The experience of health and welfare workers in identifying and responding to domestic abuse among military personnel in the UK

BMC Health Services Research

Ana Alves¹  Katherine Sparrow²  Deirdre MacManus²  Filipa Alves-Costa³  Neil Greenberg⁴  Nicola T. Fear⁴  Louise M. Howard⁵ 

[1] Barnet Enfield and Haringey Mental Health NHS Trust, London, UK;Forensic and Neurodevelopmental Science Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, SE5 8AF, London, UK;Forensic and Neurodevelopmental Science Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, SE5 8AF, London, UK;Barnet Enfield and Haringey Mental Health NHS Trust, London, UK;King’s Centre for Military Health Research (KCMHR) Academic Department of Military Mental Health (ADMMH), King’s College London, London, UK;Section of Women’s Mental Health, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK;

关键词: Military;    Veterans;    Domestic abuse;    Intimate partner violence;    Healthcare services;    Welfare services;    Support services;   

DOI  :  10.1186/s12913-020-05672-x

来源: Springer

【 摘 要 】

BackgroundAwareness of domestic violence and abuse (DVA) as a problem among military personnel (serving and veterans) has grown in recent years, and there is a need for research to inform improvements in the identification of and response to DVA in this population. This study aimed to explore the experience of health and welfare professionals in identifying and responding to DVA among the UK military population (serving personnel and veterans).MethodsThirty-five semi-structured telephone interviews were conducted with health and welfare staff who work with serving UK military personnel and veterans. Interviews were analysed using thematic analysis.ResultsThree superordinate themes were identified: i) patterns of DVA observed by health and welfare workers (perceived gender differences in DVA experiences and role of mental health and alcohol); (ii) barriers to identification of and response to DVA (attitudinal/knowledge-based barriers and practical barriers), and iii) resource issues (training needs and access to services). Participants discussed how factors such as a culture of hypermasculinity, under-reporting of DVA, the perception of DVA as a “private matter” among military personnel, and lack of knowledge and awareness of emotional abuse and coercive controlling behaviour as abuse constitute barriers to identification and management of DVA. Healthcare providers highlighted the need for more integrated working between civilian and military services, to increase access to support and provide effective care to both victims and perpetrators. Furthermore, healthcare and welfare staff reflected on their training needs in the screening and management of DVA to improve practice.ConclusionsThere is a need for increased awareness of DVA, particularly of non-physical forms of abuse, and of male victimisation in the military. Standardised protocols for DVA management and systematic training are required to promote a consistent and appropriate response to DVA. There is a particular training need among healthcare and first-line welfare staff, who are largely relied upon to identify cases of DVA in the military. Employing DVA advocates within military and civilian healthcare settings may be useful in improving DVA awareness, management and access to specialist support.

【 授权许可】

CC BY