A brighter future: re-imagining domestic violence prevention and support

  2 August 2021  Nicole MacKee – Croakey Health Media   

This article was written by Nicole MacKee and first published on Croakey.org

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Introduction by Croakey:

It’s been called the ‘shadow pandemic’ – the domestic, family, and sexual violence that erupts in the wake of COVID-19 lockdowns.

And with Greater Sydney now in its second month in lockdown, experts are bracing for an increase in the number of domestic violence incidents as the restrictions amplify financial and family tensions.

This week, concerns were raised in Queensland about a spike in problem gambling after lockdowns, and in NSW warnings were issued on the fracturing of support services for the state’s most at-risk communities.

It was timely then that experts and advocates joined a webinar and workshop last week to share their vision for a “vastly improved and holistic approach to survivor-centred health and trauma recovery” by 2031. The project comes ahead of the National Summit on Women’s Safety in September.

Croakey editor Nicole MacKee spoke to experts about the social and policy reforms required for transformative change.

Nicole MacKee writes:

A network of trauma recovery centres, the embracing of First Nations people’s knowledge about healing, and mandatory education in trauma-informed care for health care and justice workers.

These are just a few of the initiatives that could lay the groundwork for transformational change in Australia’s response to family, domestic, and sexual violence, experts say.

Others include include investing in more First Nations people becoming involved in politics, and ensuring equitable, timely access to social housing.

In her opening remarks for the ‘Family, Domestic and Sexual Violence Services in 2031: Influencing Australia’s Response Now’ webinar, Gadigal, Yuin, Bidjigal Elder Aunty Rhonda Dixon-Grovener spoke of healing after her own experiences of domestic violence and sexual abuse, which started in childhood.

“I am living proof of success … how living with trauma can be healed,” said Aunty Rhonda after offering a Welcome to Country.

Gadigal, Yuin, Bidjigal Elder Aunty Rhonda Dixon-Grovener addresses the webinar.

Diagnosed with post-traumatic stress disorder (PTSD) as an adult, Aunty Rhonda began her healing journey in her 50s by studying holistic counselling, then a Masters in intergenerational trauma and wellbeing.

“I am one of the few lucky ones who was able to go in search of what I needed to do to heal myself,” she said, adding that this has enabled her to support many others in the community.

“I would like to see organisations partner with those who are closest to the problem because usually they are the closest to the solution.”

The webinar – which was co-hosted by the Royal Australian and New Zealand College of Psychiatrists (RANZCP), the University of Sydney, Médecins Sans Frontières, and the Illawarra Women’s Health Centre – brought together experts and advocates to envisage a future with a much improved, survivor-centred approach to domestic violence.

It was a timely discussion, with concerns growing about the impact of current COVID lockdowns on domestic violence rates.

Lockdown dangers

“A lot of people refer to domestic violence as the ‘shadow pandemic’,” said Ash Johnstone, Dunghutti woman and Aboriginal Family and Domestic Violence Specialist at Women Illawarra. “When you have any kind of natural disaster – bushfires, floods, a pandemic – you have an increase in domestic violence. And that’s exactly what we are seeing.”

With the Illawarra region part of the Greater Sydney area under total lockdown, stressed families were now trapped in their homes, Johnstone told Croakey.

“Potentially, women are trapped with their abuser 24/7. Maybe they have lost work, or you have lost work, your kids are now home all the time.

“So those kinds of tensions just become more and more aggravated, and you just naturally see an increase in domestic violence incidents,” Johnstone said.

Sally Stevensen, General Manager of the Illawarra Women’s Health Centre, agreed that it was the “calm before the storm” in the region.

“It was very clear that the [last] lockdown had an amplifying effect on women experiencing violence and abuse in their homes,” Stevensen said, adding that, after the lockdown, violence became more frequent, more intense, and more complex.

“We expect that to happen probably over the next few weeks, particularly after the lockdown and restrictions have eased and women have better access to come here.”

