Progress made but more to be done to tackle family violence in health services
Victorian hospitals and health services have laid the foundations to identify and respond to family violence, but there’s more work to be done according to an evaluation of the Strengthening Hospital Responses to Family Violence (SHRFV) program.
For many people affected by family violence, a visit with a health professional may be the first and only step they take to access support and care.
Better identification and support for victim survivors in health settings was one of the 227 recommendations that came out of the Royal Commission into Family Violence in 2015, and since then the SHRFV program has been implemented across all Victorian public health services.
“In the years since it was established, the SHRFV program has grown to become a highly regarded model for change. It is now a coordinated, state-wide structure that engages hospital leadership, supports system growth and builds health service capacity to identify and respond to family violence in both patient and health worker cohorts,” said Dr Sue Matthews, Chief Executive of the Royal Women’s Hospital – who led the development of the SHRFV program with Bendigo Health.
“We know the job of eliminating family violence is not done yet and that it is only through long-term commitment and rigorous examination that we can make progress towards the goal of ensuring women and families are on a pathway to safety and wellbeing.”
Thanks to a grant from the Collier Charitable Fund, the System Audit Family Violence Evaluation (SAFE) Project was developed to evaluate the SHRFV program at 18 Victorian health services.
Professor Kelsey Hegarty, Lead Researcher and Chair of the Women’s Centre for Family Violence Prevention, said a system audit tool had helped assess how these 18 health services are implementing system change at the patient, staff, and organisational levels to address family violence.
“It is clear that the SHRFV program has enhanced the capacity of SAFE [evaluation] sites in their ability and readiness to identify and respond to family violence,” she said.
“SHRFV implementation is being undertaken by dedicated teams and people committed to improving the lives of women and children affected by family violence and ensuring their organisation is a safe place for staff to work and victim survivors to seek help. However, there is still much work to be done.”
The tool found audited services scored highly in organisational culture and policies, procedures and guidelines – the foundations crucial to realising a whole-of-organisation response to family violence – and highly in collaboration, service integration, governance and leadership. Services also scored highly in staff support, but not as highly in staff education and training.
Identification of, and response to, family violence scores varied, indicating clinical guidelines, standardised tools, and delivery of training and support for staff require additional resourcing.
The three lowest scoring domains covered organisational investment, which would help embed family violence work within health services, quality improvement and evaluation, and intersectionality and diversity.
The evaluation report concluded: “It is essential health services invest in family violence work and ensure it is embedded within the organisation through resource allocation and provide responses that are wide reaching and accessible by applying an intersectionality and diversity lens to family violence work.”
The report made nine key recommendations that provide a useful roadmap for services and government to improve family violence identification and response in health settings.