A Toolkit for GPs in NSW

According to figures released by the NSW Bureau of Crime Statistics and Research last June, domestic violence- related assaults were up by 6%.

Although the jump is concerning, experts were quick to add that the figures reflect an increase in reporting due to greater public awareness, rather than an increase in violence.

“Of greater concern is that on average one women per week is killed by a current or former partner in Australia. Already there have been 48 deaths this year,” says Helen Campbell, Executive Officer of Women’s Legal Service NSW.

Doctors have a vital role to play in reducing domestic violence, Ms Campbell adds. Over 1 in 5 women make their first disclosure of domestic violence to their GP. It is estimated that every week, a general practitioner sees up to five women who have been abused by their partners, of which the GP may not be aware. Research indicates one in 10 women attending general practice have been afraid of their partners in the previous 12 months, and one in three women have experienced fear of a partner over their lifetime.

To help medical professionals identify and respond to patients and their children, the Women’s Legal Service NSW created the GP Toolkit, ‘When she talks to you about the violence’.

This easy to use, concise and accessible resource guides doctors on what to look for, how to talk to your patients about it, safety planning, useful referrals and how to make notes and protect privacy. It also addresses how to respond if your patient is the perpetrator, or if both parties are your patients, and your obligations in relation to children.

The GP Toolkit was first launched in 2014 but was recently updated to include information on strangulation and changes to tenancy laws.

“It is now recognised in law and in police operating procedures that non-fatal strangulation is a strong indicator of escalating and potentially lethal violence,” Ms Campbell says.

The kit includes detailed information about detecting and recording symptoms, as well as advice about ongoing monitoring for subtle and delayed symptoms.

In addition, there have been recent changes to tenancy laws to allow a victim of domestic violence to end a tenancy early without penalty.

Evidence is required to do this, which in many cases will be reports or apprehended violence orders from police.

“However, many women do not want to get police involved, but do want to get away to a safer place. In this situation a doctor can make a declaration for the patient to use in support of her application to end the tenancy. This declaration does not require proof of any particular event and is based on the doctor’s statement of belief in good faith that the patient has disclosed that she is experiencing, or in fear of, violence from her partner,” Ms Campbell says.

To provide a declaration, the medical practitioner must have consulted with the victim of domestic violence in the course of their professional practice. The victim can be the tenant or the tenant’s dependent child.

Some minor changes to these laws commenced on 26 November 2019. The changes include a clarification that medical practitioners are authorised to collect, hold, use and disclose personal information about a relevant domestic violence offender in order to make a domestic violence declaration for their patient.

Medical practitioners can proactively help a victim escape domestic violence in a rented home by telling patients about the protections available to them.

As explained in the GP Toolkit, domestic violence is broadly defined as an abuse of power within a domestic relationship, or after separation, and does not have to be physical violence. There is more detail in the toolkit about the types of domestic violence your patient may be subject to.

Most victims of domestic violence are women. Research indicates women are at greater risk of violence from their partners during pregnancy, or after separation. According to the 2016 Personal Safety Survey, nearly half of women who had experienced violence by a previous partner and who were pregnant during that relationship, experienced violence from their partner while pregnant.

“In any situation of domestic violence, we know how valuable the victim’s relationship with her doctor is to accessing support and seeking safety,” Ms Campbell says.

“There is evidence showing how highly trusted and valued the confidential doctor-patient relationship is. And we know how much doctors want to help, and to see a safe outcome for their patients. Sometimes this can be frustrating as many victims may be afraid to leave, lack self esteem and be unsure of what to do, or for a variety of reasons not follow through on suggested referrals to support services.”

According to Department of Communities and Justice, on average, a woman may leave her abuser seven to eight times before she breaks away for good.

Ms Campbell adds, “Patience is essential, as it can take several attempts to make a successful escape. Continuing to show that you believe and support your patient in whatever she decides to do, or when she decides to do it, is vital. The Toolkit will help with setting out and implementing a safety plan over a period of time.”

You may be able to help patients experiencing domestic violence access financial support through the victims support scheme and/or the Centrelink crisis payment. The Toolkit explains time limits and what doctors can provide by way of documentation to assist patients in making these applications.

The toolkit is available free of charge, you can download it or order copies to be posted to you on the Women’s Legal Service NSW website.