Why Women with Multiple Complex Needs deserve our attention during the passage of the Domestic Abuse Bill 2020

The Domestic Abuse bill of 2020 will massively impact people with multiple complex needs, the below includes our response and thoughts on the subject.

Response to the third reading of the Domestic Abuse Bill

In June 2020, the South East Fulfilling Lives team responded to the call for evidence by the government on the draft Domestic Abuse Bill 2020[1]. In response to the third reading of the Bill that was passed in the House of Commons on 6 July 2020, we are disappointed that there is little in the Bill that directly references women with multiple complex needs.

Why do women with multiple complex needs deserve focus and legal protections?

More than half of every one in 20 women who experienced extensive physical and sexual violence and abuse across their life course have a common mental health condition, one in five have experienced homelessness, and one in three have an alcohol problem[2]. In December 2018, 93% of the women on South East Fulfilling Lives’ own caseload had experienced domestic abuse. Of these women, 76% were homeless (rough sleeping/in temporary accommodation/sofa surfing/in hostels), 96% had both substance misuse and mental health needs when we began working with them, 88% had histories of offending, and 72% had disabilities.[3]

Why should the complex needs of domestic abuse victims be named and defined?

Domestic abuse takes place in a wider context and not all women experience similar levels of domestic abuse nor possess similar privileges or resources to get the right support at the right time. Women facing multiple disadvantage are some of the most marginalised victims of domestic abuse and an unequal society, and are often ostracized from society and support services. They are more likely to present with a history of extensive violence and abuse, have complex and overlapping needs such as high rates of mental health problems, substance misuse, contact with the criminal justice system and homelessness. They are also more prone to victim-blaming by professionals in statutory services or being labelled non-engaging or non-compliant by essential services[4].

Having a one-size-fits-all response to domestic abuse that fails to acknowledge different levels of vulnerability creates a culture around “worthy” and “unworthy” victims of domestic abuse. Therefore, we believe that the complexities of some of the most vulnerable victims’ lives should be named and adequately defined in order to provide more targeted support as well as legal protections. Whilst we welcome the widening of the statutory definition of domestic abuse to include emotional, coercive or controlling, and economic abuse, we also reiterate our call for the Bill to include a clear definition of ‘Multiple Complex Needs’.

Reconsidering New Clause 23: Commissioning specialist domestic abuse services

We are disappointed that a majority of MPs voted against the new Clause 23 which seeks to establish a statutory duty on relevant public authorities to commission specialist support and services to all persons affected by domestic abuse[5]. Women with multiple complex needs, who use the independent and women-led specialist domestic abuse services seldom respond well to traditional forms of service delivery models and access routes to support.

Our own project learning revealed that women with multiple complex needs are harder to reach, less visible to services and under-represented in statistics[6]. Research carried out by AVA and Agenda found that out of 173 local areas in England and Wales, only 19 had access to support for women facing multiple disadvantage that could address all of the following issues: substance use, criminal justice contact, mental-ill health and homelessness.[7] Survivors with complex needs and their children often require additional services and higher levels of support and outreach by trusted professionals who have the social skills and gendered understanding of how perpetrators operate and who can empathetically support them on their path to freedom and recovery.

In our experience, the response to domestic abuse continues to be siloed, with little joint work between the police, probation services, substance misuse services, children’s services and health practitioners and the specialist charities working supporting women. Victims of domestic abuse with complex needs require a holistic, comprehensive and whole-systems approach to tackling domestic abuse which includes partners in housing, health, relevant public authorities and statutory services in addition to the Bill’s sole focus on criminal justice and crisis response. This means an integrated cross-government response, rather than individual departments publishing separate guidance and being provided with separate funding arrangements.

Furthermore, those experiencing domestic abuse and complex needs may access a range of public services, such as their GPs, who are often the first point of contact.These non-specialist services play a crucial role in early intervention by identifying complex needs and recognising signs of abuse. Yet, women frequently do not receive a service which reflects an understanding of the complexities, dynamics and risk issues of domestic abuse or receive a trauma informed response, due to a lack of understanding. Thus, we urge for specific training duties for non-specialist domestic abuse services to be established in the Bill and embedded within the implementation plans. This echoes Agenda’s #AskAndTakeAction campaign, which places a duty on public authorities to ensure all frontline staff make trained enquiries into domestic abuse, which is crucial to ensuring victims get the support they need at the earliest possible opportunity [8]. 

We also hoped to see the Bill pave the way for new forms of accommodation that can provide emergency rapid-access accommodation that is self-contained and dispersed within communities, where wrap-around support is provided, and to include Specialist Multiple Complex Needs Refuge Accommodation as an option as often additional complex needs, such as substance misuse, excludes women from accessing the current refuge models, meaning many are being forced to return to their partner and abuser or being placed in non-specialist accommodation settings.

