Feature
Keeping Christmas safe
As rates of family violence increase over the holidays, it is important to remember that Christmas is not a happy occasion for all.
This article was first published in 2018.
Most have happy associations with Christmas as a time to enjoy with family and friends.
But Dr Elizabeth Hindmarsh, Chair of the RACGP Specific Interests Abuse and Violence network, emphasises the importance of remembering that Christmas is not fun for everyone.
‘The risk of family abuse and violence increases at this time of the year,’ she told newsGP.
Research shows the numbers of hospitalisations caused by a spouse or partner assault increased by about a third between the winter and summer months. Events such as Christmas and New Year’s Eve showed a particular spike in numbers, and can serve a trigger for family violence for a range of reasons.
‘Families spend more time together [at Christmas], there’s more use of alcohol and drugs,’ Dr Hindmarsh said. ‘And it seems to be a time that brings up conflict in families.’
The trusted and often regular nature of the GP–patient relationship make GPs well-placed to enquire about, and assist, patients who are experiencing family violence. Dr Hindmarsh had some helpful advice to help start the conversation.
‘[It helps to] talk to our patients in a way that acknowledges [the fact] we know Christmas isn’t a good time for everybody,’ she explained.
‘Then, in that context, you might ask them what happens at Christmas. For some it is a lonely time when they have nowhere to go, and for others it is a time when conflict occurs. We could ask about the likelihood of conflict and whether they are afraid of what might happen.
‘If there is a risk of conflict, we could talk about how to keep safe and invite them back in the new year to discuss this further – this could be early intervention in a family abuse and violence situation.’
Although these issues may be uncomfortable, Dr Hindmarsh believes it is often important to raise them, especially as the issue can often be well hidden.
‘[Family violence] is really quite common in our community, and people don’t usually come to general practice and say this is what’s happening to them,’ she said.
‘So we need to be asking. It’s about listening, believing, not judging, asking, and then looking at safety.’
Dr Hindmarsh points out that family violence can also have a wider definition than many people usually consider.
‘It can be more than just between husband and wife,’ she said. ‘A number of different family relationships can become abusive or violent. For example, it could be between grandparents and extended family, children.’
Although some concerning beliefs about family violence still persist in Australian society, attitudes have changed considerably over time, a trend that Dr Hindmarsh has been heartened to see and hopes will continue into the future.
‘The attitude in the community used to be “It’s none of my business”,’ she said.
‘[Now] people do see that it’s not just a personal issue and they should be ringing the police, or talking to their families or supporting each other better.
‘It’s about encouraging us all to not be bystanders, but to do what we can to help when we become aware that something is happening.’
Resources for GPs
The RACGP offers Abuse and violence – Working with our patients in general practice (the White book), of which Dr Hindmarsh was a clinical editor. Developed for GPs by GPs, this resource contains evidence-based information, tools and resources (including webinars and videos) for dealing with family violence in general practice. It can help GPs to recognise the signs of family violence among patients in consultations as well as provide practical assistance to patients who are experiencing it.
GPs can also take part in the RACGP’s Professional development program on family abuse and violence, which provides effective resources to support GPs assisting families who are experiencing violence.
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abuse and violence family violence intimate partner violence the White book
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