Independent domestic violence adviser services have been shown to reduce the number of incidents and increase victims’ safety and well-being, writes Alison Petch
Authors: Emma Howarth, Louise Stimpson, Diana Barran and Amanda Robinson
Underpinned by an accredited training programme, the IDVAs provide short- to medium-term specialist case work to high-risk victims of domestic violence. Grants (average £20,000) were given to charities already active in the area in order to expand capacity. This report provides detail of the evaluation of seven of these schemes and was conducted between January 2007 and March 2009. It is the first large-scale, multi-site evaluation of IDVA services.
The evaluation focused on three areas.
● The social and demographic profile of those accessing IDVA services, including the nature and extent of the abuse they were experiencing.
● The interventions and resources that were accessed for individuals, the intensity of support and the potential for this support to be tailored to the needs of the individual.
● The outcomes from the support in terms of increased safety and well-being, including the factors likely to influence the achievement of these outcomes and their sustainability over time.
Across the seven services, the research collected data on more than 2,500 women at the point of referral. Further data, on interventions and outcomes, were gathered for 1,250 of the group on case closure or after four months. Short interviews were conducted with about 400 individuals when they left the service to elicit their views on the factors that had influenced their safety during their time with the project. Thirty-four individuals were contacted after six months to explore the sustainability of any changes.
The evaluation of the IDVA schemes highlights several positive achievements.
IDVAs work with complex, high-risk cases. In these, the individual is at high risk of serious harm and homicide, with severe abuse including violent behaviour causing injuries; strangulation; rape and other sexual abuse; stalking; and extreme controlling behaviour. Three-quarters of the victims had experienced abuse of this type, with more than 60% experiencing choking or strangling and 62% having been threatened with death. Moreover, 86% had experienced multiple forms of abuse. Abuse had been occurring, on average, for five-and-a-half years, and for two-thirds of people had continued despite being separated from their partners. More than two-thirds (69%) had children, the majority of primary age or younger. Almost a quarter of the sample were from ethnic minority communities, a higher proportion than the community structures. The authors suggest this may be an encouraging sign of easier access to the IDVA service. A range of interventions was mobilised by the IDVAs, with most helped to access multiple services, four being the most common. Two-thirds of victims had more than five contacts with the IDVA.
More than half (57%) of the victims reported that the abuse stopped after the intervention of the IDVA, with a range from 44% for those receiving limited support to 67% for those receiving intensive support. Outcomes were impressive for those experiencing multiple or severe abuse. The most significant reductions were in respect of physical abuse. IDVAs reported reduced risk in 79% of cases, backed up by 76% of victims reporting that they felt safer. Direct risks to children were also reduced. In terms of more general well-being, an improvement in individuals’ social networks was reported for 47% of cases and an improvement in coping abilities in 63% of cases.
Victims are much safer when they receive intensive support. The data showed that the improved safety and well-being highlighted above were more likely to be achieved when the support was intensive and multi-faceted, confirming that it is correct to attribute the changes to the IDVA intervention.
Victims were much safer when multiple services were offered. The likelihood of positive outcomes increased according to the number of interventions received. For example, 88% of victims who had been helped to access six to 10 forms of support felt safer, compared with 37% with one or no form of support. The likelihood of positive outcomes for safety and well-being did not vary with demographic profile. But several factors were identified which appeared to be identified with less positive change – more severe abuse, previous referral to a service, and separated or separating from their partners. In terms of longer-term sustainability, IDVAs judged that, in 39% of cases where abuse had ceased, this was sustainable in the longer term. For the 34 individuals followed up at six months, 82% reported no further abuse.
The evaluation of the IDVAs required the systematic collection of data at baseline and at four months. In effect, this provided a formal case review mechanism which was welcomed by the IDVAs. Two of the schemes also decided to implement a six-month follow-up.
The authors of the evaluation draw on their findings to make four recommendations.
First, they argue that the association of positive outcomes with intensity of support and the number of resources mobilised proves the need for more IDVAs. They suggest that the number of trained IDVAs ought to be more than doubled to give adequate coverage to all high-risk victims in the UK.
Second, they assert that IDVA services ought to be part of mainstream commissioning, with the capacity to offer intensive support and as part of a multi-agency response.
Third, in recognition of the risk factors for children of domestic violence, combined with the substance misuse (more than half) and mental health problems (40%) among perpetrators, there must be much closer links between IDVAs and children’s services.
Finally, stronger links ought to be made to health services and with those who work with perpetrators. The limited information gathered on health issues by IDVAs should be enhanced and referral pathways to and from health-related services should be reviewed and strengthened.
There are several reasons for commending this evaluation of IDVA provision. It provides a stronger evidence base for an area of major need, focusing on the key outcomes of safety and well-being; it provides signposts to effective interventions; and it highlights key recommendations focusing on closer multi-agency working. The authors are enthusiastic about the success of the schemes, citing “incredibly positive changes in victims’ safety and well-being over the course of the intervention”.
A word of caution needs to be added. Notwithstanding the heartening reductions in incidents of violence, individuals were tracked for only a short time, most for four months or fewer. Longer-term follow-up is needed to ensure that these positive outcomes can be maintained over time – and in particular what mechanisms for support need to be in place to ensure that this happens. Likewise, in seeking to expand the capacity of the IDVA network there needs to be careful oversight to ensure that the features that appear associated with its success are maintained.
LINKS AND RESOURCES
➔ Research in Practice has produced a briefing, Domestic violence and child abuse, which highlights that children living with domestic violence comprise up to two-thirds of cases seen at child protection conferences.
➔ In 2005, following the recommendations of the Domestic Abuse and Pregnancy Advisory Group, the Department of Health published Responding to domestic abuse: a handbook for health professionals.
➔ A 2009 Scottish Government publication, Safer lives: changed lives – a shared approach to tackling violence against women in Scotland, supports the need for a multi-agency approach across all partners to tackle violence against women in Scotland.
The evaluation highlights the need for excellent communication and collaboration between the agencies involved in responding to domestic violence if optimum outcomes are to be achieved. It is essential that the mechanisms to ensure a multi-agency response are clearly specified and details are implemented to plan.
Specification of service
The evaluation clearly highlights the positive outcomes associated with a more intensive service, both in terms of the number of contacts with the IDVA service and the multiplicity of services accessed. It is essential that any replication of service pays attention to this detail and does not proceed with insufficient provision.
The evaluation reported significant successes. But the follow-up period was relatively short and only a small number of people were spoken to after six months. It is important that any initiative of this type should have long-term scrutiny to ensure that initial success is sustained.
Delivery to design
When seeking to replicate projects that appear to be successful it is important to pay attention not just to the components that make up the project but also to the delivery process. For example, the ways in which services are accessed and mobilised may be a significant factor in their success. The IDVA programme was underpinned by a training process which sought to provide a common platform across the projects.
A clear need for more people to undertake IDVA work is demonstrated in order to provide intensive support to those who need it.
Alison Petch is director of the Institute for Research and Innovation in Social Services
This article is published in the 28 January 2010 edition of Community Care under the headline “Domestic violence advisers at heart of positive change”