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Topic on a Page - Domestic Abuse

Data Sources:

Public Health England (PHE):

Public Health Profiles

Domestic Abuse

NSPCC:

Domestic Abuse- Facts and Statistics

Supporting Information:

Lincolnshire County Council:

Multi Agency Domestic Abuse Protocol Resource Pack for Practitioners

Joint Protocol MAPPA and MARAC

Domestic Abuse Policy

Public Health England (PHE):

Domestic abuse: a toolkit for employers

Faculty of Public Health:

The role of public health in the prevention of violence

NICE:

Pathway: Domestic Violence and Abuse Overview

Quality Standard: Domestic Violence and Abuse [QS116] February 2016

Guidance: Domestic Violence and Abuse: multi-agency working [PH50] February 2014

Local Government Briefing: Domestic Violence and Abuse: how services can respond effectively [LGB20]

Clinical Knowledge Summary: Domestic violence and abuse

HM Government:

Guidance: Female Genital Mutilation: Resource Pack

Guidance: Forced Marriage

Serious Crime Act 2015 section 76

Domestic Violence, Crime and Victims (Amendment) Act 2012

Adoption and Children Act 2002 section 120

NHS Evidence:

Domestic Abuse

Safeguarding Adults

Social Care Institute for Excellence (SCIE):

Domestic Violence: Resources and Services

Abuse and Neglect – Safeguarding Adults

Safe Lives:

Safe Lives - Knowledge Hub

Local Government Association (LGA):

Adult safeguarding and domestic abuse: A guide to support practitioners and managers (2nd edition)

Vision for services for children and young people affected by domestic violence

Public health approaches to reducing family violence

The relationship between family violence and youth offending

Ministry of Defence (MOD):

No Defence for Abuse: Domestic Abuse Strategy 2018 - 2023

Department for Work & Pensions (DWP):

Domestic violence and abuse: help from DWP

House of Commons Library Briefing Papers:

Progress on protecting victims of domestic abuse in the family courts

Domestic Violence in England and Wales

House of Commons Library: Secure Tenancies (Victims of Domestic Abuse) Bill 2017-19

Home Office:

Ending Violence against Women and Girls 2016-2020 Strategy Refresh

National Rural Crime Network:

Domestic Abuse in Rural Areas

Linked Topics:

Topic last reviewed: Dec-18

JSNA Topic: Domestic Abuse

Background

The Home Office (2013) definition of domestic violence and abuse is:

Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This can encompass but is not limited to the following types of abuse:

  • Psychological / emotional abuse
  • Physical violence
  • Sexual violence
  • Financial abuse

Controlling behaviour is: a range of acts designed to make a person sub-ordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour.

Coercive behaviour is: an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.

This definition, which is not a legal definition, includes so called 'honour’ based violence, female genital mutilation (FGM) and forced marriage, and is clear that victims are not confined to one gender or ethnic group.

Research cited by the World Health Organisation (WHO) states there are a range of negative outcomes associated with being exposed to domestic abuse; besides the physical impacts of abuse, such as injury, death and disability, the mental health of the victim may be damaged by the experience. Depression, anxiety, post-traumatic stress disorder, self-harm and low self-esteem are among the mental health difficulties experienced by victims following domestic abuse, and can continue long after the violence has stopped.

The Crime Survey for England and Wales (CSEW) estimated that for the year ending in March 2017, 26% of women and 15% of men aged 16 to 59 had experienced some form of domestic abuse since the age of 16. In addition to this, around one in five children and young people have been exposed to domestic abuse, including domestic violence. It is shocking to note that in this country 2 women are killed every week by a current or former partner and 45 men are killed each year (ONS Domestic abuse in England and Wales: year ending March 2017).

Context

National Strategies, Policies & Guidance

Domestic abuse is an important issue for national government. In March 2016 the Home Office published the revised Violence Against Women and Girls Strategy. The strategy talks of ending violence against women and girls and ensuring all victims get the right support at the right time. The strategy introduces a 'National Statement of Expectations (NSE) ':

'Areas will be supported through a new network of local and national experts and a range of tools and guidance to transform their services to meet the needs of all victims. We will provide local areas with the resources they need to support transformation by aligning increased central Government funding to promote effective local leadership, joined up commissioning and the evaluation of emerging models which support earlier intervention and coherent pathways of victim support.'