‘We are open’

Stevensen said perpetrators used a raft of strategies to keep women in the home, and often amplified their surveillance and control of women at these times.

“They use statements such as ‘you are not allowed out, you can’t access support’,” she said.

Stevensen said the Centre was working with police to issue community service announcements through social and mainstream media to ensure women were well informed about service availability at this time.

“We are open,” she said. “Restrictions don’t apply for seeking safety.”

Stevensen added that the Illawarra was also home to a newly opened ‘safe room’ at Stockland Shellharbour, to help women to escape domestic violence.

Towards 2031

In a creative take on addressing the national response to family, domestic and sexual violence, the webinar saw experts speaking from the future, outlining successful strategies that had transformed Australia’s response to this national epidemic.

The presentations, in conjunction with subsequent workshops to further develop the ideas discussed in the forum, informed a series of recommendations to inform the next National Plan to Reduce Violence Against Women and Children. The current plan is set to run to 2022.

The recommendations are:

  • Recognise trauma behaviour as a natural response to violence and abuse and treat it as an injury.
  • Fund the first National Prevalence Study of Perpetration, which recognises this as a men’s violence issue, and identifies the personal, social, and structural drivers for that violence.
  • Fund mandatory trauma education and training programs for all health and justice qualifications.
  • Embrace First Nations people’s healing knowledge to address trauma and invest in community-controlled responses to domestic, family and sexual abuse.
  • Fund Women’s Trauma Recovery Centres, starting with a multi-site five-year community-based pilot project, then rolling out the successful model nationally.
  • Integrate family, domestic and sexual violence in emergency planning and disaster response frameworks; and increase support, education and training for the health, welfare and emergency frontline workers.
  • Work with the RANZCP and other professional associations to ensure access to affordable evidence-based individual and group therapies under the Medicare Benefits Schedule for those with trauma-related conditions.
  • Adopt a long-term (20 year) multi-partisan National Plan to Reduce Violence against Women and Children.

World-first initiative

Sally Stevenson was hopeful that a recently submitted business case for a Women’s Trauma Recovery Centre in the Illawarra region would lead to the first of 20 such centres throughout Australia by 2031.

“This would be the first Women’s Trauma Recovery Centre in the public health system in the world,” Stevensen told Croakey.

She described the model as a “community-led, community-based, dedicated, specialised wrap-around one-stop-shop that supported women to recover from the trauma of violence and abuse”.

Based on the healing framework of First Nations people, the centres would be trauma- and violence-informed, and would ensure that women were not judged, but listened to and believed, Stevenson said.

“The centres would also support women across all aspects of recovery: medical, mental health, legal, and parenting, for as long as it took,” she said, adding that women would be supported to navigate systems such as the family law or justice system to prevent re-traumatisation.

She said the centres would promote a “reframing” of support, ensuring the focus was on “what happened to you?” not on “what’s wrong with you?”.

“It puts the focus on men’s violence,” Stevensen said, adding that symptoms women experienced after violence were often a normal response to an extreme threat.

Stevensen and colleagues are lobbying the state and federal governments for a $25 million investment over five years, which equated to $25,000 to support a woman to recover, usually over three years.

“If nothing is done, the cost to NSW over three years is $31,000, or $100,000 over 10 years, so it’s a clear cost–benefit … to invest in women recovering,” said Stevensen.

She added that a recent Federal Parliamentary Inquiry had recommended the Federal Government fund the centre in partnership with the NSW Government. She said:

“Domestic and family violence is the largest contributor to the disease burden of women between 15 and 44 years.

“It’s a massive cost, not just to women but to the health system and the policing system.

“The police here at Oak Flats would say that between 50 percent and 70 percent of their workload is domestic and family violence call-outs.”

Targeted resourcing

Ash Johstone said increased resourcing was also key to better support Aboriginal and Torres Strait Islander women, who were up to 35-times more likely to experience domestic violence than non-Indigenous women.

