Bringing family violence out of the shadows

‘Violence does not always present with bruising.’
 
These are the words of caution Rosie Batty, a survivor and fierce advocate against family violence, has for GPs across the country.
 
This month marks 11 years since her son Luke was murdered by his father.
 
The horrendous act had followed years of abuse directed towards Ms Batty.
 
To equip GPs with the tools, knowledge, and resources to identify, respond to, and support families affected by violence, the RACGP is hosting ‘A Safe Space: Empowering GPs to Support Families Affected by Violence’ on 29 March, and Ms Batty is one of the keynote speakers.
 
With GPs being the most accessed health professional in Australia, she says they have ‘one of the most critical roles’ when it comes to supporting people experiencing family violence.
 
‘Why we are going to the doctor is often not to disclose the situation that we may be in at home, and so it’s really important for a GP to be mindful of what else may be happening in the family,’ Ms Batty told newsGP.
 
‘It’s understanding the different forms of violence and how that may affect the mental health and disposition of each of the family members.’
 
Ms Batty was in this exact position.
 
While she had a regular GP she trusted – a relationship that was further strengthened through the support she received following the loss of her son – she admits to never disclosing her experiences of abuse.
 
‘I didn’t involve her with my experiences of family violence, but as a result of my domestic abuse, I was struggling with increasing anxiety, which escalated after an assault where I then required anti-anxiety medication,’ Ms Batty recalls.
 
‘I wasn’t really sure what it was, but I wasn’t able to function properly without that medication, which I was on for three years.
 
‘In the past, a doctor and the health system did not have the sophisticated and appropriate knowledge to know how to recognise, to know what to do, and to know who to and how to refer and support.
 
‘[But] when you understand the complexity and the confidentiality required, and the trust, that’s a very key role when you may also be treating the perpetrator.’
 
The statistics of domestic and family violence in Australia are sobering.
 
In 2021–22, one in six women, and one in 18 men, had experienced physical and/or sexual violence by a current or previous cohabiting partner since the age of 15. While one in four women, and one in seven men, had experienced emotional abuse.
 
That same year, on average 13 women and girls aged 15 and over were hospitalised due to family and domestic violence.
 
One woman is killed every nine days by a current or former partner.
 
But even for those who do receive the support to leave a family violence situation, Ms Batty says it is important for GPs to remember that it is unlikely to end there.
 
‘It’s an ongoing situation,’ she said.
 
‘A woman and her children are at the greatest risk of harm, an escalating risk of more severe harm and potential fatalities, when they’re planning to leave or have more recently left.
 
‘It’s understanding the risk factors and the appropriateness of the role that you can play.’
 
Through her advocacy over the last 11 years, Ms Batty says she has come to understand that any change is a ‘very slow journey’, but she has hope that more awareness among health professionals can speed up that process and save lives.
 
As in Ms Batty’s case, where she presented with heightened anxiety due to the abuse she was experiencing, she encourages GPs to question any changes in a patient’s mental health status.
 
‘There is expertise in gently asking, “Are you safe? Do you feel safe at home?” It’s recognising that you may have reservations and concerns, and then it’s recognising that this could be family violence,’ she said.
 
‘And, ultimately, then what do you do with that answer?’
 
Ms Batty says many people experiencing family violence may be weary of any police involvement, particularly if English is not their first language and they are from overseas.
 
Instead, she says supplying them with the contact details of 1800 RESPECT, or a crisis centre, can be helpful in the instance that the violence escalates.
 
However, for true change to occur, Ms Batty says there needs to be accountability for perpetrators. To help achieve this, she says it is important GPs know how to navigate patients who they suspect may be perpetrating violence.
 
‘What we have always done is place an onus of responsibility on the victims’ shoulders for their safety,’ she said.
 
‘But do GPs know how to refer and respond to, or look for that perpetrator’s face? Because without accountability, without intervention, the violence continues.
 
‘As important as it is to keep women and children safe, it is as important to know how to engage more men who are potentially becoming more aware of their behaviours and the societal condemnation, without the collusion and the minimisation and excuses that we have hidden behind.
 
‘That’s part of what my journey has been to advocate, to bring it out into the open as a subject, so that it no longer is seen as that dirty little secret that’s able to be kept behind closed doors where it does so much damage.’
 
To help further empower GPs, the RACGP’s event will also include keynote speakers Ian Freckleton, a leading expert in family violence law, Dr Bill Liley, co-founder and managing director of Violence Prevention Australia, and Dr Chelsea Tobin, Chief Executive of Safe Steps.
 
It will conclude with a panel Q&A, where experts from various fields, including addiction, cardiology, and obstetrics, will answer questions and provide practical insights into dealing with family violence in diverse clinical settings.
 
Speaking to Ms Batty ahead of the 11-year anniversary of Luke’s passing, she cannot fathom it has been that long since she last saw her boy, acknowledging the journey to recovery is ‘a long, hard, arduous one’.
 
While she now recognises that she was propelled into advocacy, in part, to help get through her darkest days, her main motivation has always been to help ensure that nobody else has to live through the same hell she has.
 
These days she is more selective about the speaking engagements she takes part in, reserving her energy for audiences she believes hold the biggest opportunity for change – and that includes GPs.
 
‘I do see a journey that involves a doctor, not just through the violence and the crisis itself, but also potentially for those who are able to leave and the recovery and the journey onwards,’ Ms Batty said.
 
‘But it’s that critical point in time where you don’t know where to turn or what to do. It’s really, really critical that … all of these people across that health system appreciate the importance of the work that they are doing.’
 
‘A Safe Space: Empowering GPs to Support Families Affected by Violence’ is an in-person event and will take place on Saturday 29 March at RACV in Melbourne from 9:00 – 4:00 PM. For more information, visit the RACGP website.
 
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