Research for Practice and Policy

1. Research for Practice and Policy Jude Irwin School of Social Work and Policy Studies University of Sydney

2. Introduction

3. Why is research for policy and practice important • to be able to understand, assess and evaluate research data • to justify practice interventions and policy responses to particular issues -research data can assist with this and fine tune both practice and policy • to be accountable to funding bodes and client groups in these days of public accountability –we need to know what we are being funded for is working • to understand how our practice is affecting people’s lives and how programs can be developed and improved • to understand how our practice is affecting people’s lives and how programs can be developed and improved • to have skills that better enable us to critique particular policies.

4. Reasons for doing research

5. Important issues to be addressed when undertaking research • providing information about the research and how the data will be used • ensuring participants have a real choice about if, how and when they participate • the participants should be treated as an equal • ensuring that the methods of gathering data are not exploitative • the research will be used to contribute to social change and particularly the position women

6. Research on violence against women and children • more medical treatment is sought for injuries resulting from domestic violence than from any other cause (ABS (1996) • one in four women presenting at Emergency Departments in Australia have experienced domestic violence (Bates et al 1995) • more than one in twenty women experience domestic violence during pregnancy (Gazmararian et al 1996) • women abused in pregnancy are three times more likely to become a victim of attempted or actual murder (McFarlane, Campbell, Sharpes and Watson 2002)

7. Research on violence against women and children contd.. • being a target of violence puts women at increased risk of depression, suicide attempts, chronic pain syndromes, psychosomatic disorders, physical injury, gastrointestinal disorders, irritable bowel syndrome and a variety of reproductive health consequences (WHO 2002) • physical abuse of children is fifteen times more likely in families where there is domestic violence (McKay 1994) • women exposed to severe and ongoing domestic violence are more likely to suffer extreme and long term psychological effects (Coker et al, 2002).

8. Research on violence against women and children contd.. • once removed from a violent situation women’s social and emotional wellbeing is more likely to improve (Taft, 2003: Golding, 1999) • women who experience violence and have high levels of social support and extensive networks report better psychological health and adjustment than do those with lower levels and fewer networks (Short et al 2000; Fry and Barker 2001; Thompson 2000) • women,children and young people are often at greatest risk of harm after separation (Bagshaw and Chung 2000) • it is extremely difficult for a woman to disclose to a professional practitioner that she is living with domestic violence unless she is confident of being heard and believed (Dobash and Dobash, 1992; Mullender and Morley, 1994)

9. Women’s Safety Survey (ABS 1996) • 2.6 million women or 38% of women had experienced at least one incident of violence since the age of 15 • 23% of women who had been married or in a defacto relationship had at some time experienced physical abuse from a male partner. • 1.2 million women had experienced sexual violence and 2.2 million had experienced physical violence • 19 percent of young women aged between 18-24 has experienced an incidence of violence in the previous 12 months • more women experienced physical violence from a current or previous partner than from a stranger or another man known to them. • 8 percent of married women reported an incident of violence during their current relationship • 42 percent of women who had been in a previous relationship reported an incidence of violence by a previous partner • 42 percent of these women experienced violence during their pregnancy

10. Precepts to critique epistemology • Knowledge must be grounded in individual ‘experience’, ‘perspectives’, ‘subjectivity’ or in a position of discourse • The factors of power and values cannot be added on afterwards but are fundamental • Theorising is indispensable • There is no possibility of creating a stable unchanging knowledge since all knowledge must be subject to critique from other viewpoints which may revise current structures. (Griffiths 1995, 61)

11. Methodological Principles • Knowledge can only be gained using a method which allows for reflection • Power and politics need to be taken into account thus perspective’s of different groups, communities need to be taken into account • Theorising is indispensable - a way of comparing and discussing different subjectivities – a process of abstracting and ordering understandings • Continue seeking out perspectives but do not expect to reach a stable, unchanging state of know ledge. Use old knowledge using new perceptions and then use the result to rework the new perceptions. (Griffiths 1995, 62)

12. Example of research for policy and practice

13. Aims of Pilot DV Screening Project(NSW Health, 2001) • to ameliorate the effects of, and reduce the incidence of domestic violence through early identification and appropriate provision of information, support and referral to victims of domestic violence and accompanying children • identify experiences of domestic violence early in the health care response • prevent victimisation or re-victimisation of children • to promote help-seeking behaviour in victims of domestic violence and to prevent the escalation of domestic violence • to enhance intra-Health responses to victims of domestic violence presenting to NSW Health services and increase awareness amongst health practitioners about domestic violence • to enhance an integrated whole of government response by NSW Police Service, Department of Community Services and community agencies to victims of domestic violence and accompanying children presenting to NSW Health Services

14. Gathering the data 1 Pre- pilot – establishment of a baseline to estimate the number of clients/patients where domestic violence is identified in each of the participating services before the screening pilot 2 An analysis of the responses to the screening questions 3 Survey questionnaires assessing health practitioners knowledge about domestic violence 4 Feedback from health practitioners 5 Feedback from women patients/clients 6 Telephone interviews with women patients/clients

15. Gathering the data 1. Pre- pilot – establishment of a baseline to estimate the number of clients/patients where domestic violence is identified in each of the participating services before the screening pilot

16. Gathering the data 2. An analysis of the responses to the screening questions • 4170 women presented to the health services during the 3 months of the pilot • 999 (24%) were screened • 212 (5%) -there was an explanation for not screening • 2959 (71%) no explanation Percentage of women screened at services • Antenatal services most likely to screen (80%) • Emergency (21% and 13%) • Mental Health (21%) • Alcohol and Other Drugs (13% and 35%)

17. Gathering the data 3 Survey questionnaires assessing health practitioners knowledge about domestic violence

18. Gathering the data 4. Feedback from health practitioners • Barriers to screening • Privacy • Heavy Workloads • Lack of resources and facilities • Who asks the routine screening questions • General lack of resources to support women • Limited access to interpreter services • Changes to workplace practices • Training • Provision of ongoing support

19. Gathering the data 5. Feedback from women patients/clients • 97% of the women surveyed commented positively Quotes from women • Direct questions are best. • There is no nice way to ask.

