Health issues and accessing services

Health impact

The physical, emotional and psychological consequences of gender-based violence can be profound and damaging. The experience of abuse is a strong risk factor for a range of poor health outcomes both in the short and longer term. 

Experience of abuse contributes to a number of physical health problems including chronic pain, gastrointestinal difficulties, and heart and circulatory conditions. An increasing body of evidence also records factors associated with delayed effects of abuse, such as hypertension and arthritis.

GBV is significantly associated with mental health problems. Around 35-40% of women experiencing domestic abuse report depressive symptoms (Fogarty et al 2007) and have higher levels of anxiety, suicidal ideation, post traumatic stress disorder and eating disorders (Golding 1999).

Abuse during pregnancy significantly increases the risk of low birth weight and preterm birth and higher levels of antenatal and postnatal depression which is associated with behavioural problems in children at 42 months.

Childhood sexual abuse is associated with poor mental health including depression, anxiety, eating disorders, post traumatic stress disorder, self-harm, psychosis and suicidal ideation (Maniglio, 2009).

In a study of users of drug services in Scotland, nearly two thirds of female drug users contacting drug treatment services reported having been physically abused and over a third reported having been sexually abused. Among male drug users, just under a quarter reported having been physically abused and 6.9% reported having been sexually abused.

Accessing services

GBV is a sensitive and complex issue. Fear of intrusion or causing offence, lack of time or experience, and concern about making matters worse are often cited by health staff as impediments to broaching the subject. Yet research indicates that people experiencing abuse want to be asked and to have that experience validated (Feder et al. 2006)

Interviews with female and male survivors of childhood sexual abuse in Scotland by Health in Mind (2001 and 2009) highlighted experiences of judgemental and dismissive attitudes from services. Lack of understanding about abuse or acknowledgement of its impact on mental and physical health led to negative experiences of the service. Conversely, a warm, empathic and genuine response made a significant difference to survivors' ability to engage with services.

Survivors repeatedly stress the importance of respect, validation and being non-judgemental to support disclosure and recovery. However, the recognition that not all survivors of abuse have the same experiences or the same needs is also important. In 2010, a survey of 62 women with physical and sensory impairments attending the Daisie Project and who had experienced some form of abuse found that 'poor attitudes, impatience, lack of accessible alternative accommodation, unwillingness to accept someone would abuse a disabled woman, lack of communication equipment and judgmental attitudes surrounding disabled women's sexuality all played a part in creating additional barriers' to accessing services. 

A report prepared for the Home Office (2012) by Bristol University researchers presents the results of interviews with 101 male, lesbian, gay, bisexual, transgender and black and minority ethnic survivors of domestic and sexual violence and highlights the different barriers they experience to accessing services and the limitations of a 'one size fits all' approach to service provision.

 

Updated July 2015

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