This appeared last week.
Telehealth: harm or benefit for survivors of intimate partner violence?
Authored by Kelsey Hegarty
SEXUAL and domestic violence has wide-ranging impacts on health and wellbeing, resulting in high attendance of women survivors in health settings. The effects of the COVID-19 pandemic on movement restriction and finances appear to be exacerbating sexual and domestic violence incidence, nature and severity (here and here).
In July 2020, a national survey of 15 000 Australian women showed 4.6% experienced physical or sexual violence, 5.8% coercive control and 11.6% one form of emotionally abusive, harassing or controlling behaviour by a partner in the previous 3 months. For two-thirds of these women the violence started or got worse during the COVID-19 pandemic. Lockdowns enhance social isolation of women and their children, a common tactic that some men use as part of coercive control over partners, enabling more abuse to happen. Recent global updates about how to address domestic violence have highlighted how to respond generally and also in the context of the COVID-19 pandemic.
Safety concerns and barriers to accessing help for survivors have been affected by the closure of many face-to-face services. Health practitioners are the highest level of professional group told about sexual and domestic violence. To a great extent in Australia, health care during lockdowns has moved to remote consultations through electronic communication (phone or video), often known as telehealth. The Australian Government has supported this financially through Medicare, with the greatest uptake being GP and mental health consultations by telephone. An Australian Bureau of Statistics survey in 2020 showed that telehealth was being used by around one in five patients, with half saying they would use telehealth in the future.
But do we know if this mode of communication is of harm or benefit for women with trauma histories?
Much has been said about the harms and safety issues of using telehealth. The basic rule of asking about abuse and violence is that the patient is alone in a private setting. For example, all antenatal patients are screened for domestic violence in Victoria, but as most are now done through telehealth, the screening rate is likely to be less than before the COVID-19 pandemic.
On the telephone it is almost impossible to know if patients are alone, even if they are asked that question directly by the clinician. For women living with sophisticated perpetrators, for whom monitoring is a high level skill, it might be dangerous for women and children to discuss their experiences of sexual and domestic violence. However, there have been recent suggestions for how to get around this.
Read on for many useful ideas and tips here.
A very useful article on an important topic in these COVID19 times!
David.
3 comments:
David,
Are you suggesting that there's more to technology than just the technology? That's a dangerous and subversive thought. The government won't like you for suggesting such things. Technology is good, data sharing is good, digital transformation is good. It must be, everybody says so in all those magazine articles and trade papers.
The Government, frankly, does not have a clue! Their lack of real understanding is reflected in the last decade or two of Digital Health fails!
They are like a blindfolded elephant just stumbling around in the forest lacking subtlety and insight!
David.
Sadly a lot of victims of abuse are not aware that they are being abused, so expert are their perpetrators. All the more reason for those individuals to have that face to face private contact with a medical professional who can identify the signs and symptoms and offer help and assistance.
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