Call for GPs’ role expansion in responding to partner violence

GPs must be given more help in recognising and responding to intimate partner violence, according to a new national survey that reveals almost 45% of participants reported experiencing at least one form of intimate partner violence.
 
Published this week, the study of more than 7000 Australians concluded that intimate partner violence is ‘widespread in Australia’, and that practitioner education and systemic change is needed to support care of impacted patients.
 
Researchers recorded prevalence of reports of physical violence, sexual violence and/or psychological violence from 7022 participants aged 16 or above who had been in intimate relationships according to gender, age group and sexual orientation.
 
The prevalence of participants experiencing any intimate partner violence was 44.8% overall.
 
They found 29.1% of people reported experiencing physical violence, 11.7% reported sexual violence and 41.2% reported psychological violence.
 
It reveals that the lifetime prevalence of experiencing intimate partner violence is high, especially among women, and more women reported experiences of each type of violence than men, at 48.4% and 40.4% respectively.
 
More non-heterosexual people reported intimate partner violence than heterosexual people, 70.2% compared to 43.1% respectively, and among gender-diverse participants, 62 of 88 people reported intimate partner violence.
 
The researchers conclude that national intimate partner violence prevention strategies ‘have not yet achieved their objectives’ and are now calling for a long-term approach to risk factors including socioeconomic conditions and societal and structural discrimination against women.
 
They also highlight that health systems and clinical practice ‘can also contribute to primary prevention and early intervention’ by helping those most at risk.
 
‘Practitioner education and system change is required to support violence-informed, trauma-informed, and gender-informed patient care,’ they wrote.
 
‘A comprehensive national prevention policy is needed, and clinicians should be helped with recognising and responding to intimate partner violence.’
 
Dr Wei-May Su, Chair of RACGP Specific Interests Abuse and Violence in Families, said Australians are developing an ‘increased awareness’ of what constitutes abuse and violence, but change can still take time.
 
‘Often, when people are on their recovery journeys, it can take them a good 10 to 15 years to even recognise what they’re experiencing is abuse, particularly if it’s psychological,’ she told newsGP.
 
Dr Su notes the study also shows younger participants are more likely to report abuse than older respondents, which she suggests could be due to older people not recognising some forms of abuse.
 
‘Thinking about my own clinical practice, often when I work with people who are older, there’s sometimes a normalisation within sub-cultures about what behaviours are okay, and what behaviours actually constitute abuse,’ she said.
 
‘They may not even have a recognition that what they’re experiencing is not okay.’
 
Even within general practice, Dr Su said some clinicians may not recognise forms of abuse.
 
‘If within the community we don’t recognise some of these behaviours as not being okay, there’s a lot of unpacking and learning within a clinical context,’ she said.
 
Dr Su said it is important for clinicians to help ease any shame or guilt a patient might be feeling about what has happened to them.
 
‘They might justify or externalise that “they did this behaviour because I did this”,’ she said.
 
‘Nobody deserves to have violence against them. There should not be shame in being the recipient of violence. That’s a really important conversation for us to have.’
 
Dr Su also asks for GPs to not be concerned about ‘doing things wrong’.
 
‘A lot of GPs often feel a little bit concerned that they might do things wrong, they might exacerbate the violence or do the wrong thing,’ she said.
 
‘But what I’m hoping is that we can set GPs up with the right tools and frameworks, so that at whatever level they feel comfortable engaging in this work, there’s something that they can provide meaningfully.’
 
The study’s release comes as a new series of four RACGP frameworks for GP supervisors, medical educators and training for registrars is released this week.
 
They are intended to guide supervisors or educators in how to support a general practice registrar working with patients affected by abuse or violence, with each focusing on a different aspect.
 
‘I’m really excited about that because what we’re recognising is that it’s such a highly prevalent issue,’ Dr Su said.
 
The RACGP’s Abuse and violence: Working with our patients in general practice (the White Book) is another practical resource for GPs.
 
If you need help immediately call emergency services on triple zero. If you or anyone you know needs help, call 1800 Respect on 1800 737 732, the Men’s Referral Service 1300 766 491, the Women’s Crisis Line on 1800 811 811, or Lifeline on 131 114.
 
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domestic violence intimate partner violence physical violence psychological violence sexual violence