Domestic violence and abuse: ‘If we all work together, it will make a difference’

Guest blog by Medina Johnson (left), Chief Executive
and Lucy Downes (right), National Implementation Manager
IRIS Interventions



As we gear up for events and conversations to mark the 16 Days of Activism against Gender-based Violence, it’s timely to reflect on the importance of the healthcare response to gender-based violence. IRISi’s vision is a world in which gender-based violence is consistently recognised and addressed as a health issue.

Violence against women is a global health problem of epidemic proportions. Dr Margaret Chan, World Health Organization Director-General

The IRIS programme is our flagship intervention working with primary care to change and improve clinical practice and to provide patients affected by domestic abuse with access to specialist advice and support. It provides training and support to GPs, practice nurses and other primary care clinicians to help them identify and refer women with experience of domestic violence and abuse (DVA) to specialist domestic violence services. It also provides information and signposting for male victims and perpetrators.

The service is a collaboration between primary care and third sector organisations specialising in DVA. An advocate educator, based in a local specialist DVA service, is linked to general practices and works in partnership with the local clinical lead to co-deliver the training to those practices. She also supports patients referred from those practices.

Close to 1,000 general practices have already benefitted from IRIS training, which equips GPs and other general practice clinicians with the knowledge and confidence to ask patients sensitively about domestic abuse. Nine out of 10 clinicians would recommend IRIS training to a colleague:

What an excellent clinical teaching session – one of the best I’ve been to in eight years of medicine. IRIS-trained GP

Over 10,000 patients with experiences of domestic abuse, nearly all of whom are women, have been referred to their local IRIS advocate educator for emotional and practical support.

I found it helpful to be asked [about domestic abuse] by my doctor. It made me feel less alone and I never knew this support was available. IRIS service user

For clinicians, IRIS changes and improves clinical practice. For patients IRIS improves quality of life, overall health and wellbeing, and enhances safety. Ninety five per cent of patients referred into the IRIS service were pleased to be asked about domestic abuse. Seventy per cent reported visiting their general practice less frequently since receiving support.

I’m hugely grateful that the doctor referred me. I wouldn’t have done it myself. I was in a very bad place. I was really lonely and she listened to me, heard me, and just picked up where I was making excuses for my partner’s behaviour. She didn’t push anything at me but made it clear there were options. IRIS service user

IRISi’s mission is to improve the healthcare response to gender-based violence through health and specialist services working together. We look forward to continuing relationships with existing partner organisations that deliver the IRIS programme within local areas, and to developing adaptations of the IRIS programme within sexual health settings, dentistry and community pharmacies.

In the words of an IRIS-trained clinician:

If we all work together, it will make a difference.

Join us in making a difference during this year’s 16 Days of Activism: #16days #HearMeToo #irisintervent

About IRISi

IRISi is a social enterprise established to promote and improve the health care response to gender-based violence. IRISi:

  • supports the local commissioning, implementation, maintenance and growth of the IRIS programme, including bid development, training for trainers, ongoing support, national analysis and monitoring
  • collaborates with partners to develop innovative, evidence-based health interventions for those affected by gender-based violence
  • provides expert advice and consultancy in the field of DVA and health.

Domestic violence and health research at the University of Bristol

Professor Gene Feder, a GP and Professor of Primary Care at the University of Bristol’s Centre for Academic Primary Care (CAPC), and architect of the IRIS programme, leads an international programme of research into domestic violence and health. For information on current and past projects, see the CAPC website.

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