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A University of Birmingham study, reported widely today, suggests that survivors of domestic violence an abuse (DVA) are more at risk of serious mental ill health.  You can read the articles here and here.  

The study also reports that GPs are highly trained to spot DVA. What it doesn’t mention is that the signs of DVA are well-hidden and often misdiagnosed.  The Royal College of General Practitioners, commenting on the report has said that “training for all GPs on adult and child safeguarding was mandatory”.

Medina Johnson is CEO at IRISi, a social enterprise established to promote and improve the healthcare response to gender-based violence. IRISi’s flagship intervention programme, IRIS (Identification and Referral to Improve Safety), is a general practice based domestic violence and abuse training and referral programme. IRIS training provides GPs, nurses, midwives and other clinicians with the training and skills to recognise and identify the signs of a patient who may be a victim of domestic violence and refer them to a named advocate educator who can help and support them through the process of reporting and recovery. 

“We know and agree that DVA affects mental health.  We dispute that GPs are highly trained or even trained at all in many cases to recognise and respond to DVA” says Medina. “Training on adult and child safeguarding is essential, but it is not the same as focussed training for clinicians to enable them to recognise, ask about, respond to, know where to refer and how to record DVA.  IRIS is an evidence-based programme, offering all of this and widely cited as best practice.  In the last decade, IRIS programmes have received referrals from over 11,000 women, fully trained over 800 general practices, around 10% of general practices in England and Wales and been commissioned in over 40 areas.”

IRIS is not mandatory training for GP’s. The programme is commissioned and paid for by local health commissioners and local authorities and then rolled out across a specified geographical location. Not all GP’s are IRIS trained. 

By becoming more aware of the signs and symptoms that suggest abuse – long term anxiety and depression, repeat visits to the surgery for minor symptoms, unexplained gynaecological problems – I became much more aware of patients who were living with abuse and the negative effects it was having on their health outcomes. The penny drops and you realise the exact scale and extent of the problem amongst your patient population

IRIS trained GP.

“We need a systematic approach to training and resourcing this issue in health” continues Medina. “We know that IRIS works – women feel safer, have improved health and quality of life and visit their GPs less as a result; clinicians are better informed, trained and skilled to respond to patient need.”

Professor Gene Feder, OBE, a GP and DVA researcher at the University of Bristol commented

“Safeguarding training does not adequately train GPs (and other members of the primary care team) in asking about and responding appropriately and safely to patients experiencing domestic abuse. That is why we trialled and developed the IRIS programme, which to date has trained about 10% of practices nationally and for which we continue to argue for national funding, rather than local commissioning”

Gender based violence is not recognised as a health issue in the UK. It often goes undiagnosed and hides behind symptoms such as depression and anxiety. The symptoms are not always physical and it can be extremely hard to identify a patient. IRIS programmes provide general practice teams with the training that they need to be able to ask their patients the question and refer them to a named individual, should they wish to do so. This is not only saving women’s lives, it is saving the NHS time and money.

“DVA is an epidemic and should be treated as such” says Medina. “It feels like Groundhog Day when we are told again and again that DVA affects mental and physical health. Solutions exist and offer women choices. When these aren’t prioritised and made widely available, we are not acting in the best interests of patients.”

From more information on IRISi or the IRIS programme, please email medina.johnson@irisi.org

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The IRIS Programme provides specialist advocacy and support to patients registered at IRIS-trained practices who have experienced domestic abuse.

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Partners

AVA
AVA
AVA

AVA is an expert, groundbreaking and independent charity working across the UK.

Their vision is a world without gender based violence and abuse. They aim to  inspire innovation and collaboration and encourage and enable direct service providers to help end gender based violence and abuse particularly against women and girls.AVA’s work is focused around those areas where they can make the best contribution to ending violence and abuse. They do this by making sure that survivors get the help and support they need in the here and now, through providing innovative training that has a proven direct impact on the professional practice of people supporting survivors of violence and abuse

developing a range of toolkits, e-learning and other material that supports professionals to provide effective and appropriate support to survivors of violence and abuse

using our influence and networks to ensure survivors voices are heard. We work closely with AVA in many areas including the Pathfinder project

https://avaproject.org.uk

SafeLives
SafeLives
SafeLives

SafeLives are a national charity dedicated to ending domestic abuse, for good. We combine insight from services, survivors and statistics to support people to become safe, well and rebuild their lives. Since 2005, SafeLives has worked with organisations across the country to transform the response to domestic abuse, with over 60,000 victims at highest risk of murder or serious harm now receiving co-ordinated support annually. SafeLives are members of the Pathfinder consortium.

http://www.safelives.org.uk/about-us

IMKAAN
IMKAAN
IMKAAN

Imkaan is a UK-based, Black feminist organisation. We are the only national second-tier women’s organisation dedicated to addressing violence against Black and minoritised women and girls i.e. women and girls which are defined in policy terms as Black and ‘Minority Ethnic’ (BME). The organisation holds nearly two decades of experience of working around issues such as domestic violence, forced marriage and ‘honour-based’ violence.

They work at local, national and international level, and in partnership with a range of organisations, to improve policy and practice responses to Black and minoritised women and girls. Imkaan works with it’s members to represent the expertise and perspectives of frontline, specialist and dedicated Black and minoritised women’s organisations that work to prevent and respond to violence against women and girls. Imkaan delivers a unique package of support which includes: quality assurance; accredited training and peer education; sustainability support to frontline Black and minoritised organisations; and facilitation of space for community engagement and development. They are a part of the Pathfinder Consortium.

https://www.imkaan.org.uk

The University of Bristol CAPC
The University of Bristol CAPC
The University of Bristol CAPC

The Centre for Academic Primary Care (CAPC) is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research.  It is part of Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching.

A dedicated team of researchers at the Centre work on domestic abuse projects and IRISi is a co-collaborator and partner on some of these projects including ReProvide, HERA and DRiDVA.

The Health Foundation
The Health Foundation
The Health Foundation

The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. The Health Foundation’s Exploring Social Franchising programme aims to generate a deeper understanding of the potential of social franchising models for scaling effective health and social care interventions within the NHS.

We are one of four project teams participating in the programme to develop a social franchise to enable the sustainable spread of our intervention, the IRIS Programme. We receive funding and support from the Health Foundation, including technical expertise on social franchising, and attend programme learning events. The Health Foundation has also commissioned a programme-wide evaluation to support understanding of the use of social franchising in the UK health and care system. We and our franchisees will support the evaluation through co-designing data collection requirements, providing access to data as requested, hosting site visits and attending learning events.

https://www.health.org.uk

STADV
STADV
STADV

Standing Together Against Domestic Violence is a UK charity bringing communities together to end domestic abuse. They bring local services together to keep people safe

Most public services weren’t designed with domestic abuse in mind, and they often struggle to keep people safe. Poor communication and gaps between services put survivors at risk.

STADV aim to end domestic abuse by changing the way that local services respond to it. They do this through an approach that they pioneered, called the Coordinated Community Response. The Coordinated Community Response brings services together to ensure local systems truly keep survivors safe, hold abusers to account, and prevent domestic abuse.

Their model of a coordinated local partnership to tackle and ultimately prevent domestic violence is now widely accepted as best practice. They are also a part of the Pathfinder consortium.

http://www.standingtogether.org.uk

Spring Impact
Spring Impact
Spring Impact

Spring Impact is a not-for-profit social enterprise born out of the frustration of seeing social organisations constantly reinventing the wheel and wasting scarce resources. Spring Impact uses a combination of tested commercial and social principles and extensive practical expertise to support organisations to identify, design and implement the right social replication model to scale their social impact.

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