For Domestic Violence Awareness Month this October, Gemma Forsythe talks to Preetee Hylton about the signs of domestic abuse and why dental professionals need to recognize them.
October is Domestic Violence Awareness Month and this is a very important issue to highlight.
Preetee Hylton RDN discusses the signs to look out for, organizations to guide patients or colleagues, and the importance of the dental team looking for signs and providing support to their patients who may be experiencing domestic violence. Preetee is very passionate about this topic and I was lucky enough to catch some of her lectures on it.
What constitutes domestic abuse?
In the UK, domestic abuse and violence is defined by the government as: ‘Any instance or repeated occurrence of controlling, coercive or threatening behaviour, as well as violence or ill-treatment, involving individuals aged 16 and over who have been or are currently intimate partners or family members, regardless of their gender or sexual orientation.
This includes various forms of abuse, including but not limited to:
- psychological
- physical
- sexual
- financial
- Emotional.
Behavioral control involves actions aimed at subjugating and making a person dependent by isolating them from support systems, exploiting their resources for personal gain, depriving them of the means for independence, inhibiting resistance, and dictating their daily lives. .
Coercive behavior refers to acts or patterns of acts that involve assault, threats, humiliation, intimidation or other abusive tactics intended to harm, punish or intimidate the victim.’
It is important to note that the above definition, although not legally binding, includes so-called ‘honour’ based violence, female genital mutilation (FGM) and forced marriage. This highlights that victims include different genders and ethnicities.
An overview of the legal framework in the UK
The Domestic Abuse Act 2021, passed in the UK, serves to increase protection for victims of domestic abuse. This legislation expands the scope of domestic abuse to include coercive and controlling behaviour, making it a criminal offence. In addition, it mandates the creation of a domestic abuse commissioner to oversee the government and public service response to domestic abuse.
The Act introduces new instruments such as domestic abuse protection notices and orders. These empower the police to protect victims of domestic abuse. It also introduces a program for perpetrators of domestic abuse designed to support the rehabilitation of offenders. In addition, the legislation addresses improvements in the response to domestic abuse within the family courts and provides better support for victims, including provisions for safe housing.
Is domestic abuse our problem as dental professionals?
Domestic violence and abuse (DVA) is a pervasive issue that often permeates our discussions with family, colleagues and friends. It also floods our news reports and social media feeds.
When faced with these disturbing accounts, feelings of hopelessness and fear can overwhelm us, forcing us to seek a deeper understanding of the signs of domestic abuse and its profound impact on our mental and physical well-being.
Often, our search for knowledge leads us to websites that provide depressing statistics on the prevalence of domestic abuse. It is incumbent upon us, as dental care professionals, to equip ourselves with the knowledge to recognize the warning signs of domestic abuse. This will enable us to provide help and guidance when needed.
Statistical insights
According to the crime survey for England and Wales, covering the year ending March 2022, approximately 2.4 million adults aged 16 and over (5.0%) experienced domestic abuse in the past year. Notably, there was no significant change in the prevalence of domestic abuse for adults aged 16 to 59 between the year ending March 2022 and the previous year, unaffected by the COVID-19 pandemic.
During the same period, police recorded approximately 1,500,369 incidents and crimes related to domestic abuse, with 910,980 categorized as crimes related to domestic abuse. The figures show a steady increase in police-recorded crimes related to domestic abuse in recent years, with the latest statistics showing a 7.7% increase on last year and a 14.1% increase on the year ending in March 2020.
This escalation can be attributed to an increase in the reporting of domestic abuse, as the survey did not report significant changes prior to the pandemic.
Identifying possible signs of domestic abuse
- Showing signs of social withdrawal and detachment from loved ones and peers
- Showing visible indications such as bruising, burns and bite marks, especially around the neck, ears, shoulders and arms
- Experiencing financial control, which may include inadequate access to essential needs such as food or medicine, or complete control over bank accounts by the abuser
- Forced into marriage under the threat of harm from relatives
- Suffering from isolation at home, preventing participation in work, school or social gatherings
- Enduring constant verbal belittling and abuse, whether in private or in public. A ‘smear campaign’ is often used to discredit the victim and shift blame from the perpetrator.
- Being a victim of forced sexual acts or non-consensual relations, which qualify as rape and must be reported to the authorities. Spousal rape is also a crime and must be reported to the police
- Coping with theft, defined as the non-consensual removal or damage of a condom during sexual intercourse, constitutes sexual assault and is illegal in the UK
- Experiencing gaslighting, where the abuser denies the abuse or blames the victim—a manipulative and dangerous tactic that leaves the victim questioning her thoughts, words, actions, and mind.
- Facing surveillance on all forms of communication such as texting and email, including social media and online activities
- Forced to always share their location with the abuser through various apps. There have been cases where perpetrators have installed software/apps on victims’ phones to track their location without their knowledge.
Protection of training for dental professionals
Cases of child abuse, elder abuse, modern slavery and domestic abuse often appear in media reports, prompting us to wonder how such occurrences went unnoticed.
As dental professionals, our unique position affords us the opportunity to observe changes in behavior, physical injuries, or nonverbal cues and signs. Consequently, it becomes our duty to voice any concerns we may harbor, bearing in mind our responsibility for the well-being of our patients, colleagues and the wider community.
In line with NHS England, safeguarding includes protecting an individual’s health, wellbeing and human rights. This ensures that their existence remains free from damage, abuse and neglect.
Protection is a collective responsibility, requiring the presence of adequate measures and their activation when necessary.
Protection of children and young people
- Level 1: Involvement of non-clinical staff such as receptionists and practice managers
- Level 2: Includes most dentists and dental care professionals
- Level 3: Determined based on need and risk within larger organizations.
Protection of adults:
- Level 1: Involvement of non-clinical staff, including receptionists and practice managers
- Level 2: Covering most dentists and dental care professionals.
My personal opinion is that all members of staff, including non-clinical team members, in a dental practice/organisation should receive level 2 training in both child and young person safeguarding and adult safeguarding.
How to offer support if someone is experiencing abuse
- If you suspect someone is coping with abuse, show your availability to listen and support them
- Find a private and safe environment and time to engage in conversation, bearing in mind that they may not yet be ready to discuss their experiences
- When someone believes you, refrain from judgment and praise their courage to speak up
- Reiterate that no one deserves to endure abuse and emphasize their right to safety and happiness
- Extend your support, encourage them to express their emotions and respect their personal decisions
- Refrain from pressuring them into decisions they may not be ready for, such as leaving the abusive relationship or reporting the abuse
- In the event of a physical injury, offer to accompany them to seek medical attention at their GP or hospital
- Help them report the abuse to the police if they decide to do so
- Be prepared to provide information about organizations that provide assistance to those experiencing domestic abuse
- In cases involving children, consider seeking help from social services.
Call 999 in an emergency or if someone is in immediate danger
Ensuring the safety and well-being of our patients remains paramount, underlining the critical importance of adhering to the training guidelines set out by the General Dental Council (GDC) and the Care Quality Commission (CQC).
This standard of care should be uniformly applied to our fellow dental professionals, while the onus falls on employers to provide support to team members who may be dealing with domestic abuse.
It is our ethical duty to foster a workplace environment that is both safe and supportive for all staff members. Shockingly, the grim reality is that less than one person a year chooses to disclose their experience of domestic abuse to their employers or supervisors – a statistic we are committed to changing.
Services to guide patients and team members
Email (email protected) for references
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