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Domestic violence and abuse: how NIHR research is helping families in the South West

3 October 2019

The National Institute for Health Research (NIHR) in the South West is driving forward groundbreaking research to understand the experiences and needs of children affected by domestic violence and abuse and looking at innovative ways of delivering support.

Domestic violence and abuse is devastating and impacts the whole family, not just the person who is the focus of the abuse. But children can often be hidden victims or fail to get appropriate support. Research shows that only half of children affected by domestic violence and abuse are known to social services and only 42 per cent receive support from a specialist abuse service. 

According to the NSPCC, one in five children and young people in the UK have experienced domestic violence and abuse. In the South West in 2017/18, there were nearly 50,000 domestic abuse related offences recorded by the police, accounting for 13 per cent of all offences. In the same period, there were 2,302 children of the adults referred and supported in Next Link’s community and accommodation specialist domestic abuse service. Next Link offers evidence-based support to those experiencing domestic violence and abuse in Bristol and South Gloucestershire.

Carol Metters, CEO of Next Link, said:

“Every day we see the impact that domestic violence and abuse has on children. People can think that children are not affected by abuse happening in the home because they are asleep, or in a separate room. But children tell us the impact that living through domestic abuse has had on their education, friendships, wellbeing, self-esteem and understanding of healthy relationships. They can sometimes take on adult responsibilities and the role of protector, or blame themselves for the abuse. This can have a detrimental effect on their development and mental health.

“Research is vital in reaching out to children who may present with symptoms caused by violence in the home. Equally important is sustainable funding for specialist services to provide evidence-based support to children and young people, such as our CRUSH group work programme. We know that with the right support and intervention children can recover after being exposed to domestic abuse.”

Previous NIHR research has revealed the lack of evidence on how best to support children in these situations. So NIHR teams from Bristol and Exeter are working on studies that will shed light on this often overlooked issue, which can affect children for the rest of their lives.

Bristol University developed IRIS (Identification and Referral to Improve Safety), a programme of domestic violence and abuse training and support for general practice teams. The programme helps GPs identify women who have experienced domestic violence and abuse and gives them a direct route for referral to specialist services. IRIS has now been commissioned in over 30 areas in England and Wales. IRIS+ is a pilot study to extend IRIS to children and young people and men.

The pilot of IRIS+ has led to a substantial number of children being referred for specialist support alongside their non-abusive parent. The identification and referral of children exposed to domestic abuse is a breakthrough in the general practice setting. Early findings suggest that children and young people benefited from support from IRIS+, particularly through support from specialist children’s workers.

Professor Gene Feder, Professor of Primary Care, at the Centre for Academic Primary Care, Bristol Medical School and NIHR School for Primary Care Research, is research lead for IRIS+. He said:

“Children are hidden victims of domestic violence and abuse, which causes long term damage to their mental health, wellbeing, education and even future employment. GPs often see children with behavioural problems, anxiety and physical symptoms without an obvious cause. Sometimes these are caused by exposure to domestic violence and abuse in their family. In the NIHR-funded IRIS+ study, we are training GPs and other health care professionals in primary care to recognise children who are exposed to domestic violence and abuse and to refer for support by Next Link, a specialist domestic violence and abuse agency.”

Another approach being explored to support children who have experienced domestic abuse and family breakdown is Family Vision. It’s a 10 week life coaching programme for lone parents or carers, designed to empower them to be the leader of their family and improve their relationship with their child. Researchers from the NIHR Applied Research Collaboration (ARC) South West Peninsula and the University of Exeter worked with Get Up and Grow Coaching to develop the programme.

Family Vision has been piloted in Exeter, in partnership with a primary school and local children’s centre providers. Parents who participated reported an increase in confidence and feelings of control. In many cases, relationships with their children improved through parents’ ability to better understand their child’s behaviour and needs.

Dr Vashti Berry, Senior Research Fellow at NIHR ARC South West Peninsula and the University of Exeter Medical School and lead researcher on Family Vision, said:

“Children exposed to domestic violence can be at risk of social, emotional and behavioural difficulties, even after they have left the violent family context. We need interventions both to prevent early childhood trauma and to respond when it occurs. Research in this area, partnered with families affected and our commissioners and providers, is critical to ensuring that community, social and healthcare services are acceptable and effective in meeting the needs of children.”

Dr Berry is also part of FReDA (Family Recovery after Domestic Abuse), a new research project testing the effectiveness of helping children to develop coping strategies to deal with conflict and stressful situations. Mothers are also given guidance in how to support their children in coming to terms with their experiences.

If you are affected by domestic violence and abuse

Next Link’s CRUSH programme is for 13-19 years olds in Bristol and South Gloucestershire. It supports up to 10 victims in closed groups. It aims to help young people to understand how to recognise and avoid abusive relationships, how to leave a relationship which is unsafe and how to manage any exposure to domestic abuse within the home environment.

If you would like to access the CRUSH group, would like support with domestic violence and abuse or are concerned about someone you know then please contact Next Link on 0117 925 0680 or visit their website at www.nextlinkhousing.co.uk.

If you are outside Bristol and South Gloucestershire, the 24hr freephone National Domestic Violence Helpline (run in partnership between Women’s Aid and Refuge) is available on 0808 2000 247 hours a day, 7 days a week.

Watch ITV West Country tonight (Thursday 3 October) to find out more about how the NIHR is helping children affected by domestic violence and abuse in the South West.

Further information

About the Centre for Academic Primary Care, University of Bristol

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow us on Twitter: @capcbristol.

About the NIHR

The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:

  • funds, supports and delivers high quality research that benefits the NHS, public health and social care
  • engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
  • attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
  • invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
  • partners with other public funders, charities and industry to maximise the value of research to patients and the economy.

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR commissions applied health research to benefit the poorest people in low- and middle-income countries, using Official Development Assistance funding.

This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. The NIHR recognises and values the role of patient data, securely accessed and stored, both in underpinning and leading to improvements in research and care. www.nihr.ac.uk/patientdata

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