Local Strategies & Plans

The Safer Lincolnshire Partnership (SLP) is the single multi-agency forum for addressing community safety issues across Lincolnshire. The Safer Lincolnshire Partnership aims to:

  • Reduce crime and disorder and increase the safety of individuals and communities across Lincolnshire
  • Ensure those living, working or visiting Lincolnshire feel safe and are equipped to cope with any hazards or threats they may encounter
  • Improve communication, coordination and cooperation between agencies allowing them to work together more efficiently and effectively

The SLP has identified domestic abuse as a core priority for 2018-2021 and the Domestic Abuse Core Priority Group (DACPG) has agreed the following focus areas:

  • Prevention of Domestic Abuse before abuse occurs
  • Early intervention to prevent the intergenerational cycle of abuse
  • Late intervention to prevent known abusers from abusing again

The DACPG have produced a delivery plan with clearly defined actions and activity around each of the focus areas, as well their other routine responsibilities:

  • Domestic Abuse Strategy and Domestic Abuse Charter
  • Domestic Homicide Review Coordination
  • MARAC oversight, performance, evaluation and development.

What is the picture in Lincolnshire?

What the data is telling us

Data from the Crime Survey for England and Wales is not available at a local Lincolnshire level. Therefore unless stated otherwise, the data used in this section relates to England.

Domestic abuse has a significant impact upon the communities and public services of Lincolnshire. Estimates from the Crime Survey for England and Wales (CSEW) suggest that for the three year period between April 2013 and March 2016, an estimated 7.0% of the resident population of Lincolnshire aged 16-59 years experienced at least one domestic abuse incident (approximately 27,400 people). This is above the national average of 6.2%, and places Lincolnshire 13th out of 42 police force areas in terms of its domestic abuse prevalence.

On average there are over 10,000 domestic abuse incidents reported to Lincolnshire Police every year. Of these, 6,500 are standard risk incidents, equivalent to around 3 in 5 domestic abuse incidents reported. A quarter of domestic abuse incidents are graded as medium risk while 8% are high risk. There were 598 victims who were at high risk of serious harm or death referred into the Multi Agency Risk Assessment Conference (MARAC) by partner agencies in 2017-2018. Since the introduction of the Statutory Domestic Homicide Reviews in April 2011 there have been 13 cases involving 18 deaths that have met the criteria for a domestic homicide review in Lincolnshire.

Domestic abuse remains an underreported issue. CSEW national figures suggest that only 37% of partner abuse victims told someone in an official position about their abuse (ie police, health professionals, or local council department). Women were more likely to do this than men (43% compared to 23%). 21% of victims told the police, 19% told a health professional and 1% told a local council department. The majority of partner abuse victims instead told somebody they knew personally about their abuse, although women were again more likely to do this than men (80% compared to 55%). 1 in 5 partner abuse victims told nobody at all about their abuse (19%), meaning that for every victim who disclosed their abuse to a health professional, there was another victim of partner abuse who suffered in total silence. (Source: Office of National Statistics)

The true number of victims of domestic abuse is also likely to be higher when children are included. CSEW figures suggest that 46% of partner abuse victims suffered abuse while their children were in the house, and that 20% of victims disclosed that the children did see or hear what happened. (Source: Office of National Statistics) If only one child was present at each of the 20% of domestic abuse victimisations in Lincolnshire each year, this would mean that 5,500 children witnessed domestic abuse in their home each year. This means that the true number of Lincolnshire residents affected by domestic abuse each year is likely to be upwards of 33,000 adult victims and child witnesses.

The relatively high rate at which children are present during partner abuse incidents has a number of consequences. At a basic level it places additional responsibility on those agencies encountering domestic abuse to ensure that appropriate checks, risk assessments and safeguarding referrals are being made for child witnesses as well as adult victims of domestic abuse. Domestic abuse is the single most prevalent assessment factor identified in children’s social care assessments. It is more prevalent than the presence of factors such as mental health, alcohol misuse, drug misuse, disability and illness, emotional abuse, physical abuse, or sexual abuse. In Lincolnshire during 2015-16, 57.9% of assessments identified domestic abuse as an issue. This is higher than the national average of 49.6%, and places Lincolnshire 41st among the 150 local authorities in England that supplied information. (Source: Department for Education) Domestic violence has also specifically been identified as a factor in 60% of all serious case reviews, which investigate child deaths relating to maltreatment, abuse and neglect.

