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Key Learning from Dhrs

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Key Learning from Dhrs Key Learning from DHRs Miranda Pio The Coordinated Community Response “No single agency or professional has a complete picture of the life of a domestic abuse survivor but many will have insights that are crucial to their safety.” Standing Together: Building the CCR DHR Definition . The death of a person aged 16 or over has, or appears to have, resulted from violence, abuse or neglect by (a) a person to who he/she was related or with whom he/she was or had been in an intimate personal relationship, or (b) a member of the same household as her/himself . held with a view to identifying lessons to be learnt from the death DHR -Statutory context • Implemented through section 9 of the Domestic Violence, Crime and Victims Act 2004 • Following a homicide, local authorities should conduct a ‘Domestic Homicide Review’ (DHR) into what happened • In some circumstances, local authorities may decided to conduct a ‘Near Miss Review’ (NMR) – Into those cases that did not result in a homicide but are of particular concern, e.g. because of a life changing incident and/or extensive contact with local services – Not a statutory requirement DHR Process Overview CSP First Panel IMRs and Report written completes Homicide meeting: chronologies & reviewed at Action Plan meets DHR Chair compiled Panel CSP publishes definition appointed Terms of Submits all to Review Reference & Presented at Agreed & Home Office (CSP) membership Panel meeting submitted to Quality CSP Assurance Contact with family, friends, perpetrator Parallel Reviews Standing Together’s Case Analysis Report 32 deaths 75 Intimate Partner Homicide- 24 25 Family-Related Homicide-8 % % Partner or ex-partner 23 Matricide 5 (1 friend) Patricide 2 Murder-suicide 4 Fratricide 1 Partner also carer 4 Intimate Partner Violence (IPV) VS Adult Family Violence (AFV) • Dearth of research AFV • Both are gendered • Different dynamics • Caring responsibilities • Mental health & problematic substance use • Clustering of risk factors – previous criminality Overview of Victim Demographics 5 5 5 Sex Disability 84% female 27 19% disability 27 1 10 Age 15 Sexuality 20-81; Mean 41 1 gay male victim 7 31 Ethnicity 17 7 Children 5/8 AFH BME 71% / IPV cases ⅓ IPV Black Women 15 17 Key Themes Identification/assessment and referral Risk pathways Health Primary Care and Mental Health Safeguarding Adults Age, disability, caring responsibilities Safeguarding Not always considered, thresholds for Children assessment, accountability Informal Hold vital information, wider Networks community involvement Risk Factors Most common risk factors identified: • Abuse to previous partners • Wider offending history- family members & other offences • Coercive Control • Jealous surveillance • Separation • Suicide and attempts of perpetrator • Older women • Disability • Caring relationship Women killed in the context of separation- ‘separation as a process not a single event’ Femicide Census, 2009 - 2015 Risk Assessment: Key Findings • Failure to identify and assess risk • Lack of understanding of coercive control • Not ‘weighting’ victims concerns • Incidents viewed in isolation • Not viewing risk as dynamic • Bail conditions seen as ‘managing’ risk • Invisibility of perpetrator What did DHRs reveal about Children Social Care? Findings • Child safeguarding issues in 1/3 of IPH cases • Range of professionals came into contact w children as well as mothers – little consideration of risks to children • Women held accountable for safeguarding children while perpetrator invisible • False allegations made by perpetrator Adult Safeguarding: Key Findings • Over a 1/4 of IPH victims over 58. • Assumptions about age and domestic abuse • 1/4 of IPH cases involved a partner who was also the carer • Barriers faced by older and disabled victims Findings for Health • Most likely to have contact with victims and perpetrators • Missed opportunities to identify and enquire GPs – Victim Presentations MH– Victim Presentations • Depression (8); Injury / falls (7) • Depression (9) • Anxiety, Panic attacks, Alcohol, • Panic attacks (2), Self-harm (2), Headaches, Sleeping (2) PTSD (1) • Long term health (5) GPs – Perpetrator Presentations MH – Perpetrator Presentations • Mental health (7), depression (6) • Depression (6); Psychosis (4), • Problematic substance misuse (5), • Self-harm (3); Personality Stress (4) Disorder, Bipolar Disorder, Schizophrenia (2), Delusion (1) Health Findings: GPs • GPs only stakeholder group consistently engages with V/P • Over half of IPH reports note that GPs missed opportunities to ask the victim about IPV • Quarter missed opportunities to ask perpetrator about IPV • Lack of curiosity about relationship with partner/father of child • Sharing information across the healthcare system – a ‘national problem’ Health Findings: Mental Health • Second most common health related theme • 2/3 of IPH victim and perpetrator had MH related needs • Depression, alcohol and substance use often present for both victim and perpetrator • Tendency to focus on substance misuse & MH and miss opportunity to identify DA Recommendations for Health Training Record keeping Information Domestic Abuse sharing Policy Enquiry about DVA Informal networks: friends & family • Victims of IPV are more likely to contact friends or family for help before a formal agency • Often friends, family and colleagues hold vital information around level of risk • AAFDA provide expert support and advice for families [email protected] The Literature • DHR Case Analysis Report (Standing Together, November 2016) • Key Findings from Analysis of DHRs (Home Office, December 2016) • Preventing Domestic Violence and Abuse: Common Themes Lessons Learned from West Midlands DHRs (Dr Lucy Neville and Dr Erin Sanders- McDonagh, 2014) • Southend, Essex and Thurrock Domestic Homicide Review Case Analysis January 2017 (SET DHR Thematic Review Sub-Group) • Domestic abuse and change resistant drinkers: preventing and reducing the harm; Learning lessons from DHRs. (Alcohol Concern & AVA, June 2016) • Redefining An Isolated Incident, Femicide Census, Profiles of Women killed by Men. (Women’s Aid & Nia, December 2016) My contact details: • Miranda Pio [email protected].
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