Fully funded longer consultations needed to address family violence

Morgan Liotta

8/04/2021 2:20:41 PM

GPs see up to five female patients per week with abuse and violence underlying their presentation, validating the need for MBS-subsidised plans.

Woman talking seriously with counsellor
Much like mental health issues, longer consultations are needed for people experiencing family violence, according to experts.

In 2016, the Australian Bureau of Statistics found an estimated 1.6 million Australian women had experienced physical or sexual violence from a current or previous cohabiting partner since the age of 15.
Since then, that figure has likely only increased; a recent Australian Institute of Criminology report revealed 22% of women cohabiting with their intimate partner in 2020 had reportedly experienced emotionally abusive, harassing and controlling behaviours.
Amid these statistics, harrowing reports of systemic failures have described the helplessness some women face when trying to escape these situations, which is where Professor Kelsey Hegarty believes GPs can step in.
The Chair of Family Violence Prevention at the University of Melbourne and Director of the Safer Families Centre says while many survivors are isolated from family and friends as part of the abuse, most are still able to see their GP. As such, she is calling for the establishment of fully funded Family Safety Plans for people experiencing family violence, as well as a comprehensive framework for GPs.
‘A full-time GP is seeing up to five female patients per week who have a chronic social condition of abuse and violence underlying their presentation,’ she told newsGP.
‘GPs are the professional told most about current domestic violence, and therefore a key link in the pathway to safety for survivors and their children.
‘Family Safety Plans are currently not implemented, and they may never be, but we are advocating for them.’
Similar to a General Practice Mental Health Care Plan, a Family Safety Plan allows GPs to take extra time with families where family and domestic violence is occurring, to assess their safety and health needs to enable appropriate referrals to specialist workforce.
Professor Hegarty said this could be both for those experiencing family violence, such as women and children, or the perpetrators.
‘Like Mental Health Care Plans, after assessment patients could be eligible for up to 10 sessions with social workers and psychologists trained in trauma-informed care specific to domestic, family and sexual violence,’ she said.
‘The GP would need to review these referrals and provide ongoing care.’
Domestic, family and sexual violence are underlying of many health issues such as depression, anxiety, chronic pain, reproductive and gastrointestinal symptoms, according to Professor Hegarty.
‘We know that survivors want to be asked in a non-judgemental way and will disclose to a trusted GP,’ she said.
Currently there is no mechanism in place to fund the extra time needed upon disclosure to assess, respond and refer all members of a family to appropriate care.
Professor Hegarty is calling for Medicare item numbers and further training for GPs and other healthcare professionals. But GPs need to be wary of potential privacy concerns.
‘It would be appropriate for GPs to have extra training in adult and child safety in the context of family violence to use these item numbers,’ she said.
‘In particular, there would need to be privacy measures in place for those families where inadvertently alerting a perpetrator – through use of the plan’s item numbers to the disclosure of a survivor – might increase the risk for that survivor.’
Training GPs in how to ask and respond to domestic violence increases inquiry and improves survivors’ mental health symptoms, according to Professor Hegarty.
‘This is essential for a pathway to safety and healing, especially for children exposed to domestic violence in these families,’ she said.
‘The chronic mental and physical health of these children in later life are very likely to be improved if this early identification and intervention is put in place.’
RACGP President Dr Karen Price also said it is crucial that people experiencing family violence don’t slip through the cracks.
‘Some women experiencing family violence may meet the criteria for a General Practice Mental Health Plan; however, it is important to remember that some may not. Helping people experiencing family violence requires comprehensive and protective safe care,’ she said.
‘We are supportive of Medicare patient rebates that assist in the development of “family health treatment plans” as part of a national approach to healthcare delivery for women and children experiencing family violence.
‘These will help patients have adequate time with, and support from, their specialist GP.’
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