Given the high levels of child witnesses to domestic abuse, Domestic Abuse Support Services need to ensure they are able to accommodate and offer appropriate support to both adult and child victims of domestic abuse. CSEW data suggests that the main reason given by abused partners for not leaving the accommodation they shared with the perpetrator was the presence of children; 54% of victims feeling unable to leave their abuser because they had nowhere to take their children. (Source: Office of National Statistics)

CSEW figures also suggest that adults who witnessed domestic abuse as a child were three times more likely to experience abuse by a partner as an adult compared to those who did not witness domestic abuse. 34% of child witnesses of domestic abuse will suffer domestic abuse from a partner as an adult. (Source: Office of National Statistics) So supporting and safeguarding child witnesses of domestic abuse not only helps the adult parent victim to escape their abuse, it may also help to prevent the child from becoming a domestic abuse victim in the future.

Around a fifth (19%) of partner abuse victims that reported abuse in the last year stated that they currently shared, or had previously shared, accommodation with their abusive partner. Of these victims, 42% reported leaving the accommodation because of the abuse, even if it was for only one night. Of those who left the shared accommodation, 65% spent their first night with relatives, while staying with friends or neighbours was the next most likely destination (18%). Of those who didn’t leave the shared accommodation, a quarter (24%) stayed because they had nowhere else to go. (Source: Office of National Statistics)

National CSEW figures suggest the most common type of physical injuries sustained as a result of a domestic related assault were minor bruising or black eye (17%) and scratches (12%). There were no significant differences between the prevalence of physical injury for male and female victims (29% and 23% respectively). However, these figures also suggest that the majority of partner abuse victims (75%) did not sustain a physical injury as a result of the most recent episode of abuse. While the level of physical injury reported by victims was relatively low, over half of partner abuse victims (61%) reported experiencing non-physical abuse. Female victims were more likely than male victims to report that they had sustained non-physical effects (51% compared with 37%). For both male and female victims, the category most likely to be reported was ‘mental or emotional problems’ (30% of male victims and 47% of female victims) followed by ‘stopped trusting people or difficulty in other relationships’ (19% of male and 22% of female victims).

Around a third (32%) of partner abuse victims who had experienced any physical injury or other effects sought some sort of medical attention. The majority of victims (84%) received this at a GP surgery, 13% had gone to a hospital’s Accident and Emergency department and 28% to a specialist mental health or psychiatric service. Of those victims who received medical attention, 73% were female and 27% were male. Looking at the type of effects felt by those who received medical attention, 51% experienced non-physical effects, 44% experienced both a physical injury and other effect and 5% had experienced a physical injury. (Source: Office of National Statistics)

Basic details of assault patients who attend Accident and Emergency departments in Lincolnshire have been collected by ULHT and LCHS operated hospitals since October 2015 (in an arrangement based on the ‘Cardiff Model’). While this information does not specifically identify those assaults that were domestic related, an interesting pattern has emerged in the data which would suggest that a significant minority of assaults may be domestic related. Although men were most likely to be assaulted in the street (31.8% of assaults on males occurred in street locations), women were much less likely to be assaulted in the street (16.0% of female assaults occurred here), but much more likely to be assaulted in their own home. 1 in 4 female assault patients attending Lincolnshire A&Es were assaulted in their own home, compared to 1 in 10 male assault patients. This means that 7.6% of all assault patients who attended A&E were females who had been assaulted in their own home. Collection of further details about these assault attendances (in particular whether or not an assault is domestic-related) would allow for a more robust analysis of this data from a domestic abuse perspective.

