Article
Safeguarding against domestic violence during COVID-19
Since the implementation of the lockdown restrictions, the number of calls received by police regarding domestic abuse has risen by one third.1
As social distancing measures were introduced, vulnerable individuals may have been forced to spend prolonged periods with their perpetrator. Restrictions may cause an escalation in the frequency and/or severity of violence for those living in an abusive household. Conflict may be further exacerbated by financial stress, health concerns or anxiety caused by the uncertainties of COVID-19. The lockdown restrictions have made it more difficult for individuals to access the support and protection of their friends and family, leaving them increasingly isolated.
As healthcare professionals we are well placed to identify domestic abuse presenting as facial or dento-alveolar injuries. Telephone consultations make identifying vulnerable patients more difficult and domestic violence may be missed. Dentists may well be the first point of contact for a vulnerable person as lockdown restrictions ease. As we begin to start face-to-face consultations, we should be aware of the increased incidence of domestic violence and be confident identifying and managing such cases.
The World Health Organization2 and the IRISi3 have published guidance for healthcare sectors on domestic abuse during and following COVID-19. Both these documents provide valuable information about recognizing and responding to potential domestic abuse over telephone consultations and during face-to-face consultations. They also provide examples of services from which victims can seek support and advice.
IRISi guidance encourages us to ASK, RESPOND, RISK ASSESS, REFER and RECORD.4 If healthcare professionals have concerns during a telephone consultation, we are advised to ask closed ‘yes/no’ questions to enquire if the patient is experiencing domestic abuse, is safe to talk, or in immediate danger. Clinicians should enquire as to whether the patient has any support currently and what support they feel will benefit them. Once a disclosure is made, the victim's situation should be risk assessed. If there are children at home, or if the victim feels that he/she is in immediate danger, then the police should be contacted on 999. Any concerns about potential domestic violence should be raised via the local safeguarding referral pathway. The victim should be signposted to the various support services available and encouraged to make use of them. We must ensure that any enquiries, disclosures and referrals are recorded contemporaneously within the patient's clinical records.
Although we have seen many changes to the way in which we work, safeguarding adults and children remains as important as ever. In these ever-changing times, it is imperative that we continue to remain vigilant for the signs of domestic abuse. We need to feel confident to broach the subject with our patients during telephone and face-to-face consultations and subsequently manage any disclosures. In doing so, we may prevent at risk individuals from experiencing further harm that may otherwise continue unnoticed during the pandemic and beyond.