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

According to the NSPCC, one in five children and young people in the UK have experienced domestic violence and abuse

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

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 dependent 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.

One 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.

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, 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."

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.

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