CSEW figures found that there remains a perception among a small but significant minority of the population that there are occasions where it might be acceptable to assault their partner. For instance, 5.9% of the national population stated that it might be acceptable to hit or slap their partner in response to their partner constantly nagging or moaning. This would equate to roughly 23,600 people in Lincolnshire (assuming a similar prevalence of these attitudes in Lincolnshire compared to the England and Wales average). Furthermore, 7.9% might assault their partner in response to seeing them flirt with other people, and 17.2% in response to an affair. Work to tackle these cultural views and perceptions about domestic abuse therefore continues to be an essential part of preventing both the toleration of abuse by victims and the perpetration of abuse by offenders. (Source: Office of National Statistics)

Since they were first commissioned by Lincolnshire County Council in 2013, domestic abuse support services for standard and medium risk victims of domestic abuse have been significantly oversubscribed. Originally modelled on an expected volume of 5,250 service users, providers had instead supported 6,000 users by the end of 2016/17 and this figure may well have been higher if resources had allowed. Not only have support services had to cope with an unexpectedly high number of users, but they have also reported an increase in demand for intensive support. This has been driven by a number of factors, including an increase in referrals for clients with mental health issues, an increase in referrals for child to parent/carer abuse, an increase in the workload for supporting clients through the court process following changes to legal aid, and an increase in demand on translation budgets as referrals increase for Eastern European migrants in Boston and South Holland. (Source: Domestic Abuse Service Review Toolkit (June 2017), Lincolnshire Public Health)

Trend

Data from the Crime Survey for England and Wales is not available at a local Lincolnshire level. Therefore unless stated otherwise, the data used in this section relates to England.

In general, the latest national prevalence estimates for all types of domestic abuse experienced in the last 12 months showed no statistically significant change compared with the previous year. However, while the CSEW has shown little change from year to year in the prevalence of domestic abuse, the cumulative effect of small reductions over time has resulted in a significantly lower prevalence for the latest year (ending March 2017) compared with the year ending March 2012 (5.9% compared to 7.0%).This trend has mainly been driven by reductions in partner abuse which has fallen from a prevalence rate of 5.2% to 4.5% over the same period. Family abuse has also followed a similar trend with a significantly lower prevalence for the year ending March 2017 (1.8%) compared with the year ending March 2012 (2.7%). (Source: Office of National Statistics)

Trend data for the amount of domestic abuse reported to agencies within Lincolnshire is more difficult to infer as recording practices for the collection of this information changes and develops over time. Domestic incidents reported to Lincolnshire Police remain the most robust source of reported domestic abuse within the county, although even this has been affected by changes to the way data is recorded. Taking these changes into account, the overall trend for domestic abuse reported to the police in the last 5 years (2013/14 – 2017-18) has been flat at between 10,000 and 10,400 calls per year.

Key Inequalities

Although domestic abuse can affect anyone, some groups are disproportionately likely to become victims of domestic abuse:

  • The latest CSEW national data would suggest that women, young people, those who are separated/divorced, single parents and those with a long-term illness or disability that limits their activity are all at significant risk of domestic abuse victimisation. Of these groups, single parent mothers were most at risk, with 1 in 5 (21.9%) becoming victims of domestic abuse in the last twelve months.
  • Domestic abuse is more likely to be reported in certain locations of the county, particularly those suffering from high levels of deprivation (especially in parts of Gainsborough, Skegness and Lincoln). In fact, those living in the most deprived areas of Lincolnshire are up to four times more likely to report domestic abuse (either in a recorded police incident or in a non-police MARAC referral) than those living in the least deprived areas of the county. It should be noted that these figures reflect reported domestic abuse and therefore it may be these groups are more likely to report than others and thus are disproportionately represented.
  • Information from the CSEW suggests that as an individual’s age increases, their chance of experiencing DA reduces. While 10.3% of 16-19 year olds experienced domestic abuse in the last year, only 4.1% of 55-59 year olds experienced abuse during the same time. The data suggests that the age profile of police and MARAC victims is broadly similar. Those aged between 16 and 44 are disproportionately affected by DA, while those aged over 44 are disproportionately less likely to suffer abuse. The most disproportionately affected group are those aged 25-34, where despite only accounting for 13.2% of the adult population, more than 30% of the victims can be found. The least affected group were those aged 60 or more, who despite accounting for 1 in 3 of all adults in Lincolnshire, suffered less than 7% of abuse.
  • All available data on domestic abuse victims suggests that the majority are female. However, the extent of male victimisation is less clear. While CSEW findings suggest that up to 1 in 3 DA victims are male, data from police and from MARAC suggest that a far smaller percentage of victims are male. Lincolnshire reported incidents show 1 in 5 police incident DA victims are male, 1 in 15 MARAC victims are male, and just 1 in 20 non-police MARAC victims are male. These figures would appear to corroborate the findings of the CSEW that men are far less likely to report their abuse to official agencies than women (only 23% of men report their abuse to an agency compared to 43% of women).