In Croakey recently, senior Aboriginal academics issued an open letter, calling for urgent efforts to address the rates of violence against Aboriginal and Torres Strait Islander women.

Johnstone told Croakey that there was insufficient investment in domestic violence generally, and even less targeted support for Indigenous people in the area.

“You have organisations like Waminda, which is an Aboriginal women’s health service, and does fantastic work, then you have organisations like mine, which have dedicated Indigenous support pathways, but it’s very limited,” she said.

Johnstone said First Nations people’s healing knowledge could be harnessed to better address the trauma associated with domestic violence, pointing to Professor Bronwyn Carlson’s “exciting” work in this area.

“We have the oldest continuing culture in the world, with over 60,000 years of learnings and teachings, and we actually have people in our communities who have the solutions, but just don’t have the resourcing,” she said.

Social housing critical

A lack of access to affordable housing was preventing many women from escaping dangerous family circumstances, Johnstone said.

In the Illawarra region, she said, people could wait for years for access to long-term housing. And access to short-term emergency housing was not much better.

“You might be able to access one- or two-nights’ emergency accommodation in a motel or a caravan park, but what do you do when that runs out?” she asked. “We are at a point now for our area, where you have services saying, ‘we’re full’ and they are literally sending women and children away, and that just shouldn’t be the case.”

By 2031, Johnstone hoped that one in five housing projects had to address social housing:

“If you walk through Wollongong CBD right now there are about half a dozen high-rise apartments going up; where is the social housing investment?

“We have the power to make it that there are enough beds for people to sleep in, that there are enough homes for people to go to, but tonight in the Illawarra there will be people who do not have a safe place to sleep, and it’s just not good enough.”

First Nations voices

Johnstone also proposed investment in First Nations people becoming involved in politics.

“What if we had a radical investment in funding First Nations people to enter politics, whether that’s in councils, the Senate, or eventually, the Prime Minister?” she said.

“If we had … First Nations’ voices heard and represented in that way, you would see a dramatic shift in how our society responds to so many different types of issues, with improvement in many areas.”

Not the least of which was climate change, Johnstone said, where investment and action was urgently needed.

“In 10 years, we will be experiencing the day-to-day effects of climate change, it’s undeniable at this point,” she said, adding that this would result in an increasing number of natural disasters and associated domestic violence incidents.

“If we are serious as a society about reducing domestic violence in our communities, then we also need to be serious about reducing climate pollution and the effects of climate change.”

Improved trauma care

Psychiatrist Dr Karen Williams looked forward to a future in which clinicians were trained in trauma-specific and trauma-informed care, and such care was accessible for women and children who had experienced domestic and sexual violence.

She reflected on a domestic violence homicide case where she was able to treat the attending police officer for PTSD, but not the daughter who had witnessed the murder.

While the police officer was covered by WorkCover – and could access a range of care from psychiatric support to yoga, meditation, and exercise therapy – the daughter did not have private health insurance, so could not access psychiatric care for her PTSD.

“There are no public inpatient PTSD services in Australia,” Williams told Croakey.

She said while some psychological services were available through mental health plans and victim support services, much trauma went untreated.

Williams hoped that this would be “unheard of” in 2031.

Williams noted that at present, women who had experienced trauma were treated for their symptoms, not the trauma itself.

“If a traumatised woman was depressed, she would have a depressive disorder and be given antidepressants. If she was anxious, she would have an anxiety disorder and be given anti-anxiety medication. If she wanted to hurt herself, she would have a personality disorder, and if she went to hospital, they would tell her that the hospital couldn’t help her,” she said.

Williams hoped that by 2031, women traumatised by violence would be recognised as having experienced an injury and that injury could be used as evidence, rather than used against her.

She also hoped that GPs were supported to provide long consultations to women experiencing trauma after domestic violence.

