Other issues
Health professionals need training to
increase their awareness, knowledge, understanding of family
violence and attitudes to domestic violence and children’s issues.
Although training programmes for domestic violence have yet to be
adequately evaluated (26) there are models available which address
the issue of domestic violence for the children, including the
Department of Health’s document “Domestic violence: A resource
manual for health care workers” (6), which could be adapted for
local use.
- The needs of high-risk and less
accessible groups
Women and children living in refuges are
the most easily identified high-risk group who may have experienced
both domestic violence and child abuse. Primary care professionals
need to recognise that these individuals have a significant risk of
mental health problems and they often have unmet health needs, such
as immunisations or dental problems. They are a peripatetic
population, whose accessibility to services may be transient, and
they deserve proactive support and care from the practice (20).
Primary Care Organisations need to ensure the provision of primary
care to refuges and to accept that additional resources, such as
counselling, should be resourced adequately.
There are particular language and cultural issues for ethnic
minorities, especially in the situation when children are asked to
act as interpreters. Practices need to be able to work with
impartial interpreters that they trust routinely so that they can
consult with women without the presence of their families.
Children and mothers with disabilities may have particular
difficulties when there is family violence; they may be dependent
on the perpetrator for practical care or have established care
packages at home that make it difficult to leave.