- Inter-Agency Cooperation – General Information
- The Role of the Health Sector
- Criminal Procedure in Cases of Domestic Violence
- National Criminal Procedures
Learning objectives
+ to understand how frontline responders work with a special focus on the medical sector
+ to understand why cooperation in multi-professional teams is most successful in tackling domestic violence.
+ to understand the multi-faceted challenges associated with multi-professional cooperation
Of note: The learning materials are not tailored to the needs of every country; they include generic cases that need local adaptation.
IMPRODOVA: Why is cooperation in cases of domestic violence important?
1. Inter-agency Cooperation – General Information1
Working in a multi-agency partnership is the most effective way to respond to domestic violence at an operational and strategic level. Initial and ongoing training and organisational support and supervision are essential.
Domestic violence has harmful impacts for individuals, families, and relationships. It affects the health, well-being and education of children witnessing or experiencing abuse. It affects the economy, businesses, and employers in the community where victims/survivors or perpetrators work. It increases demands of housing and results in other health and social care needs. All these service providers and agencies often deal with the same issues in divergent ways, with different interventions and different outcomes.
In practice cooperation between different organisations is determined by local, regional and/or national circumstances and contextual knowledge is the key to successful cooperation. It is important for medical professionals to get to know their partners in other organisations and agencies and build trust and lasting networks, so cooperation can be fast and smooth in emergencies (more information on the specific role of the medical sector). For example, a point of contact with local police (e.g. victim protection officer or similar role) and with women’s counselling services and/or domestic violence protection centres should be established beforehand.
In order for the victim to receive a professional risk assessment with the help of DV experts, it is crucial for medical professionals to refer them to the respective regional service centers.
2. The Role of the Health Sector
Case study: Domestic violence has a negative impact on children
Gabby married her husband Nick after a long relationship and shortly thereafter moved to her husband’s family farm. The couple was happy at the farm and soon had their first child. During the pregnancy Nick’s behaviour began to change and by the time their daughter was born the relationship did not ‘feel’ as it had before. Nick seemed withdrawn and spent long periods of time by himself. He began to remind Gabby of Nick’s father who had always been a stern presence in his life.
Nick’s behaviour became threatening and controlling, especially in relation to money and social contact. He was increasingly aggressive in arguments and would often shout and throw objects around the room. Gabby thought that, because he wasn’t physically hurting her, his behaviour did not qualify as abuse. Nick did not show much interest in their daughter, Jane, except when in public, where he would appear to be a doting and loving father.
Jane was generally a well-behaved child, however, Gabby found that she was unable to leave her with anyone else. Jane would cry and become visibly distressed when Gabby handed her to someone else to be nursed. This was stressful for Gabby, and also meant that her social activities were limited further.
Jane took a long time to crawl, walk and begin talking. Her sleeping patterns were interrupted, and Gabby often did not sleep through the night, even when Jane was over 12 months of age. When Jane did begin to talk, she developed a stutter, and this further impeded her speech development. Gabby worried about Jane a lot. Their family doctor told her that this was normal for some children and that, if the speech problems persisted, she could always send Jane to a specialist at a later date.
After a number of years, Nick’s behaviour became unacceptable to Gabby. During arguments he would now hold on to the rifle that he had for farming purposes, and Gabby found this very threatening. On a number of occasions, items that Nick threw hit Gabby and she was increasingly afraid for their daughter. Gabby decided to leave and consulted the local women’s service, who assisted her to get an intervention order against Nick.
Once Gabby had taken Jane away from Nick, her behaviour changed. Jane’s development seemed to speed up and Gabby couldn’t understand why. As part of her counselling at a local women’s service, she discussed this issue, and her counsellor recognised the developmental delay, stutter, irritation, and separation anxiety as effects of Jane’s previously abusive situation.
This can be seen as a missed opportunity for identifying family violence. If the family doctor would have asked Gabby or Nick (who had presented with chronic back pain) about their relationship, about what was happening to the family, and specifically to Jane, the situation could have been identified much earlier.
Task for reflection
a) What could have been done better by those involved?
b) Take a moment to consider which agencies and professionals should have been involved in supporting and/or providing services to Gabby from the beginning.
c) Make a list of different professionals who make up the multidisciplinary team in your organisation and who could be involved in the provision of services for those who have experienced domestic violence (this will vary depending upon where you are based).
The wide range of professionals, provider services and specialist agencies who may be involved in supporting victim-survivors of domestic violence can include—but are not limited to—primary and secondary health care services, mental health services, sexual violence services, social care, criminal justice agencies, the police, probation, youth justice, substance misuse, specialist domestic violence agencies, children’s services, housing services and education.