Also speaking on the webinar, Lula Dembele hoped to see a shift in focus from subtle communal victim-blaming – such as the question, ‘why didn’t she leave?’ – to efforts to stop people from abusing their partners.

Dembele, of the Accountability Matters Project, said: “At a systemic level, while violence is a problem for victims, it is not a victim’s problem – but a perpetrator’s problem.”

She said the approach needed to shift from a reactive one to a proactive one “focused on targeted prevention and early intervention against abusive behaviours”.

By 2031, Dembele hoped that by quantifying the level of violence perpetrated by men, it was possible to map “the personal, social and structural motivators and drivers of violence at an individual and group level” and support recovery by “lessening stigma and shame experienced by victims”.

LGBTIQA+ concerns

While not a participant in the webinar, Joe Ball, CEO of switchboard Victoria, hoped to see a national approach to LGBTIQA+ family violence.

In September 2020, switchboard launched Rainbow Door, a Victoria-wide LGBTIQA+ Family violence helpline, but Ball noted that there was no equivalent helpline in any other state.

“To date, the responses in our communities are vastly different state to state. By 2031, I would hope that as an LGBTIQA+ person you would have the same experience in Wodonga as you would in Albury,” they said.

In the next decade, Ball also hoped that more LGBTIQA+ people were consulted on national family violence strategies and that government policies would be litmus-tested for harm and prejudice. For example, they said, “you wouldn’t see a Religious Discrimination Bill that works to both drive LGBTIQA+ family violence in family of origins while allowing for organisations to deny LGBTQA+ family violence services through religious exemptions”.

Ball hoped to achieve a fully funded LGBTIQA+ community-controlled family violence sector, so that organisations “weren’t relying on fundraisers and crumbs off the table to offer services to keep our LGBTIQA+ communities safe from family violence”.

While data was not available on the impact of COVID lockdowns on domestic, family and sexual violence among LGBTIQA+ people, Ball said there were anecdotal reports of people feeling locked out of mainstream support networks.

“When we do talk to people in our communities about family violence, we hear about how few are accessing mainstream family violence services. Tragically, LGBTIQA+ people don’t see that family violence service are for them, partly because of how family violence services are still promoted and understood as services for the protection of women and children against the violence of men. This doesn’t speak to large parts of our community and the violence they are experiencing,” Ball said.

They did note, however, that an increase in the number of people contacting the Rainbow Door service for support during periods of lockdown. The service has averaged of about 1,500 contacts per month since opening last year.

The right choice

If the right choices were made, Ash Johnstone said a safer, more equitable society was within reach.

“As a society, we have the power to build communities that work for us; that are sustainable and safe, that provide equal opportunities, and support all of our people to achieve healthy and happy lives,” she said.

“All it takes is for us collectively to be really vocal about that.”

And beyond 2041?

Stevensen said she hoped that the number of Women’s Trauma Recovery Centres would begin to decline, as intergenerational violence and abuse was reduced, and the demand for such services dropped significantly.

Notes from Croakey

Croakey acknowledges and thanks donors to our public interest journalism funding pool for supporting this article.

See Croakey’s archive of stories on family violence.

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Notes from NWMPHN

NWMPHN partnered with Professor Kelsey Hegarty from the University of Melbourne Safer Families Centre to deliver the Family Violence Quality Improvement Project with local general practices in 2021.

To learn more about the role of primary care professionals and how to respond to family violence, visit the family violence for primary care page. This page includes family violence services and other resources including a short video Starting Conversation About Family Violence by Professor Kelsey Hegarty of the University of Melbourne.  

To take part in the 2022 Community of Practice: Family Violence sessions, register below:

Areas: Brimbank, Hobsons Bay, Maribyrnong, Melton, Moorabool and Wyndham  

Areas: Darebin, Hume, Macedon Ranges Melbourne, Moonee Valley, Moreland and Yarra. 

Promotional image for 2022 Family Violence Community of Practice.