Authors: Rachel Sacks, Rageshri Dhairyawan, Daniella Brawley, Michelle Carroll, Rachel Caswell, Charlotte Cohen, Katherine Coyne, Christine Donohue, Praveen Jayadeva, Emma McCarty, Alison Mears, Rimi Shah, Kate Shardlow, Deborah Wardle
SUMMARY Patients experiencing domestic abuse (DA) commonly present in sexual health services and NICE recommends routine enquiry5 (i.e. asking all patients about the experience of DA, regardless of any visible signs of abuse) to identify DA within these services.
Alternative approaches include case-based enquiry (i.e. asking all patients with risk indicators e.g. un-explained injuries, depression) or targeted enquiry (i.e. asking specific patient cohorts e.g. under 18s, commercial sex workers). The BASHH Sexual Violence group has produced this document to support sexual health services who want to introduce DA enquiry.
Whatever identification approach is used, it is crucial that enquiry and management of a disclosure is carried out safely. This necessitates departmental guidelines, a DA proforma, management flow chart with clear referral pathways to relevant services and role-appropriate initial DA training for staff with training updates and ongoing support and supervision.
The enquiry process follows 4 steps: ASK> VALIDATE> ASSESS> ACTION