GP recognised in shifting ‘enormous blight’ on society

Dr Libby Hindmarsh is a pioneer in supporting GPs to recognise and respond to family abuse and violence and improving care across communities – but, she says there is still much to be done.
 
A leader in implementing a whole-of-family, culturally safe approach, Dr Hindmarsh was the inaugural Chair of RACGP Specific Interests Abuse and Violence in Families, co-editor of the college’s Abuse and violence: Working with our patients in general practice (the White Book), and involved in development of family violence training for primary care.
 
Her work has shaped the way health professionals and educators understand and respond to family abuse and violence and embedded this work at the core of general practice.
 
For this, Dr Hindmarsh was awarded the RACGP’s inaugural Morton Rawlin Award.
 
‘For me, it’s a very special honour and a real privilege that what I’ve done in this area has been recognised,’ she told newsGP.
 
Presented for the first time at the GP25 conference, the award recognises a GP who has ‘contributed substantially’ by developing an interest in a specific area based on the needs of their community, demonstrating a commitment to improve health and wellbeing.
 
Awarded for her visionary work in addressing family abuse and violence within general practice, Dr Hindmarsh humbly adds credit to Professor Kelsey Hegarty, Director of the University of Melbourne’s Safer Families Centre.
 
‘We have done a lot of work together and … I can remember a long time ago saying to her that we [GPs] are trying to teach this without sufficient evidence,’ Dr Hindmarsh said.
 
‘So through the Safer Families initiative, we now do have a great deal more evidence for what works and part of that is running these whole-of-practice training courses.’
 
With GPs often the first point of contact for patients to disclose experiences of family abuse and violence, the White Book is used nationally and internationally to guide GPs in responding. It includes recommendations for trauma and violence-informed care, clinical training and state and territory resources.
 
Now in its fifth edition, Dr Hindmarsh says this ‘very important piece of work’ is due for a revision, with greater consideration given to support for GPs to work with perpetrators as well as survivors through tailored education.
 
‘We need to be able to identify the patients we have who are perpetrators and be able to encourage them to seek appropriate help,’ she said.
 
‘But that’s even more challenging and we’ve had no training in that, but clearly they’re coming to our practices.
 
‘Also, it’s really an impossible task to be looking after the victims, the children and the perpetrator at once – we need to find ways of being able to manage that within our general practices, and that is often quite difficult in country practices where there’s only a small number of GPs.
 
‘So there’s still lots to be done.
 
‘We need to be giving more encouragement, teaching and support to GPs. This is not easy work to do, and the way I survived in my practice is that we had group supervision every week.’

Dr Libby Hindmarsh with RACGP Specific Interests Chair Dr Jeremy Hudson at the awards ceremony. (Image: Jake Pinskier)
 
Many GPs report working in family abuse and violence as challenging and they feel unsupported and unsure they are responding appropriately.
 
Dr Hindmarsh believes all GPs should be involved in peer support or another form of supervision to arm them with more confidence to support patients, but she acknowledges the situation can be difficult to navigate.
 
‘First of all, you’re asking and you’re believing, and then you’re saying that you want to stand by them as they negotiate how they’re going to manage this,’ she said.
 
‘Which is very much the technique GPs use with what you would call social issues, but this is an issue where this person might die. We know that one woman is dying every week in Australia from some form of family abuse and violence.
 
‘So, it is a very fatal social issue and certainly it’s having an enormous impact on our children.
 
‘It is an enormous blight upon our society, and GPs can’t solve it, but we need to be part of an organisation that helps to identify it to help these people find ways out of this situation.’
 
Despite retiring two years ago, Dr Hindmarsh has laid the valuable groundwork in primary care, and is grateful for the next generation of GPs working in this space, including current Chair of RACGP Specific Interests Abuse and Violence in Families, Dr Wei-May Su, and Monash University Associate Professor Jenny Neil.
 
‘I decided that the younger ones needed to be taking this on, and I’m just so thrilled that they and many others see this as an such an important issue,’ she said.
 
‘I feel very hopeful that the work will continue, but those people need to be supported.’
 
In addition to the RACGP’s White Book, the December issue of the Australian Journal of General Practice focuses on domestic and family violence.
 
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abuse and violence family violence general practice education RACGP Awards RACGP Specific Interests