly more likely to be the PuV.
• Women are significantly more likely to be victim-survivors of DFV.
• Women who use violence are more likely to do so in self-defense, in resistance or in response to current or past trauma.

Self-Care

The content of this guideline may bring up strong feelings in some readers. There are services and support groups available to assist.

For advice and support related to DFV,1800RESPECT is a free service where you can call, chat online or video call for support. They also offer support for professionals working with DFV. Call 1800 737 732 or visit https://1800respect.org.au/

All Queensland Health employees and their immediate family members also have access to confidential counselling 24 hours a day, seven days a week, through the Employee Assistance Program (EAP). Details about how to contact your relevant EAP provider is available on QHEPS.

Background

Domestic and Family Violence (DFV) presents a significant health issue, and in 2013, the World Health Organisation declared that DFV be recognised as a global public health issue. As a recognised public health issue, the health sector plays a critical role in responding to and addressing DFV within the Queensland community.

Recommendations made by the Women’s Safety and Justice Taskforce Hear Her Voice: Report One and Report Two, the Queensland Domestic and Family Violence Death Review and Advisory Board Annual Report 2022-23, and the Queensland Audit Office Report 5: 2022-23 Keeping people safe from domestic and family violence all highlight the importance of ensuring that the Queensland Health workforce have the skills, confidence, and knowledge to effectively respond to suspicions and disclosures of DFV.

DFV is when an individual acts in a way designed to threaten, control or harm a partner or family member. It comes in many forms and is not always physical. DFV behaviours often play out over time to make someone feel fearful and unsafe. In Queensland, the primary legislation addressing DFV is the Domestic and Family Violence Protection Act 2012. This Act aims to maximize the safety and protection of people experiencing DFV, prevent or reduce its occurrence, and ensure accountability for people using violence.

The health system is often the first point of contact for many people who experience DFV. It is highly likely that all healthcare professionals, clinical and non-clinical, will encounter DFV. Your role is to support patients' health and connect them to appropriate care. Every health worker should be able to:

• Recognise the signs someone may be experiencing DFV.
• Enquire about experiences of DFV when it is safe and appropriate to do so.
• Refer people to appropriate support and other health professionals who may specialise in DFV response or be better equipped for what the person is experiencing.

Given the widespread use of telehealth-based clinical care, it is important to consider the delivery of telehealth services in the context of DFV.

Intersectional considerations

To provide culturally capable services, health professionals should use culturally appropriate processes and communication strategies when working with Aboriginal and Torres Strait Islander peoples and offer access to Aboriginal and Torres Strait Islander services, such as hospital liaison officers, health workers or health practitioners.

Provision of services to patients from culturally and linguistically diverse (CALD) backgrounds should be in accordance with the Multicultural Queensland Charter as detailed in the Multicultural Recognition Act 2016.

Medicare- ineligible victim-survivors of DFV and/or sexual assault can access free healthcare in relation to an experience of DFV and/or sexual assault.  Further information is available at - Guideline - Access to public health care for Medicare-ineligible victim-survivors of Domestic and Family Violence and/or Sexual Assault | Queensland Health.

Engage an appropriately qualified interpreter, if required, to effectively communicate with people from non-English speaking backgrounds, and people with disability who require AUSLAN interpretation, or other communication adjustments.

DFV will also look and feel different in LGBTQIA+ relationships. Health professionals must be able to recognise the unique challenges faced by victim-survivors in priority populations and understand that DFV can present in any relationship to support the provision of inclusive support and targeted safety planning.

Requirements

Principles

TheTelehealth Strategy 2021-2026 (the Strategy) aims to enable consumer-centered care delivery for any model of care or physical location. In alignment with the Strategy, the following principles provide a foundation for safety and are a priority for any response to DFV:

• Safety is a core priority
• Empowerment and client / consumer-centered care
• Confidentiality
• Integrated, coordinated, collaborative and responsive
• Diversity - inclusive and equitable
• Evidence-based and co-designed with users
• Understanding the dynamics of gender, power and control.

