Health visitors' perceptions of domestic violence: the private nature of the problem

This study investigates health visitors' perceptions of domestic violence with a focus on the abuse of women by their male partners. Criticism has been levied at health visitors for responding inappropriately to women who seek help. There has been limited research into the process of health visiting practice in dealing with this emotive health need. The extent of the problem is difficult to ascertain, but estimates would suggest that it is a major public health issue. The abuse frequently commences or intensifies during pregnancy, and many of the women who experience domestic violence have children of pre-school age. It is during this time that they are most likely to come into contact with the health visiting service. The research was carried out in two National Health Service (NHS) trusts, one in the London region and the other in the south-east of England. A brief questionnaire was sent to all health visitors within the NHS trusts to ascertain the numbers of abused women known to the health visiting service. The findings suggest that the majority of health visitors in both NHS trusts were involved with families where domestic violence occurs. One of the key themes which emerged from interviews with 12 health visitors from each NHS trust (n = 24) was the very private nature of domestic violence in terms of identifying the issue. Implications for practice are that health visitors need to be more proactive in their questioning techniques and in influencing public policy, but they also require support through the provision of appropriate training.