Current Activity & Services

Lincolnshire County Council currently commissions a number of domestic abuse services and has recently invested in some new elements of service, so as of 1st August 2018 this includes:

  • Countywide Outreach support for children and adults. This service is currently being delivered by EDAN (Ending Domestic Abuse Now) Lincolnshire, formerly West Lincolnshire Domestic Abuse Services.
  • Independent Domestic Violence Advisor (IDVA) Service to support high risk victims of domestic abuse referred to a Multi-Agency Risk Assessment Conference, including a hospital-based IDVA provision (as recommended in the November 2016 Safe Lives publication 'A Cry for Health').
  • Supported accommodation for people fleeing domestic abuse.

In addition, there are a considerable amount of resources dedicated to supporting the Domestic Abuse Partnership, including the County Domestic Abuse Team employed by Lincolnshire County Council who:

  • Assist in the commissioning and contract management of the County's domestic abuse services
  • Coordinate and deliver multi-agency domestic abuse training funded by the Lincolnshire Safeguarding Adults Board
  • Run campaigns; produce numerous domestic abuse leaflets, posters, resources, policies and protocols.
  • Produce a monthly Domestic Abuse Bulletin for practitioners.
  • Maintain the Domestic Abuse Website for Lincolnshire residents and a password protected area for practitioners.
  • Deliver a project working with schools to prevent domestic abuse.
  • Coordinate and administrate the Multi Agency Risk Assessment Conferences. The MARAC is a forum to share information about those victims who are at high risk of further serious harm or death. The number of referrals to MARAC has increased every year since it began.
  • Manage the Domestic Homicide Review process on behalf of the Safer Lincolnshire Partnership.

The County Domestic Abuse Team has supported the County Council to implement a domestic abuse policy which has resulted in mandatory domestic abuse training for all Lincolnshire County Council employees. Other partner agencies also require all staff to have domestic abuse training.

The County Domestic Abuse Team and other members of the domestic abuse partnership also work closely with the Lincolnshire Children and Adult Safeguarding Boards. This has resulted in:

  • A Joint Domestic Abuse Protocol
  • Joint conferences
  • Female Genital Mutilation mandatory reporting to the Police
  • Joint Domestic Homicide Reviews

Unmet Needs & Gaps

There are currently no voluntary domestic abuse perpetrator programmes in Lincolnshire, although there are a number of strands of activity taking place to develop and implement countywide interventions aimed at perpetrators of domestic abuse who have not received a criminal conviction through the Court, but who want to change and reform.

Further work is needed to ensure that all GP practices in Lincolnshire have trained doctors and support staff who can recognise domestic abuse and respond safely and appropriately, adhering to the Joint Domestic Abuse Protocol.

Prevention work in schools has vastly improved over the last few years, helped by the introduction of Lincolnshire County Council's 'Stay Safe' project which offers healthy relationships education to secondary schools. This project has seen a near 80% take-up rate of the offer, but more work is needed to ensure this becomes a universal offer to all primary, secondary schools and referral units across Lincolnshire.

More information is needed about the prevalence of honour based abuse, female genital mutilation and forced marriage in Lincolnshire. It is important for the partnership to not only understand what is being reported but also what the potential is for under reporting of these issues in Lincolnshire, and therefore what improvements/interventions may be needed. The same could also be said for stalking and harassment.

Improved data collection is needed from all partners to help identify needs and gaps and support in the development of longer term strategies and commissioning. As part of this work the voice of the survivor is vital and the partnership should build on the work already done in relation to obtaining service user feedback.

Risks of not doing something

Without a focus on domestic abuse and a consistent approach across commissioning and strategic bodies there is likely to be an inconsistent approach to tackling domestic abuse which could lead to, a reduction in publicity about the issue, inconsistent domestic abuse training, gaps in provision or duplication, a 'postcode lottery' for victims and a potential closure of specialist domestic abuse services. This would have a huge impact on agencies that rely on the specialist services to support vulnerable people, reduce risk and provide ongoing support.