Telehealth enables better access to healthcare regardless of where people live, improving healthcare equity. Convenient and safe, high-quality care is easily accessed through Queensland Health’s Telehealth Program. It is important to remember, telehealth communication may be the only point of contact available to a patient experiencing DFV.

Approach

Where possible, face-to-face is the preferred service provision if it is known a patient is experiencing DFV or if a health professional suspects a person is experiencing DFV.

To continue with a telehealth appointment for a patient experiencing DFV or suspected of experiencing DFV, health professionals should consider:

• Current or existing protective factors
• Whether the PuV is living with the patient
• Access to safe devices for telehealth
• Access to other locations to do a telehealth appointment
• Utilising a safe time or window of opportunity for the appointment to occur
• Whether telehealth is the only option for a patient to attend the appointment.

In addition, health professionals should:

• Assess the capacity of, and barriers to, the patient participating in a telehealth consultation using the patient technology checklist (PDF 156 kB).
• Acknowledge DFV could be occurring and be aware of personal biases.
• Understand risk and vulnerabilities and wide-ranging impacts of DFV on a person’s life.
• Understand increased DFV risk associated with isolating events such as natural disasters and health events.
• Know the increased risks and barriers of priority populations (people from culturally and linguistically diverse backgrounds, First Nations peoples, people with a disability, young people, LGBTQIA+ people).
• Understand the psychosocial risk factors that increase the risk of DFV (mental health, pregnancy, isolation, lack of social support, harmful substance use).
• Be aware of a previous history of DFV by reviewing the medical record or alerts before the first appointment.

Scheduling telehealth

• Health professionals should ask the patient:
  • What is the best time for the appointment?
  • Do they have access to a private space where they cannot be overheard? Advise the patient privacy is important for this appointment.
  • What is the best method of connecting (computer or phone)?
  • Do they have access, and can they connect a headset?
• Where possible, plan an approach with the victim-survivor to assess safety, including the use of non-verbal cues and establishing a safe word (see Definitions section).
• The use of telehealth (videoconferencing) as opposed to telephone in all first appointments will assist with establishing rapport, safety and trust.
• Advise the patient about privacy and confidentiality limitations of your role and legal responsibilities under legislation, including mandatory reporting of child harm concerns.
• Explain Queensland Health telehealth platforms are secure. However, it is possible sessions may be monitored by someone in their location using other devices.
• If the patient advises their home device is compromised or is monitored then ask the patient if they can attend a health facility, a local facility or another location to conduct the telehealth appointment.
• If a patient continues to cancel or not attend their telehealth appointment, consider alternative options such as a face-to-face appointment.

The telehealth visit

• Ask the patient if they are safe to talk and if they are alone.
• Assess the patient readiness to meet.
• Assess if others are present and ask to be introduced if you can see another person in the background.
• Develop a plan if the call or video is suddenly disconnected, including who should re-initiate the call, and explore if there are other family or friends that could be called if unable to reconnect.
• Make a safety plan with the patient - a minimum for all health professionals is a plan for follow-up.
• Establish a safe word (see Definitions section).
• Where the patient indicates it is not safe to talk or to talk further about DFV, use their safe word and continue the engagement relating to other health matters and the need to book their next appointment as a face-to-face consultation.
• Reassess the suitability of telehealth as a modality following any DFV disclosure or when the health professional identifies DFV risks.
• Be familiar with high risk factors associated with DFV, which are known to increase the likelihood of violence, injury or death in DFV situations (see Definitions section).
• Provide information on support services and with the patient’s consent refer to support services. Consider various support services – DFV national phone numbers, Queensland phone numbers, 24-hour support services numbers.
• Only provide referrals and information if it is safe to do so.
• Fulfil all legal obligations as a health professional, including reporting any concerns about a significant risk of physical or sexual harm to children to appropriate child protection agencies.
• Consult with the Hospital and Health Service social worker or DFV Specialist Health Workforce clinician for further support and advice. Relevant contacts and referrals can be found here.