20. Gathering the data 6 Telephone interviews with women patients/clients • I think it’s really important to ask women these questions especially when they’re pregnant. • A really good project and it’s important to reach women who may not know how to reach help. • I think it’s a really good idea to continue this kind of thing. I think women should be asked if they need help because sometimes it’s really hard to speak up.

21. Dissemination of Research Findings Domestic Violence Screening Policy • Routine screening for domestic violence is a prevention strategy which provides information to at risk populations as well as early identification and appropriate intervention. Area Health services will introduce routine screening for domestic violence in accordance with NSW Department of Health’s protocols for all women attending Antenatal services and Childhood services and women 16 years and over attending Alcohol and Other Drug Services and Mental Health services. Routine screening will be fully introduced by December 2004. (NSW Department of Health 2002)

22. What does all this mean • ‘Continue seeking out perspectives but do not expect to reach a stable, unchanging state of know ledge. Use old knowledge using new perceptions and then use the result to rework the new perceptions.’(Griffiths 1995,62)

23. What does all this mean • A participant at the British Council Seminar used the metaphor of embroidery to describe the global work on violence against women. I liked this image –good embroidery takes time and patience, every stitch counts, it requires many colours, different threads and stitches- and as everyone familiar with needlework knows sometimes you have to unpick a section and begin again- but now with the knowledge of what was not right the first time. We have three decades of stitching to draw on –my hope is that we can unravel some of the knots and work on the same design. (Liz Kelly)

24. References • Australian Bureau of Statistics (1996) Women’s Safety Australia, Canberra, ABS and Office for the Status ofWomen. • Bates L., Redman S., Brown W., and Hancock L. (1995) “Domestic Violence Experienced by Women attending an accident and emergency department’ Australian Journal of Public Health.Vol 19. 293-299. • Bagshaw, D. and Chung, D. (2000) Women, Men and Domestic Violence Report for Partnerships Against Domestic Violence, University of South Australia.

25. References • Coker, A.L., Smith, P.H, Thompson, M.P., McKeown, R.E., Bethea, L., Davies, K.E. (2002) “Social Support Protects against the Negative Effects of Partner Violence on Mental Health”, in Journal of Women’s Health and Gender-Based Medicine, 11(5): 465-476. • Dobash R.E. and Dobash R.P.(1992) Women, Violence and Social Change. London, Routledge. • Fry P.F. and Barker LA (2002) ‘Quality of relationships and structural properties of social support networks of female survivors of abuse’ Genetic Social and General Psychology Monographs, 128 (2), 139-164.

26. References • Gazmararian J.A., Lazorick S., Spitz A.M., Ballard T.J., Saltzman L.E. and Marks J.S. (1996) ‘Prevalence of violence against pregnant women’ The Journal of the American Medical Association, 275 (2) 1915-1920. • Golding, JM (1999). “Intimate partner violence as a risk factor for mental disorders: a meta analysis” in Journal of Family Violence, 14(2): 99-132. • Griffiths, M.(1995) Feminisms and the Self: the Web of Identity Routeldge, London and New York. • Kelly L., (2001) ‘Inaugural Professorial Lecture’ University of North London, UK.

27. References • McFarlane J., Campbell J.C., Sharpes P. and Watson J.K. (2002) ‘Abuse during pregnancy and femicide: urgent implications for women’s health’, Obstetrics and gynaecology 100, 27-36. • McKay M (1994) ‘The link between domestic violence and child abuse: assessment and treatment considerations; Child Welfare 73 (1) 29-39. • Mullender A and Morley R eds (1994) Children Living with Domestic Violence London, Whiting and Birch. • NSW Health (2001) ‘Unless They’re asked’ Routine screening for domestic violence in NSW Health. NSW Department of Heath, Sydney.

28. References • NSW Health (2003) Policy and Procedures for identifying and responding to domestic violence, NSW Department of Heath, Sydney. • Short L.M.; McMahon P.M.; Shervin D.D.; Shelley G.A.; Lezin N.; Sloop K.S. and Dawkins N.; (2000) ‘Survivors identification of protective factors and early warning signs for intimate partner violence’ Violence Against Women 6(3), 272-285. • Taft A (2003) Promoting Women Mental Health; The Challenges of Intimate/Domestic Violence Against Women. Australian Domestic and Family Violence Clearing House, UNSW.

29. References • Thompson, M.P., Kaslow, N.J., Kingree, J.B, Rashid, A., Puett, R., Jacobs, D. and Matthews, A. (2000) “Partner violence, social support and distress among inner-city African American women” in American Journal of Community Psychology, 28(1), 127-143. • World Health Organisation (2002) World Report on Violence and Health: Summary. Geneva, WHO: 54.