This uncoordinated approach and potential closure of specialist support services could then lead to:

  • An increased demand on health agencies to manage the emotional and psychological impact of domestic abuse.
  • An increase in suicide or self-harm – victims of domestic abuse are 10 times more likely to attempt suicide. 30 women each day attempt suicide – 3 women each week commit suicide in England and Wales having experienced domestic abuse.
  • An increase in the domestic abuse cases requiring hospital treatment e.g. A&E, fracture clinic etc.
  • An increase in Homeless applications to district council due to a lack of early intervention.
  • An increase in applications to Supported Accommodation (refuge) due to a lack of other support services.
  • Practitioners may need to be more adept and able to provide support and information on civil proceedings, signposting to other agencies around Housing, financial issues etc. This would involve further training and would impact on the capacity of practitioners.
  • An increase in referrals to the MARAC – either because practitioners have nowhere else to turn for support for victims or an escalation in risk due to a lack of early intervention.
  • The Independent Domestic Violence Advocacy (IDVA) service would not have ongoing support services to refer into which would potentially mean that they would have to work with victims longer (there is no capacity to do). Without the ongoing support that is needed we could see an increase in repeat referrals to MARAC.
  • There could be an impact in reporting to the Police – it could increase due to escalation of abuse due to lack of early intervention or a decrease as victims will not have the support they sometimes need to report incidents. Domestic abuse services regularly support victims at court. If the support was not available there could be an increase in the retraction rate at court.
  • Outreach workers often develop a good professional relationship with the family and often receive information about changes in risk to the victim or the children. Without this knowledge, early intervention and referral into safeguarding services, children and victims could be put at greater risk.
  • There could be an increase in deaths as a result of domestic abuse. There is a statutory requirement to conduct a Domestic Homicide Review for each death. There would no doubt be considerable criticism of partnerships and individual agencies if there was insufficient support provided locally for victims of domestic abuse.

While domestic abuse is terrible in its own right, the cost to public services is significant and will continue to rise should the need not be addressed. There are five major services used by victims of domestic abuse:

  • The criminal justice system: costs to the police, the prosecution service, Courts, prisons and probation are included.
  • Health care (both physical and mental health): GPs and hospitals are the major costs included.
  • Social services: only the costs linked to children are included.
  • Housing and refuges: the cost of emergency Local Authority housing and refuges are included.
  • Civil legal services: the cost of solicitors and injunctions are included.

Estimates from a report by Sylvia Walby (Walby, S., 2009, The Cost of Domestic Violence: Up-date), show the financial demand on public services totalling £3,856 million:

Services Cost 2001 £m Cost 2008 £m
Criminal Justice System 1017 1261
Health Care 1396 1730
Social Services 228 283
Housing and Refuges 158 196
Civil Legal Services 312 387
Total 3111 3856

Including the cost to public services, economic output and the human and emotional costs, domestic abuse is estimated to cost society £15,730 million (Walby,S. 2009)

What is coming on the horizon?

In 2018, the Government consulted on a proposed approach to address domestic abuse at every stage from prevention through to rehabilitation, and reinforced the government's aim to make domestic abuse everyone's business:

'Our aim through this work is to prevent domestic abuse by challenging the acceptability of abuse and addressing the underlying attitudes and norms that perpetuate it'.

The consultation was wide-ranging and views were sought on both legislative proposals for a landmark draft Domestic Abuse Bill and a package of practical actions from prevention through to rehabilitation.

What should we be doing next?

Areas for development include:

  • Working with educational settings and young people to promote healthy relationships
  • Work with perpetrators of domestic abuse to challenge their attitudes and behaviour and therefore prevent escalation of abuse and serial perpetrators.
  • Develop resources/interventions for child to parent/carer violence
  • Ensure that we learn the lessons from Domestic Homicide Reviews, Serious Case Reviews and Safeguarding Adult Reviews
  • Developing interventions and ways of working with people who have complex needs.

 

If you need to contact us about this topic, please email JSNA@lincolnshire.gov.uk