For the Domestic Abuse Bill to be truly transformational in its intent and also its outcomes, it is vital that no victim is left behind, and all victims feel heard, safe, and valued. Although many improvements have been made to the Bill, there are still holes in the protection the law provides to some of the most marginalised victims of domestic abuse. As the Bill is in the process of being scrutinised by the House of Lords[9], we hope further amendments will be tabled to ensure the scope of its protection is extended to all victims, especially those who have complex needs, and face multiple disadvantages and vulnerabilities simultaneously.

This post has been authored by Aditi Bhonagiri, with valuable contributions from Emily Page, Sandra Sylvester and Rebecca Riley.


If you have any questions after reading this piece, please feel free to get in touch with the author at aditi.bhonagiri@sefulfillinglives.org.uk

For more information on what we do, download our reports and resources please visit https://www.bht.org.uk/fulfilling-lives/


1 https://publications.parliament.uk/pa/cm5801/cmpublic/DomesticAbuse/memo/DAB86.pdf

2 http://weareagenda.org/wp-content/uploads/2015/11/Hidden-Hurt-full-report1.pdf

3 https://www.bht.org.uk/wp-content/uploads/2019/11/Fulfilling-Lives-Manifesto-for-Change.pdf

4 https://www.changing-lives.org.uk/wp-content/uploads/2019/03/Too-Complex-Evaluation-Final-Nov-2018.pdf

5 https://www.theyworkforyou.com/debates/?id=2020-07-06e.780.0#g781

6 Sarah Robinson, Oct 2016, Where are the Women?: Supporting Women with Multiple Needs. Cached at: https://wy-fi.org.uk/?mdocs-file=2277

7 https://avaproject.org.uk/resources/mapping-maze-full-report/

8 https://weareagenda.org/askandtakeaction/

9 https://services.parliament.uk/bills/2019-21/domesticabuse.html

Behind Closed Doors

Kate is a Playwright,  and Project Consultant Assistant with Fulfilling Lives. In this piece she writes about her experience of domestic abuse and what services have been being doing to combat it during the current pandemic

No one knows what goes on in people’s lives behind closed doors, but what is known is that there has been a sharp increase of domestic violence during the Coronavirus outbreak, with us all having to live our lives in lock-down. For some, trying to live in an abusive relationship can be traumatising, fearful and shameful. What I mean by shameful is that it can be something that people do not want to talk about in case they are not believed, or they are frowned upon. They might have been made to believe it is their fault, and even be frightened to think that what they might share could get back to the person who is abusing them.

I say this as someone who has lived most of my life in violent, controlling, coercive relationships and it’s not just as easy as getting up and leaving or talking to someone about it. The amount of times I wanted to talk to someone, especially after I had taken a beating. That hand around my throat, strangling me. That knife held to my throat, in front of my children. That trainer that is just about to stamp on my head. Oh and how can I forget the line “I didn’t mean it, it won’t happen again, I promise, I love you”. Unfortunately, time and time again, I believed that line and believed it was love. What I should have believed in more is the saying, that actions speak louder than words. This is exactly what has been happening in many communities during Covid-19.

Government and Services Response to DV

The government and services have been acting. There have been some fantastic campaigns raising awareness of domestic abuse, here are some examples:

  • Numerous organisations have created information posters and leaflets with key guidance for ‘non-specialist services”.
  • Pharmacy schemes with the launch of the “safe space” initiative where Boots, Superdrug, and Morrisons have allowed their consulting rooms to be a safe space for women experiencing domestic abuse. Go to the healthcare counter and ask to use their consultancy room. The pharmacist will you show you to the safe space and once inside you will have access to all specialist domestic abuse information and be able to make the call safely. https://uksaysnomore.org/safespaces/.
  • There is printed information of the national domestic abuse line on pharmacy bags and at the bottom of Tesco’s shopping receipts.
  • UK says no more has the #listeningFromHome campaign. Encouraging members, friends, colleagues, and neighbours to be aware of and to report signs of domestic abuse whilst in lockdown. If you are concerned you can help by following these guidelines:Check in with victim but be mindful communication channels maybe monitored or call the police.
  • If you are feeling unsafe the best thing to do might be to call 999 and get support from the police. You can do this silently if you are worried about your partner knowing. When dialling 999 from a mobile listen to the prompts from the operator, then cough or tap. The operator will then prompt you to press 55 this will transfer your call to the police, pressing this only works from a mobile and does not allow police to track your location.  
  • “At home shouldn’t mean at risk” logo has been added on the specialist domestic abuse services and if you are experiencing domestic abuse you don’t need to stay at home. Police response and support services remain open for help and support visit https://www.gov.uk/guidance/domestic-abuse-how-to-get-help  #YouAreNotAlone campaign.
  • The sanctuary scheme provides an alternative to relocation away from family and friends with vital support networks and key services through installation of enhanced security measures in your home. It’s voluntary, free and available to both homeowners and tenants who meet certain requirements. The scheme is funded by members of the Hastings and Rother Domestic Violence forum which has reps from CGL, Sussex Police, HomeWorks, and Optivo. If you would like to request sanctuary in your home call the CGL Domestic Abuse Portal service on 01424 716629 or housing options team on 01424 451100.  
  • East Sussex refuges are still accepting referrals. You can self-refer or enter through Hastings, Eastbourne, Lewes and Wealden and Rother councils or alternatively through East Sussex Police or the Portal. Also, through health services and social care website http://www.refuge.org.uk
  • Fulfilling Lives also played an essential role in trying to influence the content in the Domestic Abuse Bill for women with Multiple and Complex needs.


