Training scheme helped identify more hospital victims of domestic violence

The number of women identified as domestic violence victims rose threefold in accident and emergency wards where staff underwent a special Women's Aid pilot training programme, a press conference was told yesterday.

Dr Mark Doyle, a consultant at Waterford Regional Hospital, said it now encountered one battered woman a week in its casualty ward, compared to 18 in the year before the pilot programme was introduced.

Without special training in the identification and treatment of such women, medical workers felt the problem was either untreatable or a social issue and thus outside their area of responsibility, he said. This tended to lead to "a mutual conspiracy of silence" among hospital staff and victims.

He was speaking at the launch of a formal Women's Aid training programme for A & E staff, based on the pilot programme which was introduced in nine hospitals in the Eastern and South Eastern Health Board areas last year. The initiative was launched after research found that, following a friend or relative, the person whom a woman experiencing abuse was most likely to disclose it to was her GP.

Ms Denise Charlton, director of Women's Aid, noted that, in the United States, battering by a partner was the single biggest reason for women being admitted to casualty units, accounting for between 22 per cent and 35 per cent of female admissions. A pilot study at St James's Hospital found that 119 women were admitted in 1993 due to an assault in the home, 46 of whom said it was part of a long history of abuse.

However, Ms Charlton said that "even if A & E staff know or suspect domestic violence, it is often ignored, because they do not know how to proceed". Worse still, hospital staff can discourage women from seeking help elsewhere by giving a negative or dismissive response.

The training programme covers the areas of identification, intervention and referral and is aimed at medical staff from GPs and consultants to nurses and hospital receptionists. Women's Aid is seeking funding from the Department of Health to promote the initiative as widely as possible.

Dr Doyle said the pilot programme had given staff in Waterford "an awareness about the issue and about the prejudices surrounding it, including our own. One of the things we had to challenge was our medical instincts to take control of the situation and feel we know what's best for the patient. We had to learn to let the woman set the pace and not regard it as a failure if she decided not to take action on a particular occasion."

Among the other hospitals which underwent the pilot programme was the James Connolly Memorial in Blanchardstown, Dublin, where referrals of battered women to medical social workers rose from 14 in the year before it was introduced to 40 in the year afterwards.