This blog from Professor Caroline Bradbury-Jones (@jones_bradbury) starts our week-long focus on violence and abuse. Caroline leads a research programme at the University of Birmingham called Risk Abuse and Violence that undertakes national and international research and scholarly work. Caroline was also part of a team who together with colleagues at Nottingham University HELM and Universitas 21 Health Sciences group produced a free to access reusable learning object to help us learn about Gender Based Violence and our role as health care professionals.
It has been utterly devastating to watch the news over the past weeks and months reporting the daily death toll due to COVID-19. Entire nations have gone into lockdown in a bid to slow the transmission of the virus. The world awaits a vaccine and until we have one, social distancing and isolation are likely to remain, in at least some form. In the UK, we have been advised that this could extend into 2021. Although some countries have begun to ease their rules on restriction of movement, there are fears and uncertainties about subsequent outbreaks and so exiting lockdown is going to be a long, tentative process.
Social distancing and isolation are difficult for most people, but there are some people for whom the measures taken to tackle COVID-19 have been catastrophic. The solution to a problem should not create greater negative impacts than the problem itself, but unfortunately lock down has had significant impacts on rates of domestic violence. Refuge, one of the leading domestic abuse organisations in the UK, has reported that calls to its National Domestic Abuse Helpline, have spiked significantly during the lock down, with an average increase of around 50% in calls and over 400% in visits to its website since lock down began. Refuge point out that the stay at home measures are a critical part of the Government’s strategy to save lives during the pandemic, but it is important to consider the implications of lock down when home is not a safe place. As Refuge (2020) puts it: ‘for many women, isolating with an abusive partner is a matter of life and death – in a very different way’. The increased rates of domestic violence are because home is where dynamics of power can be distorted and subverted by those who abuse. The restrictive measures of lock down play directly into the hands of people who abuse through tactics of coercion, control and surveillance. Moreover, they shut off avenues of escape, help-seeking and ways of coping for victim-survivors. Violence and abuse are able to take place literally ‘behind closed doors’ and out of the view of other people (Bradbury-Jones & Isham 2020).
So what does all this mean for nursing and nurses? In a broad sense it is important to think critically about idealised representations of home and family and to understand that home is far from a safe haven for many people. Nurses in many settings have a crucial role in identifying and responding to domestic violence. The current situation calls for a ‘hyper-awareness’ among nurses to fine tune their domestic violence radar. This is not solely for patients and clients, but also colleagues, family and friends. It does not require specialist skills, rather a mindfulness of the potential for domestic violence to be a problem in a person’s life. Nurses can be reassured that if done sensitively and safely, most people are not offended by being asked if all is OK at home and crucially, asking someone who is experiencing domestic violence, could be like throwing them a lifeline.
Once we get a vaccine for COVID-19, we can eradicate it, but there is no vaccine for domestic violence. As part of a public health approach however, we can still do much to tackle it. Programmes for the primary prevention operate at population-level, and tertiary prevention is offered by services to support victim-survivors of domestic violence. A crucial part of secondary prevention is in nurses’ identification and response to domestic violence and in the COVID-19 pandemic, the fine-tuned domestic violence radar is essential.
Bradbury-Jones, C. & Isham, L. (2020) The pandemic paradox: The consequences of COVID-19 on domestic violence, Journal of Clinical Nursing, DOI: 10.1111/jocn.15296
Refuge (2020) Refuge response to Home Affairs Select Committee report on domestic abuse during Covid-19. Available: https://www.refuge.org.uk/refuge-response-to-home-affairs-select-committee-report-on-domestic-abuse-during-covid-19/
Freephone 24-hour National (UK) Domestic Abuse Helpline: 0808 2000 247
Open Access resource on Gender Based Violence: https://www.nottingham.ac.uk/helmopen/rlos/safeguarding/gbv/#