Research for Practice and Research for Practice and PolicyPolicy

Jude IrwinJude Irwin

School of Social Work and Policy StudiesSchool of Social Work and Policy Studies

University of SydneyUniversity of Sydney

IntroductionIntroduction

Why is research for policy and practice important Reasons for doing research Research and violence against women and children Example of research for policy and practice Dissemination of research for policy and practice

What does all this mean?

Why is research for policy and practice Why is research for policy and practice importantimportant

• 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.

Reasons for doing researchReasons for doing research

Important issues to be addressed Important issues to be addressed when undertaking researchwhen 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

Research on violence against women and Research on violence against women and childrenchildren

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)

Research on violence against women and children Research on violence against women and children contd..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).

Research on violence against women and children Research on violence against women and children contd..contd..

once removed from a violent situation women’s social and once removed from a violent situation women’s social and emotional wellbeing is more likely to improve (Taft, 2003: emotional wellbeing is more likely to improve (Taft, 2003: Golding, 1999)Golding, 1999)

women who experience violence and have high levels of women who experience violence and have high levels of social support and extensive networks report better social support and extensive networks report better psychological health and adjustment than do those with psychological health and adjustment than do those with lower levels and fewer networks (Short et al 2000; Fry and lower levels and fewer networks (Short et al 2000; Fry and Barker 2001; Thompson 2000)Barker 2001; Thompson 2000)

women,children and young people are often at greatest risk women,children and young people are often at greatest risk of harm after separation (Bagshaw and Chung 2000)of harm after separation (Bagshaw and Chung 2000)

it is extremely difficult for a woman to disclose to a it is extremely difficult for a woman to disclose to a professional practitioner that she is living with domestic professional practitioner that she is living with domestic violence unless she is confident of being violence unless she is confident of being heardheard and and believed believed (Dobash and Dobash, 1992; Mullender and Morley, (Dobash and Dobash, 1992; Mullender and Morley, 1994)1994)

Women’s Safety Survey (ABS 1996)Women’s Safety Survey (ABS 1996) 2.6 million women or 38% of women had experienced at least one 2.6 million women or 38% of women had experienced at least one

incident of violence since the age of 15incident of violence since the age of 15 23% of women who had been married or in a defacto relationship 23% of women who had been married or in a defacto relationship

had at some time experienced physical abuse from a male partner.had at some time experienced physical abuse from a male partner. 1.2 million women had experienced sexual violence and 2.2 million 1.2 million women had experienced sexual violence and 2.2 million

had experienced physical violencehad experienced physical violence 19 percent of young women aged between 18-24 has experienced 19 percent of young women aged between 18-24 has experienced

an incidence of violence in the previous 12 monthsan incidence of violence in the previous 12 months more women experienced physical violence from a current or more women experienced physical violence from a current or

previous partner than from a stranger or another man known to previous partner than from a stranger or another man known to them.them.

8 percent of married women reported an incident of violence 8 percent of married women reported an incident of violence during their current relationshipduring their current relationship

42 percent of women who had been in a previous relationship 42 percent of women who had been in a previous relationship reported an incidence of violence by a previous partnerreported an incidence of violence by a previous partner

42 percent of these women experienced violence during their 42 percent of these women experienced violence during their pregnancypregnancy

Precepts to critique epistemologyPrecepts to critique epistemology Knowledge must be grounded in individual Knowledge must be grounded in individual

‘experience’, ‘perspectives’, ‘subjectivity’ or ‘experience’, ‘perspectives’, ‘subjectivity’ or in a position of discoursein a position of discourse

The factors of power and values cannot be The factors of power and values cannot be added on afterwards but are fundamentaladded on afterwards but are fundamental

Theorising is indispensableTheorising is indispensable There is no possibility of creating a stable There is no possibility of creating a stable

unchanging knowledge since all knowledge unchanging knowledge since all knowledge must be subject to critique from other must be subject to critique from other viewpoints which may revise current viewpoints which may revise current structures. (Griffiths 1995, 61)structures. (Griffiths 1995, 61)

Methodological PrinciplesMethodological Principles Knowledge can only be gained using a method which Knowledge can only be gained using a method which

allows for reflectionallows for reflection Power and politics need to be taken into account thus Power and politics need to be taken into account thus

perspective’s of different groups, communities need to perspective’s of different groups, communities need to be taken into accountbe taken into account

Theorising is indispensable - a way of comparing and Theorising is indispensable - a way of comparing and discussing different subjectivities – a process of discussing different subjectivities – a process of abstracting and ordering understandingsabstracting and ordering understandings

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

Example of research for Example of research for policy and practicepolicy and practice

