Medical doctors are important frontline responders

Of the direct costs of domestic violence, medical costs that stem from medical diagnostics and treatment are the highest. This includes costs of treatment, mental health problems (e.g., alcohol and drug dependence, depression, anxiety), increased rate for non-communicable diseases (e.g., cancer, cardiovascular diseases) and reproductive health problems (e.g. unintended pregnancy, HIV and other sexually transmitted infections, low birth weight babies, spontaneous abortion; De Sousa, Burgess, & Fanslow, 2015). Not surprisingly, a great number of victims have to seek help from the medical profession at some point because of health-related issues that are consequences of the abuse they had to suffer from.

At the same time, measures are taken on different levels to combat domestic violence, but the victims of domestic violence are more likely to talk with friends and relatives than with members of the professional help system about the abuse (WHO, 2005). Thus, one of the most important goals in the fight against domestic violence is to draw more victims into existing help systems/networks. The fact that victims seek help from the medical profession because of health-related consequences of the abuse or because of other non-domestic violence related health issues the medical profession can be an important entry point to help networks for victims. Physicians are often the first third party outside friends and family, who either hear about the incident of violence or he/she is the first one who see clues and symptoms pointing towards a potential incident of domestic violence. They have an opportunity to identify victims of domestic violence relatively early and are also the ones who can secure evidence in a court-proved manner.

Based on our fieldwork in IMPRODOVA we know that, unfortunately, even though many victims of domestic violence consult a physician, domestic violence is seldom addressed at practice visits to the physician and knowledge about symptoms and signals of domestic violence is limited in the medical sector. One reason seems to be that physicians too rarely consider themselves as frontline responders to domestic violence and the medical profession in general is too infrequent an active partner of any networks fighting domestic violence.
An active involvement of the medical profession like physicians and other health care staff in these networks would be of high importance. In line with this, the medical profession is already mentioned in the Istanbul Convention (Chapter 4 Article 18.114; Chapter 4 Article 20.127; Chapter 4 Article 22.132; Chapter 4 Article 25.141) as an important stakeholder.

References

Council of Europe (2011). Convention on preventing and combating violence against women and domestic violence. Council of Europe Treaty Series - No. 210. Retrieved from:
www.coe.int/conventionviolence

De Sousa, J., Burgess, W., & Fanslow, J. (2015). Intimate Partner violence and women's reproductive health. Obstetrics, Gynaecology and Reproductive Medicine, 24, 195-203.

World Health Organization (2005). WHO multi-country study on women's health and
domestic violence against women. Retrieved from https://www.who.int/reproductivehealth/publications/violence/24159358X/en/

* www.improdova.eu; IMPRODOVA is a research and innovation project concerning human factors shaping responses to domestic violence. The project studies responses to domestic violence in eight European partner countries (Austria, Finland, France, Germany, Hungary, Portugal, Scotland and Slovenia) to improve and integrate the response of police, social work, health and non-governmental organizations. The current frontline response was explored by more than 290 interviews that were conducted with various frontline responders

2019-10-22 by By Prof. Dr. Dr. Bettina Pfleiderer & M.Sc.-Psych. Lisa Richter, Research Group Cognition & Gender, Medical Faculty, University of Münster (Germany)