Practitioner advice: spotting the signs

Most of the domestic abuse, the disclosures that I’ve had, have been grumbling, low mood, not coping with things. When people aren’t sleeping well, when they’ve got lots of worries, or ‘I’ve got memory loss.’ Memory loss? You’re 20. If somebody is dealing and managing domestic abuse, walking on eggshells, adjusting their behaviour the whole time to reduce their risk of confrontation and argument and harm, that takes up a huge part of your life, so other things might not get done. We need to be aware that people may use their health conditions against them. So I think it’s having that open mind. If anything’s a bit strange, maybe think about asking.

We always speak to victims on their own because they are easily influenced by another party. So you could be talking to a victim, and before answering questions, they will look to the party to look for assurance that they’re all right talking. There are a lot of signs in relation to people controlling where they go, checking the phone, always ringing them when they’re out, controlling their finances. We look for unexplained damage in the house, for example, where somebody may have punched a door.

We look for the way in which children respond to the perpetrator, and even animals respond to the perpetrator, because sometimes within domestic abuse, you’ll also find that the perpetrator is violent to other people or animals even within a relationship. Unexplained injuries, victims constantly making excuses for the perpetrator. Now family and friends and even health professionals while coming into contact with individuals all the time may notice a change in behaviour, a change in appearance, just a change in the way that the person talks about themselves and their family relationship. And also victims of domestic abuse can become withdrawn. And perpetrators will often try and isolate them from friends and family to further control their behaviour.

People can start to get a really, really shaky sense of what’s right and wrong. And often, that’s because if they are being kind of cut off from other perspectives because they’re no longer seeing friends and family and things as much, and the only kind of messages that they’re getting about what’s going on is coming from the abusive partner. Then it starts to get very difficult for people to determine what’s actually kind of real and what’s a realistic way of looking at things.

So you’ll get a lot of people sort of almost asking you questions about what you think about this situation, or just kind of asking for reassurance and saying that that’s normal for people to behave like that, isn’t it? If someone has mental health needs, not necessarily at the higher end, but depression, anxiety, stress, just a low mood, these can be indicators that something’s going on at home. Physical ailments are common for victims/survivors of domestic abuse. So, for example, I don’t mean just injuries like the black eye or the very obvious impacts - health-related impacts - but things like persisting tiredness, low immune, frequent infections, or non-specific infections, or sexually transmitted disease or infections too.

These are all kind of indicators that we should sort of then think, OK, these could be the cues for us to ask questions about what’s going on at home. I did a project with older people. And one of the things for older people is the signs, the indicators might be quite different. So, for example, if you’ve got an older woman who has regular contact with a health care practitioner, GP, or hospital, either primary or secondary care, if her partner is accompanying her, he might appear to be a very caring partner. He might talk on her behalf because she finds it difficult to talk about whatever it is that needs talking about.

So there might be a perception that someone is very loving and supporting and caring, but actually, that could be part of a very controlling and manipulative relationship. One of the examples I always give was, maybe say five, six years ago, it was a classic Friday afternoon, maybe half past 4. And we got a phone call from a young woman who wanted us to meet her in a part of town that we know it’s mainly white people that live there. So myself and my colleague, we drove out - half an hour journey - met with this young woman who had learning difficulties, and she was actually sharing a house with a white young man.

And when we went out to see her, she talked about some of the issues she had about rent but, overall, didn’t really share a lot more. And when we came back, the advocacy worker was saying to me as her manager, should we really not be closing this file because the woman didn’t really seem to share anything? And for me, the fact that she was a young Asian woman - she was about 18 years old - the fact that she’d rang us on a Friday, I felt that there was more that maybe she wasn’t sharing. So what I suggested is that the advocacy worker build a relationship with her.

As it happened as a number of months went by, the woman shared lots and lots of issues around domestic violence and eventually about sexual violence that was taking place in her home environment.