Advice and guidelines
NICE guidelines state that there is insufficient evidence to recommend domestic abuse screening or routine enquiry in most healthcare settings. However, some physical and mental health issues, such as anxiety, depression, chronic pain, headaches, urinary incontinence, difficulty sleeping, facial or dental injuries, chronic fatigue pregnancy and miscarriage have a strong link to being a victim or survivor of domestic abuse. GPs are recommended to be professionally curious about domestic abuse and set the threshold low for asking about it.
If someone is causing harm in their intimate or familial relationships, they may disclose relationship difficulties in their consultation. You can encourage them to access help through the Somerset Domestic Abuse Service which offers a voluntary programme for people who want to change their abusive behaviour.
Dash Risk Identification
To help assess the current risk of a domestic abuse victim, the Domestic Abuse Stalking and Honour-Based Violence (DASH) Risk Identification Checklist should be completed as it provides an evidence-based assessment of the current situation.
Please note that it can be completed retrospectively after you have seen a patient, with all the information that you have obtained and using your professional judgment.
Please complete as fully as possible but sometimes referrals can be accepted where some information is missing if this is absolutely necessary. Your referral should always note whether the victim does or does not provide consent (please be aware if it is a high risk, then their consent for referral is not required) and include details of how the Somerset Domestic Abuse Service can safely contact the victim.
If you are not able to complete a DASH, then the validation of your decision-making will need to be based on your own risk assessment. Please make a referral to the Somerset Domestic Abuse Service using the referral form articulating clearly your concerns. The service may then contact you about the person and can also offer a training and awareness-raising session on domestic abuse and completion of the DASH.