The Brick Wall

The Brick Wall The Development Of A Routine Screening Tool To Identify Same Sex Relationship Violence Robert Ball Service and Workforce Development HIV/AIDS and Related Programs SSWAHS.

The SSWAHS HIV/AIDS & Related Programs Strategic Framework 2008-2012 identifies a need to increase the capacity of HARP funded services to identify and respond to sexual assault and domestic violence issues amongst clients.
SSWAHS HARP Framework 2008-2012 Action Plan (5.4)
As a means of accomplishing this, the plan calls for the piloting of a domestic violence screening tool for same sex attracted clients of HARP funded services.
WHY DID WE EMBARK ON THIS?

Physical Psychological Bruises and welts Depression and anxiety Body injury Alcohol and drug abuse Chronic pain Sleeping disorders Disability Eating disorders Gastrointestinal disorders Physical inactivity Ocular damage Poor self esteem Reduced physical function Suicide and/or self harm Irritable bowel syndrome Unsafe sexual behaviour THE HEALTH CONSEQUENCES OF DOMESTIC VIOLENCE

Sexual and reproductive Fatal health Gynaecological disorders AIDS related Mortality Infertility Death Pelvic inflammatory disease Homicide Pregnancy complications Suicide Sexual dysfunction Sexually Transmitted Infections, including HIV/AIDS NSW Policy & Procedures 2003 P.49 The health consequences of domestic violence (continued)

THE INITIAL RESPONSE TO THIS PROPOSAL
When this proposal was first canvassed there were three main responses:
Does that happen is gay or lesbian relationships?
Are you stereotyping “girly boys” and “butch dykes”?
Domestic violence is about men bashing their wives

Some consequences to consider are those relating to HIV testing, treatment access including PEP and medication compliance. & Where the form of abuse centres around; psychological (outing), social (isolation), immigration or residency issues, sexuality or sexual practices and health status. What are the unique impacts of domestic violence in Gay or Lesbian relationships?

WHAT THE SCREENING TOOL IS This screening tool is not part of the support, counselling and care of an individual experiencing domestic or relationship abuse/violence and should not be used for that purpose.
Its purpose is:
To assist health care workers to identify the
possible presence of domestic or relationship
abuse/violence.

What the screening tool is (continued)
to give the victim of such abuse the opportunity
to recognise it for what it is and seek support and
help should they choose to do so.
the tool has the added benefit of assisting the
health care worker to identify their mandatory
reporting responsibilities.

they are believed
they are respected
they are not alone
abuse happens to other people as well
such abuse can affect their health
the health worker is willing to listen
the issue is being taken seriously
SCREENING TELLS THE PERSON
they can get help

Sexual Health Services
HIV/AIDS Treatment Services including PEP
HIV/AIDS Support Services
Mental Health Services
Alcohol and other Drug Services
PROGRAM AREAS

Identified GLBT people over the age of 16 years
Preamble outlining purpose, choice
and limits to confidentiality
Scripted questions during assessment
Questioning in safe and private space
Information card offered to all
Follow-up and documentation
PROTOCOL

Screening is not to be carried out if:
The person is not physically or mentally well
enough to respond to the questions coherently
The person has already disclosed domestic
violence as the presenting problem
Maximum privacy cannot be given
In the presence of a partner, children over three
years old, other family member or friend
WHEN NOT TO SCREEN

In this health Service we ask all people
about types of violence in their lives
This is because violence can be very
common and can be serious and we
want to improve how we respond to
those experiencing this
You don’t have to answer the question if
you don’t want to
THE PREAMBLE

This information will remain confidential to the
Health Service except where there are serious
safety concerns for you or your children should
you have any
The preamble (continued) In the Fair’s Fair DV Survey 13.8% of respondents reported they had children under the age of 16 years in their care, being 26.6% women and 5.2% men Fair’s Fair Survey 2006 A snapshot of violence and abuse in Sydney LGBT relationships. Same Sex Domestic Violence Working Group. AVP. ACON. P16

THE QUESTIONS
Within the last year have you been hit, slapped, hurt, intimidated, threatened or coerced in some way, in a relationship or by an ex-partner or a casual partner? YES NO
Did this upset you or are you frightened of this person? YES NO
If the person answers NO, give the information card to them and say: “Here is some information that we are giving to all people about relationship violence”.

If the person answers YES to any of the above questions: continue with following questions:
Are you concerned this could happen with them again?
YES NO
Do you feel safe in your home? YES NO
Do you have someone to support you if this happens again? YES NO
Would you like some assistance with this?
YES NO
THE QUESTIONS

Who took part in the focus testing?
Health Care workers within SSWAHS Liverpool and
Royal Prince Alfred Hospitals.
(Sexual Assault, Youth Health, Haemophilia,
Allied Health and Nursing)
A number of Community Workers from
Non-government Organisations and the SESIAHS
(ACON, SSDV Working Group, The Gender Centre,
Lesbian & Gay Anti-Violence Project, CSN,
Positive Life, SESIAHS Community Health)

The focus testing identified
The parties may or may not share an abode
The connection with each other may be through sexual play only without an emotional or other social bond
The community status of a person may hold
relevance to the possibility of psychological abuse through the threat of “outing”
That the package supporting the introduction of the testing tool was too long and attempted to educate about domestic violence and legal issues/obligations

The focus testing asked
Are there services that will work with the perpetrators of the violence as a control issue rather than anger management ?
Should we identify Same Sex Domestic or Relationship Violence when there are few specific same sex support or referral services; will they feel abandoned?

THANK YOU
Alison & Kim, Anthony, Chas, Colin, Joe, Kathleen, Kim, Liam, Mick & Robbie, Norman, Victoria.
Warwick Allan – Senior counsellor Sydney Sexual Health Centre SSEIAHS.
Denise Cummins – CNC HIV Community Health SSWAHS.
Sekneh Hammoud – Psychologist (Private Practice) Sydney.
Caron Hewett – Educator Education Centre Against Violence Parramatta.
Susan Hill – Training & Educator Child Protection Service SSWAHS.
Corrine Maynard – Quality improvement Coordinator Drug Health SSWAHS.
Joan Silk – Health Education Officer Harm Reduction Program SSWAHS.
Anthony Schembri – General Manager Fairfield Hospital SSWAHS.
Helen Young – Social Worker HIV Bigge Park Clinic SSWAHS.
And the many people who gave their time and advice at the Focus Testing Sessions.

The Brick Wall

by ACON on Oct 13, 2009

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The Brick Wall — Presentation Transcript