Response

Mandatory reporting

• Queensland Health professionals should consider sharing any relevant information about a patient with relevant support services if it will avert a serious risk to the life, health or safety of the patient or another person. However, this is not mandatory, and the patient’s consent should be sought where possible (see the Queensland Health Information Sharing for Domestic and Family Violence Guideline).
• Health professionals have mandatory reporting requirements in relation to a child in need of protection, and the implications of any potential disclosure should be understood by the client (see Reporting Concerns of Child Abuse and Neglect to Child Safety and Sexual Offences Against Children to the Police Guideline (PDF 2808 kB)).

Responding to a disclosure

• A script can be found in the Telehealth and DFV Factsheet.
• Information to guide all health professionals in responding to disclosure of DFV, including referral of patient and PuV to specialist support services, is detailed in the Introduction to domestic and family violence booklet.

If the patient does not disclose

• When enquiring about DFV with patients, it's crucial to remember that non-disclosure is a common and valid response, and it is not a failure.
• Many patients choose not to disclose their experiences of DFV, even when asked directly. A patient may not disclose DFV if they are not safe to do so.
• A patient’s decision not to disclose does not reflect poorly on your skills or approach as a health professional.
• By sensitively asking about DFV, you have created an opening. While patients may not be ready to share immediately, they will remember you offered a safe space.
• The patient may disclose their experiences of DFV when they feel they have enough trust in the health professional. The disclosure may occur at a subsequent appointment.
• For patients that disclose DFV, not all will want help or referral. Respect the patient’s answers and provide the local specialist DFV service or helpline information that is available (only if safe to do so) should they ever require it.
• Remind the patient Queensland Health hospitals are open 24 hours; 7 days a week and they can present to any hospital to seek support and safety.
• Document in the patient’s clinical record that DFV was suspected but the patient did not disclose and to screen for DFV at future presentations.
• It is important to remember your role is to provide support, not to press for a disclosure.

If the patient is the PuV or you suspect the patient's partner is a PuV

• Research shows health professionals are one of the few groups of people that a PuV may disclose to about their use of DFV, and they do this because they are seeking help or believe their use of violence is a symptom of a medical condition.
• The PuV may state they are having problems with stress, anger, depression, alcohol, drugs, relationship problems, or temper issues, instead of specifying DFV. They may also disclose behaviours and acknowledge using force while seeking medical treatment because they do not believe what they did was wrong.
• Acknowledge the disclosure and behaviour as a first step.
• Health professionals can categorise the behaviours as DFV.  Using a matter-of-fact approach is best when gathering information and conveying concerns about the violence.
• If a person discloses they are using violence, never breach the confidentiality of victim‑survivors and their children by sharing any information the victim-survivor may have provided to you. Only engage with the person about their individual circumstances.
• Consider the risk they are posing to their partner or children and what steps need to be taken to reduce this risk.
• Be respectful, empathetic and matter of fact, but do not minimise the use of violence or collude.
• Document into the medical record details about the behaviours disclosed, when they happened, any relevant context, influences, and risk to self and others.
• Determine what supports are required and, with consent, make appropriate referrals.
• Share information about DFV with relevant agencies where there is an ongoing risk, or to manage serious threats (refer to the Queensland Health Information Sharing for Domestic and Family Violence Guideline).

Education and training

The Queensland Health Domestic and Family Violence Capability Framework was developed to ensure that all members of the Queensland Health workforce have an appropriate understanding of the dynamics and impacts of DFV, and can respond to DFV presentations consistently, safely, and appropriately.

The Framework outlines three levels of capability for the Queensland Health workforce, with a separate level for leaders, including people leaders and system leaders. It is important that staff can identify their level and are aware of the training, resources, and information that is available to support them to meet the responsibilities outlined for each level.

All Queensland Health staff are expected to complete the mandatory Keeping Everyone Safe training (available on iLearn via the Employee Dashboard) and are encouraged to complete the Introduction to DFV online module. This aligns with Capability Level 1 under the DFV Capability Framework.

