Note: The Office of the Chief Psychiatrist is working to update clinical guidelines and reporting directives under the Mental Health and Wellbeing Act 2022. Clinical mental health service providers can continue to use these guidelines referencing the Mental Health Act 2014 - these remain current until further notice.
Key messages
- Family violence is a fundamental violation of human rights and is unacceptable in any form.
- Mental health services have a responsibility to address family violence. Mental health clinicians are expected to become skilled in recognising, understanding, enquiring about and responding to family violence. They are not expected to become family violence specialists.
- Effective responses to the needs of women, children and others experiencing family violence should be integrated into usual mental health care. Equally, responding to people who perpetrate violence must be part of mental health care.
Family violence takes many forms and covers a wide spectrum of behaviour. It includes physical, sexual, psychological, financial and emotional abuse or coercion, and other behaviours that hurt, frighten, intimidate, humiliate or isolate another person. Appendix 1 contains a full definition of family violence from the Family Violence Protection Act 2008 (Vic).
Examples of family violence include stalking, neglect and abuse of children, cruelty to pets, damage to property, financial abuse and preventing a person from interacting with others.
Perpetrators' attempts to exercise power and control over another person can escalate over time. Although every experience is unique, family violence is not a one-off incident for most victims/survivors. Family violence is understood as a pattern of repeated and coercive control, aiming to control another person's thoughts, feelings and actions.
While family violence remains one of the most underreported crimes, police data show alarmingly high rates of violence. Victoria Police recorded 76,497 family violence incidents in 2016 -17, with women comprising three-quarters of the victims. Family violence accounts for 17.5 per cent of all crime in Victoria.
Family violence is a major public health problem across the world and is associated with many serious physical and mental health impacts.
Most victims of family violence are women and children and most perpetrators are men. However, both men and women can be perpetrators or victims of family violence (see the box on the following page). The most common and pervasive instances of family violence occur in intimate partner relationships. Gender inequality has been identified as the leading cause of family violence, particularly intimate partner violence.
However, violence can occur in all types of families, kinship networks and intergenerational relationships. Lesbian, gay, bisexual, transgender, intersex, queer and asexual (LGBTIQA+) people experience violence in their relationships. Family violence can be perpetrated by young people against their parents or siblings, or by adult children against their elderly parents (elder abuse). Some family members and non-family carers perpetrate violence against people they care for, and violence is sometimes perpetrated against carers.
Certain people or communities are at higher risk of experiencing family violence. They are also more likely to experience barriers to accessing services or to receiving an appropriate response. The section on 'diversity and intersectionality' in this guideline provides further information.
About this guideline
The guideline outlines expectations of mental health services managers and clinicians regarding their roles in responding to family violence.
Scope and focus
The guideline applies to publicly funded clinical mental health services in Victoria, including all service settings (mental health inpatient units, community teams, subacute services, residential services, emergency departments and general hospital inpatient units) and services delivered in people's own homes. The document may also be used by private mental health services and mental health community support services; however, the Chief Psychiatrist does not direct these services.
The guideline focuses predominately, but not exclusively, on women and children as the main victims/survivors. Other forms of family violence are recognised, and the guideline provides information and practice suggestions to work with diverse groups, including men who use violence.
Sections
While the guideline can be read in its entirety, it has been organised into different sections that can be lifted out, copied and used in practice as prompts. The key messages, for example, could be copied and displayed to remind all clinicians of their responsibilities.
Reviewed 06 December 2023