Adapted from a case study from RACGP (2014): Abuse and Violence: Working with our patients in general practice
Task of medical professionals within broader violence support networks:
Medical professionals fulfill two very important roles within broader violence protection networks:
(1) They often serve as the first point of contact with support services for victim-survivors. Therefore, their actions might help victim-survivors to start their journey to break the cycle of violence.
(2) They are the only professional group able to systematically document injuries resulting from DV and/or cases of sexual violence in a way that can be used in court. These documentations might make the difference between a case being prosecuted and one being terminated for lack of evidence. Training and clear guidelines for this type of documentation are therefore of utmost importance.
However, it is important to remember that victim-survivors should always have the chance to get counselling by DV-experts before lodging a complaint with the police. The harsh reality is that most complaints do not lead to criminal proceedings and that there might be unintended consequences (e.g. re-traumatisation) that victim-survivors need to be aware of in order to make an informed decision.
Key recomendations:
- Find out where the nearest victim support service is and contact them for flyers etc.
- Flyers of the regional victim support services can be put on display in your institution. Moreover, national helplines usually offer posters etc. for free. Restroom facilities turned out to be a good spot where posters/flyers can be put to display as they offer more anonymity.
- Find out whether your local police have a victim protection officer (this type of position can vary highly depending on the country)
- Keep in mind: it is sufficient to have one or two contact persons who can take over a case and initiate further steps. E.g., if the victim agrees to be referred to a victim support service, the professionals can conduct a risk assessment and get in contact with the police (if the victim agrees).
Further task for reflection
(1) Which specialised services for victims of domestic violence exist in your area? Are their designated police officers, who are specially trained to work with victims? What kind of counselling services and/or protection centres for victims exist? Are there services for specific groups of victims (e.g. for women/men, for children or older adults)? Do your own research and find addresses and phone numbers of the most important actors in your area!
(2) Identify one point of contact – i.e. one person or organisation – that can function as your first point of contact in an emergency and can guide you through the violence protection network. Get in touch with this person or organisation and establish contact.
3. Criminal Procedure in Cases of Domestic Violence
In the criminal procedure for cases of domestic violence, several essential steps are followed to ensure a thorough and just response.
- Domestic violence occurs: Firstly, the process typically begins when an incident of domestic violence occurs within a domestic or familial setting or in a (former) relationship. This can involve various forms of violence, including physical, psychological, sexual, digital, or financial.
- Report: The reporting of the incident is often made by the victim or a concerned party, and it serves as the formal initiation of the legal process. Reporting can be a challenging decision for a victim, and the victim’s decision not to report, should be respected. However, reporting the violence can be an important step toward seeking assistance and holding perpetrators accountable. In some European countries, for example in France, the police investigation continues even when the victim does not wish to make a report.
- Documentation: The documentation involves gathering statements from the victim, witnesses, and the alleged perpetrator. In addition to verbal accounts, officers may collect physical evidence, such as photographs of injuries, and secure any relevant documents or objects that could be used as evidence in court.
- Support: Simultaneously, victims are offered immediate support and protection. This can include medical attention for injuries, counselling services, or shelters to ensure their safety. Social workers or support organisations may become involved to address the emotional and practical needs of the victim during this challenging time.
- Investigation: A critical phase in the process is the investigation stage. Law enforcement agencies conduct a thorough examination of the case, with the goal of building a comprehensive case file. This entails gathering additional evidence, interviewing witnesses, and assessing the credibility of all parties involved. The aim is to determine whether there is sufficient evidence to support criminal charges against the alleged perpetrator.
- Prosecution: Finally, if the investigation yields enough evidence, the case is referred to the prosecutor’s office. Prosecutors review the case and decide whether to file charges against the alleged perpetrator. If charges are filed, the legal proceedings move forward. This may involve court hearings, trials, and potential penalties for the accused, ultimately aiming to ensure justice, protect victims, and hold perpetrators accountable for their actions.
The following illustration shows the individual steps of the criminal procedure in cases of domestic violence and explains how they are connected. Please click on the blue circles to get more information on the various individual steps. In the illustration of the steps: please click on the cross in the corresponding circle to get more information.
4. National Criminal Procedures
Criminal procedures do vary nationally. This is highlighted exemplarily by the criminal procedures in cases of domestic violence applied in Austria, Germany, Greece, Hungary, Italy, Finland, France, Portugal, Spain, and Sweden.
Please click on each cross in the corresponding circle to receive further information on the national criminal procedures.