I really hope that this great work and national/local campaigns that has taken place during the coronavirus pandemic, has encouraged women experiencing domestic abuse to open their doors and walk free from the abuse that can happen behind closed doors. I know if these nation-wide campaigns were taking place when I was living this traumatic life then I would have felt safer to step forward, speak up and flee the violence, a lot sooner than I did.  So, let’s try to keep these conversations going within our communities not only to encourage, support and make people feel safe, but to also reduce the stigma that can occur around domestic abuse. Long may these campaigns against domestic violence continue after the coronavirus pandemic eventually ends.


Useful Contact Numbers

  • Emergency accommodation outside of Hastings Borough Councils working hours 01424 451999
  • Portal’s helpline 0300 323 9985 or 01323 417598 for Eastbourne, Lewes and Wealden or 01424 716629 for Hastings, Rother and Rye or alternatively online at https://theportal.org.uk
  • Women’s aid email info@womensaid.org.uk or helpline@womensaid.org.uk
  • Rise helpline 01273 622822 or general enquires 0300 323 9985 or https://www.riseuk.org.uk
  • National Domestic Abuse helpline 0808 2000 247 or https://www.nationaldahelpline.org.uk
  • Penny appeal Domestic Abuse support helpline 0808 802 3333 or http://www.pennyapp eal.org/
  • Rights of women.org.uk offer free advice in family, immigration, and criminal law 020 7251 6577
  • Men’s advice line 0808 801 0327
  • National LGBT+ 0800 999 5428
  • Karma Nirvana 0800 5999 247 Honour based abuse and forced marriage
  • Shelter give advice if your homeless and fleeing Domestic Abuse

https://england.shelter.org.uk

  • Hastings and Rother Samaritans 0330 094 5717 or call 116 123 free from any phone


Fulfilling Lives – Good practice for DA clients

We would like to share with you this Fulfilling Lives South East Partnership Good Practice document on the subject of supporting women with complex needs who are experiencing, or at risk of, domestic abuse during Covid-19 restrictions.

During May and June 2020, people with lived experience of multiple and complex needs interviewed local client-facing staff and researched organisations’ responses to Covid-19 before bringing together the information presented in this document.

We hope you and your colleagues find this a useful tool in your work and if you have any feedback or suggestions about the document please do contact us.

Good Practice Document: https://www.bht.org.uk/wp-content/uploads/2020/11/Best-Practice-T2-COVID-Document-V12.pdf

If you have lived experience of multiple and complex needs and are interested in working or volunteering with us, please contact Nelida at nelida.senoran-martin@sefulfillinglives.org.uk

Pilot evaluation helps share learning and shape future design of local MARAC system

Fulfilling Lives South East has collaborated with East Sussex County Council and Brighton & Hove City Council to evaluate the impact of a pilot trailing a new approach to the local MARAC systems.

The Multi-Agency Risk Assessment Conference (‘MARAC’) is a regular weekly local meeting to discuss how to help victims of domestic abuse at high risk of murder or serious harm. It brings together Representatives from a number of agencies in the local area to discuss the safety, health and wellbeing of people experiencing domestic abuse (and their children) and to agree actions and safety plans in order to reduce risk and keep individuals safe.

In 2019, the Joint Domestic, Sexual Violence & Abuse and VAWG Unit for Brighton & Hove and East Sussex reviewed the MARAC structures and referral pathways. The review highlighted the increasing numbers of referrals into the MARAC locally across Brighton & Hove and East Sussex, as well as highlighting the increasing challenges of safety planning for victims of complex and repeat cases. The MARAC Support Team worked with agencies to shape a new ‘Hub’ model in response to challenges identified in the review. A three-month pilot was launched in January 2020 to trial a new approach and was rolled out across Brighton & Hove and East Sussex.