Queensland Health clinicians and staff who work with patients are also encouraged to complete the Clinical Response to DFV learning package within six months of commencing in their role. This aligns with Capability Level 2 under the DFV Capability Framework.

Contact a DFV specialist in your Hospital and Health Service for more information about training opportunities and upskilling. Please refer to the DFV Toolkit of Resources on QHEPS.

Documentation

Health professionals should refer to local policy and guidelines to guide documentation relevant to their profession. Documentation of relevant information about what a person has disclosed to you or something you have seen or heard during your appointment is important for ongoing care and legal purposes.

Always document details about the PuV (name, date of birth, and relationship). Knowing this can assist with further risk assessments if the patient presents with injuries or other DFV‑related health issues.

Legal documents related to risk assessment and managing a serious threat to a patient’s safety, such as a copy of a Domestic Violence Order (DVO), a Temporary Protection Order (TPO) or a Police Protection Notice (PPN) can be supplied by the patient or shared by a prescribed agency and marked confidential and accessible on a patient record.

Information sharing

Part 5A of the Domestic and Family Violence Protection Act 2012 (DFVP Act) enables relevant entities to share information on a confidential basis for the purpose of assessing or responding to a serious domestic and family violence threat, in the interest of maximising the victim-survivor's safety, protection and wellbeing.

Where requirements outlined in Part 5A are met, confidential information may be shared with relevant entities to:

1. Assess whether there is a serious threat to a person’s life, health or safety because of DFV, or
2. Lessen or prevent a serious threat to a person’s life, health or safety because of DFV.

For more guidance around information giving, receiving and using information under the DFVP Act, refer to the Queensland Health Information Sharing for Domestic and Family Violence Guideline or reach out to a DFV specialist within your HHS, or your HHS Legal Services.

Relevant Legislation

In March 2024, the Queensland Government passed the Criminal Law (Coercive Control and Affirmative Consent) and Other Legislation Amendment Act 2024 which amended the Criminal Code to establish the criminal offence of coercive control in Queensland.  From 26 May 2025, coercive control is a criminal offence in Queensland and carries a maximum penalty of 14 years due to the serious nature of the offence and the harm coercive control can cause victim-survivors. For more information, please refer to the Coercive Control Factsheet.

The changes to the law also include an amendment to the Evidence Act 1977 to expand the use of preliminary complaint evidence. Historically, this type of evidence was only admissible in proceedings for a sexual offence. From 23 September 2024, this type of evidence is also admissible in a committal proceeding or trial for a DFV offence charged after 23 September 2024, regardless of when the alleged conduct occurred.  A preliminary complaint is a disclosure made by the victim-survivor about their experiences of DFV before they make their first formal witness statement to a police officer.  For further details, please refer to the Preliminary Complaint Factsheet.

• Domestic and Family Violence Protection Act 2012
• Criminal Law (Coercive Control and Affirmative Consent) and Other Legislation Amendment Act 2024
• Child Protection Act 1999 and Child Protection Reform Amendment Act 2017
• Human Rights Act 2019
• Information Privacy Act 2009
• Hospital and Health Boards Act 2011
• The Privacy Act 1988
• Multicultural Recognition Act 2016

Related documents

• Telehealth and domestic and family violence factsheet - suggested script
• Queensland Health Information Sharing for Domestic and Family Violence Guideline
• Domestic and Family Violence Information Sharing Guideline 2017
• Domestic and Family Violence Common Risk and Safety Framework
• Antenatal Screening for Domestic and Family Violence Guideline QH-GDL-456:
• Reporting Concerns of Child Abuse and Neglect to Child Safety and Sexual Offences Against Children to the Police Guideline QH-GDL-948:2015
• Queensland Health Telehealth Strategy 2021-2026
• Telehealth Information for Patients and Families

Definitions

Document approval details

Document custodian

Belinda Lewis, Director, System Policy Branch, System Policy and Planning Division

Approval officer

Tricia Matthias, Executive Director, System Policy Branch, System Policy and Planning Division

Approval date

16 December 2025

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