Aims of Pilot DV Screening ProjectAims of Pilot DV Screening Project(NSW Health, 2001)(NSW Health, 2001)

to ameliorate the effects of, and reduce the incidence of domestic to ameliorate the effects of, and reduce the incidence of domestic violence through early identification and appropriate provision of violence through early identification and appropriate provision of information, support and referral to victims of domestic violence information, support and referral to victims of domestic violence and accompanying childrenand accompanying children

identify experiences of domestic violence early in the health care identify experiences of domestic violence early in the health care responseresponse

prevent victimisation or re-victimisation of childrenprevent victimisation or re-victimisation of children to promote help-seeking behaviour in victims of domestic to promote help-seeking behaviour in victims of domestic

violence and to prevent the escalation of domestic violenceviolence and to prevent the escalation of domestic violence to enhance intra-Health responses to victims of domestic to enhance intra-Health responses to victims of domestic

violence presenting to NSW Health services and increase violence presenting to NSW Health services and increase awareness amongst health practitioners about domestic violenceawareness amongst health practitioners about domestic violence

to enhance an integrated whole of government response by NSW to enhance an integrated whole of government response by NSW Police Service, Department of Community Services and Police Service, Department of Community Services and community agencies to victims of domestic violence and community agencies to victims of domestic violence and accompanying children presenting to NSW Health Servicesaccompanying children presenting to NSW Health Services

Gathering the dataGathering the data

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

2 An analysis of the responses to the screening questions2 An analysis of the responses to the screening questions

3 Survey questionnaires assessing health practitioners 3 Survey questionnaires assessing health practitioners knowledge about domestic violenceknowledge about domestic violence

4 Feedback from health practitioners4 Feedback from health practitioners

5 Feedback from women patients/clients5 Feedback from women patients/clients

6 Telephone interviews with women patients/clients6 Telephone interviews with women patients/clients

Gathering the dataGathering the data

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

Gathering the dataGathering the data2. An analysis of the responses to the

screening questions

4170 women presented to the health services during the 3 4170 women presented to the health services during the 3 months of the pilotmonths of the pilot

999 (24%) were screened999 (24%) were screened 212 (5%) -there was an explanation for not screening212 (5%) -there was an explanation for not screening 2959 (71%) no explanation2959 (71%) no explanation

Percentage of women screened at servicesPercentage of women screened at services Antenatal services most likely to screen (80%)Antenatal services most likely to screen (80%) Emergency (21% and 13%) Emergency (21% and 13%) Mental Health (21%) Mental Health (21%) Alcohol and Other Drugs (13% and 35%)Alcohol and Other Drugs (13% and 35%)

Gathering the dataGathering the data

3 Survey questionnaires assessing health practitioners knowledge about domestic violence

Gathering the dataGathering the data4. Feedback from health practitioners4. Feedback from health practitioners

Barriers to screeningBarriers to screening Privacy Privacy Heavy WorkloadsHeavy Workloads Lack of resources and facilitiesLack of resources and facilities Who asks the routine screening questionsWho asks the routine screening questions General lack of resources to support womenGeneral lack of resources to support women Limited access to interpreter servicesLimited access to interpreter services Changes to workplace practicesChanges to workplace practices TrainingTraining Provision of ongoing supportProvision of ongoing support

Gathering the dataGathering the data

5. Feedback from women patients/clients5. Feedback from women patients/clients

97% of the women surveyed commented positively97% of the women surveyed commented positively

Quotes from women Direct questions are best.Direct questions are best. There is no nice way to ask.There is no nice way to ask.

Gathering the dataGathering the data

6 Telephone interviews with women patients/clients6 Telephone interviews with women patients/clients

– I think it’s really important to ask women these I think it’s really important to ask women these questions especially when they’re pregnant.questions especially when they’re pregnant.

– A really good project and it’s important to reach A really good project and it’s important to reach women who may not know how to reach help.women who may not know how to reach help.

– I think it’s a really good idea to continue this kind I think it’s a really good idea to continue this kind of thing. I think women should be asked if they of thing. I think women should be asked if they need help because sometimes it’s really hard to need help because sometimes it’s really hard to speak up.speak up.

Dissemination of Research FindingsDissemination of Research Findings

Domestic Violence Screening PolicyDomestic Violence Screening Policy Routine screening for domestic violence is a Routine screening for domestic violence is a

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

What does all this meanWhat does all this mean

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

What does all this meanWhat does all this mean

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

design.design. (Liz Kelly)

References 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 Bagshaw, D. and Chung, D. (2000) Women, Men and Domestic Violence Report for Partnerships Against Domestic Violence Report for Partnerships Against Domestic Violence, University of South Australia.Domestic Violence, University of South Australia.

References 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.

References 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.

References 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.

References 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.

References 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.