Domestic abuse can seriously affect physical, emotional, mental and sexual health and can be both chronic and acute in impact. Domestic abuse is perpetrated by a partner or ex-partner and can include physical, sexual, mental and emotional abuse. It is characterised by a pattern of coercive control which often escalates in frequency and severity over time.
- be actual or threatened violence
- happen occasionally or often
- begin at any time.
It is under-reported and the number of incidents is likely to greatly exceed the number of reports made to the police.
Here you can find information on the link between domestic abuse and health inequalities, as well as actions that can be taken to address this.
- 29% of women in the UK have experienced physical and/or sexual violence by a current and/or previous partner since the age of 15.
- In 2016-17 the police recorded 58,810 incidents of domestic abuse in Scotland. In 79% of these cases, the recorded victim was female and the perpetrator was male.
- 38% of LGBT people in a UK study had experienced domestic abuse.
- Almost two thirds of children exposed to domestic abuse also experience physical or emotional abuse or are neglected.
Domestic abuse and health inequalities
Health workers must understand how physical, emotional, mental and sexual health combine to affect how people access and experience health services so that the best care possible can be provided.
Domestic abuse can occur in any intimate relationship and occurs across the whole of society. Although being female is the key risk factor for experiencing domestic abuse, not all women are equally at risk.
Factors such as age, poverty, economic dependence, disability, homelessness and insecure immigration status can heighten women’s vulnerability to abuse or entrap them further.
Minority ethnic women may face barriers e.g. language in accessing services or fear being accused in their communities of bringing shame and dishonour upon their families.
Disabled women may experience communication or physical barriers to getting help or leaving an abuser, or may be isolated because of their impairment. Signs of domestic abuse may also be overlooked and attributed to their impairment.
Young women are at a higher risk of all forms of abuse yet often this can be overlooked or minimised, particularly in their teenage years.
Men can also be abused by their partners and it is important that their needs are recognised and addressed sensitively. They may be reluctant to disclose abuse because of perceived stigma around this, or a fear of not being believed or being judged. Domestic abuse can adversely affect their health, relationships, self-esteem and ability to function.
LGBT+ victims can be threatened with being 'outed' to family, friends and employers or forced to conceal their sexual orientation. They might also have concerns about encountering homophobic attitudes in services and be reluctant to seek support.
Guidance for health workers on understanding domestic abuse, its impact on health and how to identify and respond sensitively is available.
A briefing on the scale of the problem of intimate partner violence and abuse against women, and the available evidence on its ways to effectively prevent, identify and reduce intimate partner violence and abuse is also available.
The Domestic Abuse (Scotland) Act 2018 introduced a specific criminal offence of domestic abuse. As well as physical violence, it includes criminalisation of coercive control - a pattern of abusive behaviour designed to threaten, humiliate, intimidate and control which can take place over a period of time.
National developments to tackle domestic abuse include
- Scotland’s domestic abuse and forced marriage helpline (external site)
- Police Scotland Domestic Abuse Task Force – targets the most prolific and dangerous perpetrators
- specialist domestic abuse courts - fast tracking domestic abuse cases and providing domestic abuse trained Sheriffs and Procurators Fiscals
- The Caledonian System court mandated perpetrator programme
- Creation of third party reporting centres (external site)
- Online reporting (external site)
- Disclosure Scheme for Domestic Abuse Scotland (external site) which aims to prevent domestic abuse by empowering both men and women with the right to ask about the background of their new partner.
Routine enquiry of domestic abuse
NHSScotland has a programme of routine enquiry in mental health, sexual health, maternity, substance misuse, and Health Visiting services
Local developments to tackle domestic abuse include
- Independent Domestic Abuse Advisors (IDAAs) – provided through Women's Aid (external site) and ASSIST (external site)
- new approaches to working with children and families – such as CEDAR programme (external site) and Safe and Together Model (external site)
- most local authority areas having regular Multi-agency Risk Assessment Conferences (MARACs) - where information about high risk domestic abuse victims (those at risk of murder or serious harm) is shared between local agencies
- the SafeLives Domestic Abuse, Stalking and 'Honour'-Based Violence (DASH) Risk Identification Checklist (external site) - a validated tool to identify those who are at high risk of harm and whose cases should be referred to a MARAC.
We have also partnered with SafeLives to produce an e-module that provides an introduction for health staff on risk assessment for domestic abuse.
Each territorial NHS Board has an Executive Lead and Operational Lead for gender based violence (GBV). You can contact your local lead for information on local policies, training opportunities and support for staff.
Support services for the public
Members of the public can be directed towards Scotland's Service Directory on NHS inform which provides information on