Family violence – identifying and responding

The high prevalence of family violence and experiences of abuse among women and men accessing Victoria’s mental health services can present especially difficult challenges for service providers.

The guide for mental health clinicians on Identifying and responding to family violence provides information and contacts to assist staff in identifying, responding to, and collaborating on issues of family violence.

Although family violence is most commonly perpetrated by one partner towards another, it can also include abusive, coercive or controlling behaviour by an adult towards a child, between siblings, or towards an older person.

Impact of family violence on mental health

There is strong evidence linking mental illness with family violence, which can trigger a mental illness or severely impact the capacity of people to recover from one.

Mental health services have a unique role in responding to family violence and in monitoring the safety of individuals in their care:

• Women with mental illness can be more at risk of family violence due to higher levels of vulnerability and dependency on their partners, which can often make it difficult for them to leave a violent partner.
• Disclosures about family violence or incidents of violence by people with a mental illness require sensitive care and management and a coordinated response from the mental health team.
• Responding effectively to family violence requires supportive and non-judgemental attitudes, knowledge of the long-term consequences of violence, an understanding of appropriate responses, and strong relationships and collaboration with local family violence services.

Identifying family violence

It can be difficult for clinicians to identify family violence. Women do not generally present with obvious physical injuries, and are often reluctant to disclose abuse because of fear, shame, or a feeling that the clinician will simply not be interested.

Victims of family violence can present with a variety of symptoms:

• Symptoms including anxiety, depression or stress-related illness, drug and alcohol abuse, chronic headaches, diarrhoea, sleeping and eating disorders, suicidal feelings and gynaecological problems.
• Physical injuries such as bruising and lacerations.
• They may appear nervous or evasive, give unconvincing explanations of their injuries, or be accompanied by their partner, who will often do most of the talking.

It is very important for clinicians to listen carefully to any particular concerns expressed by women about their partners and to encourage them to be specific about any violence they describe.

The guide to identifying and responding to family violence

Identifying and responding to family violence provides clinical staff with advice on:

• asking women about violence and responding to their disclosures
• helping women assess their and their children’s safety
• responding to men about disclosures that they are violent towards family members.

The guide also presents comprehensive lists of referral services, legal services and a region-by-region guide to domestic violence services, sexual assault services, and victim assistance and counselling programs.

Service guideline on gender sensitivity and safety

The Department’s Service guideline on gender sensitivity and safety offers detailed advice to mental health services on:

• enquiring and responding to disclosures of violence
• providing support and referrals
• assessing the protection needs of children.

Services are encouraged to design their own policies and training programs on family violence and to display information prominently in public areas to demonstrate their willingness to talk about family violence and provide support to victims.

The Mental Health Branch has also issued a series of specific recommendations as part of its Building partnerships between mental health services, family violence and sexual assault services project, which aim to promote collaboration and referrals between service providers and to improve the care environment and clinical outcomes for women who have experienced family violence.

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