This report shares the learning of the Brighton & Hove and East Sussex MARAC pilot with a view to informing the future design of the MARAC structures locally. We also hope that these findings and reflections can support other areas in the country who are interested in developing their own local MARAC structures and systems to improve outcomes for high risk victims of domestic abuse.

What the evaluation says

From this evaluation, the data supports that the MARAC meeting now feels safer and more effective than before. Meeting conversations have moved away from having an update-focus to allow for more discussion about safety and planning. The changes that have been made have created strong foundations to continue to develop this important space. The evaluation has shown that this is dependent on effective preparation, smaller number of meeting attendees, productive relationships between agencies, and effective chairing.

You can read the full evaluation report here: MARAC report to learn more about the evaluation findings and recommendations for the future.

IfFulfilling Lives South East has a particular interest in the experiences of people with Multiple and Complex Needs (‘MCN’). 93% of women who work with us have experienced domestic abuse and many are heard at MARAC. Our client-facing work has previously highlighted to us the challenges of discussing complex cases in detail within the previous MARAC structure and we are pleased to see that conversations appear to now be more focussed on risk planning, exploring agency involvement and ensuring accountability of actions. We are also very interested in how the evaluation highlights that complex cases require clearer definition and pathways within future MARAC systems in order to ensure safety planning is completed in the most effective way possible. This is an area that we hope will be included for further consideration and development in the future.

Fulfilling Lives is committed to continue working with partners across the public and voluntary sectors to support in finding new ways of working and testing new ideas to help improve the situation for women who have multiple complex needs and experience domestic abuse and violence. Should you wish to discuss the report further, please contact Rebecca Rieley, Systems Change Lead for FLSE:

rebecca.rieley@sefulfillinglives.org.uk

Author – Rebecca Rieley

Fleeing domestic abuse whilst having multiple disadvantages: How we can improve housing options

Fulfilling Lives South East has collaborated with the University of Brighton to conduct research on what good housing could look like for women with multiple complex needs who are fleeing domestic abuse. The work draws together interviews with Fulfilling Lives’ workers and existing academic research to review the issue originally highlighted in Fulfilling Lives South East’s Manifesto for Change

The problem with domestic abuse and housing options

Domestic abuse does not occur in isolation from other issues. The research finds clear increases in likelihood of mental health issues, substance misuse and homelessness for people who experience domestic abuse. Despite this connection with multiple needs, services are not always able to provide suitable housing options for people in this group who are fleeing domestic abuse.

61% of local authorities do not have a homeless service specifically for women with multiple and complex needs (original source: ‘mapping the maze’ research report).

Managing complex risk, active addictions and trauma presentations often requires specialist knowledge and support. This is a challenge for services which may not be financed or equipt to provide the physical space or staffing required to support MCN women to stay safe. The result can be limited, inflexible offers of housing which can lead to rejection, eviction, or the choice to stay with an abusive partner to avoid having to engage with the system. Pair this with a limited housing stock offer in the South East, and the limitations of housing options are only exasperated for these women.

What can help women in this situation?

The research indicated that the following approaches could be beneficial in addressing the issues:

INDIVIDUAL LEVELSERVICE LEVELNATIONAL LEVEL

Advocacy & trauma-informed support


Workers help individuals to get the best from the system, challenge stigma and support the emotional wellbeing

Flexible policies which acknowledge complexity


Identify MCN women through referrals and plan for specific needs. Provide as much flexibility as possible.

Funding for housing options


funding to provide staffing levels and spaces for women with complex needs to feel safe and maintain tenancies

Empower women with MCN

Use information and support for MCN women to make informed decisions about their support

Trauma Informed Workforces

Identify MCN women through referrals and plan for specific needs. Provide as much flexibility as possible.

Campaigning


Providing evidence of the need for specialist housing options and sharing best practice with national decision makers

The research also acknowledged that funding limitations into new housing approaches for women fleeing domestic abuse contributed to the restricted offer available and in the current context, the report encourages us to explore enhancing and improving existing services and systems to effect positive change.

What next?

Whilst academic research on the impact of domestic abuse was prevalent, finding research on domestic abuse and multiple needs was more challenging. This highlighted the need for further research in this area, both in terms of academic contributions and pilot projects which seek to improve outcomes in this area. Our student researcher concludes:

Working with Fulfilling Lives helped me understand the work that goes behind organisations that offer services for communities. The concepts of multiple complex needs and trauma informed responses really resonated with me, as I believe they can be applied to any services that provide help and support for communities.’ – Student Researcher

If you are interested in working with us in this area, please contact Rebecca at rebecca.rieley@sefulfillinglives.org.uk. The full report is out now and available to download here:

Author – Kerry Dowding