A West Sussex initiative is keeping victims of domestic violence in their own homes safely rather than directing them to refuges, reports Natalie Valios
● Name of service: Worth Services.
● Aims and objectives: To increase the safety of domestic violence victims and their children.
● Number of staff: 24 full time, including 13 independent domestic violence advisers.
● Number of service users: About 1,600 a year.
● Funding: £1m a year from West Sussex Council, West Sussex Primary Care Trust and Sussex Police.
● Outcomes: Assessments showed that between August 2010 and January 2011, risk was reduced for 89% of clients. Also, 86% said they felt safer and 89% reported life improvements. (Source: Caada Insights and Worth Services.)
Women murdered by their partners attend A&E for their injuries 30 times before their deaths on average, but historically few domestic violence services have been based in hospitals.
An exception is Worth (Ways of Responding Through Health) Services in West Sussex, which provides independent domestic violence advisers (IDVAs) to support abuse victims who are at high risk and increase their safety.
“We felt A&E was the best place to actively identify people at risk,” says Worth Services manager Trish Harrison (pictured above with adviser Jim Alexander).
Delivered by West Sussex Council, and also funded by the county’s primary care trust and Sussex Police, it began as a pilot at Worthing Hospital in 2004.
“Before the pilot went live we trained more than 400 health professionals in understanding domestic violence, how to ask people about it, and how to respond to a disclosure. Within the first three months disclosures of domestic violence went up from one a year to one a day.”
Results were so successful that, during the first year of the pilot, it was decided to mainstream it into a seven-day-a-week countywide service. The service now operates in Worthing, Crawley and Chichester hospitals and the Princess Royal Hospital in Haywards Heath. IDVAs are also based in specialist domestic violence courts.
Referrals can be from any agency or the client. The first step is a risk assessment from which the IDVA can build a picture of the client’s risk. An individual service plan, looking at where a client might need support, is also agreed, covering issues such as legal proceedings, housing, finances and health, as is a safety plan which deals with different scenarios, such as keeping safe during a crisis or preparing to leave the family home.
The development of IDVAs has been one of the success stories of domestic violence services in recent years, with several evaluations showing their positive impact on victim safety.
The role was targeted to fill a gap, says Diana Barran, chief executive of the charity Co-ordinated Action Against Domestic Abuse (Caada), which accredits IDVA services through its Leading Lights scheme.
“A few years ago the only realistic option for victims was to go to a refuge but the majority don’t want to,” Barran says. “The IDVA role focuses on keeping them safe at home and offering them options to deal with a range of problems [connected to the domestic violence].”
First to be accredited
Worth was the first service to be accredited and is one of the largest IDVA services in England and Wales. It also employed the country’s first two male IDVAs dealing with female victims. Jim Alexander, the third male IDVA to join the team, says: “There is a preconception that women will worry about speaking to a guy but this has only happened to me once.
“We work predominantly with female clients but they often like to have a male perspective. I can tell them that the relationship is not right and not all men are like that.”
Although part of the council, the service maintains its independence: Harrison reports to the head of safeguarding, which falls under the public health, well-being and safeguarding directorate rather than adults’ and children’s services. “We are not driven by anyone’s targets, we are driven by [Caada’s] IDVA charter and have our own set of policies.”
Harrison believes hospitals are the ideal setting for IDVA services. “People trust health professionals and it is a place they can go to without too many questions being asked, which makes it a safe environment.”
Mandy Grocutt, emergency medicine consultant at Worthing Hospital, agrees: “If they come in with injuries they are aware there is a problem. You only have a small window of opportunity to effect change and the quick referral and rapid response that Worth gives us is so effective.”
Six years ago IDVAs were unheard of, but Caada has since trained more than 1,000 practitioners resulting in “sensible coverage” nationally, says Barran.
However, despite their success, the fallout from cuts could result in 20% job losses “which would leave us in a less healthy position”, she adds.
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