DA09

Committee Inquiry into Domestic Abuse

Submission of Evidence Assembly Parliamentary Service

Provision of Support, Examination of  BarriersTo empowerment for survivors of Domestic Violence and Abuse

Pat McCarthy LLB (Hons)., Dip.Ind.Law., FISMA, VRA, TRIM,  Traumatologist

1. I have worked for over 30 years across all sectors of the voluntary sector, within the trade union movement, in education and for government in a very wide range of roles and functions including project management,  group and individual empowerment, training and development, anti-discriminatory practice, capacity building and sustainability,  advising and advocacy.

2. I have been a long established campaigner on the rights of women and improving the quality of working life and home-life balance of men and women.  I have facilitated and worked consistently over many many years to end violence against women, including creating Cab Safe ♥ Cardiff., multi-agency conferences on domestic abuse and setting  up workplace negotiations to support employees experiencing domestic abuse through workplace Agreements.

3. I have provided evidence, and supported government Departments including the Department for Health on Establishing Best Practice in Workplace Agreements.  

4. I am also survivor a of domestic abuse.  Domestic abuse can happen to anyone from any walk of life.  Domestic abuse can also happen in different relationships.  Abuse patterns perpetrated against you can be though very different.   Learning about abusive relationships from the earliest age possible would help to ensure that people in the future would be less likely to be involved in abusive relationships, some of which quite literally could cost your life.  1 woman in the UK dies every other day from domestic abuse - a crime that is in the main foreseeable, likely and preventable.   1 man dies every month from domestic abuse - a crime that is in the main foreseeable, likely and preventable.

5. On  a personal note, I cannot thank enough the police officers and staff of South Wales Police who supported me and the workers of Women’s Aid & the Women’s Safety Units were kindly gave me support and advice.

History of Prevalence of Domestic Abuse & Challenging Stereotyping

6. Over the last 30-years there has been hardly any difference to incident rates of domestic abuse - domestic abuse is as endemic as ever it was.   There are so many different types of domestic abuse, maybe incident rates are actually increasing rather than decreasing.

7. There are many stereotypical assumptions about domestic abuse - and we do need to challenge the stereotypes as they exist.   

8. Domestic abuse remains the highest killer of women aged 19 - 44 - more than road traffic accidents and cancer.  

My Personal Experience from a Service User or an 'Expert by Experience’ Perspective of the Barriers to Empowerment

9. My personal experience,  having been in an abusive relationship  is set against professional knowledge and skills developed over many years of identifying gaps in service provision and then facilitating  and working  with potential  partner organizations to 'fill those’ gaps to improve the quality of life for the service users.  

I will examine identify some of the 'gaps’ from this combined perspective and suggest a number of potential solutions to fill some of those 'gaps.   Some of the suggestions are quite easy to develop from identification into action others would require a very strategic partnership approach and funding.   One particular 'gap’ that might reasonably be filled is developed within paragraph 34 which is the multi-axial diagnostic tool.    This particular intervention might reasonably add significant data-base research as well as improving the quality of life of those most at risk of serious and enduring physiological or psychological injury or  disability, and multi-agency professionals and practitioners. .

The Department for Work & Pensions - Knowledge and Skills Gaps

10. My recent experience of applying to  the DWP to obtain benefits advises that there are significant knowledge gaps amongst key professionals working within the DWP  about how de-stablising and disempowering it is to have to leave your family home due to domestic abuse.  

11. There is a distinct lack of understanding and awareness in the DWP amongst call-handlers about how difficult providing some of the 'papers’ you might need can be if you have had to flee your home (for any reason).  For some of us in this situation we may have been unable to take any papers of any sort with us.  This could also be the situation for many other claimants attempting to secure benefits - it is not that we do not want to comply with reasonable requests made of us,  we simply may not have what is  asked of us.  

Examples of how this could work include where a passport has been destroyed by the perpetrator of domestic abuse.,  where the claimant has been unable to take any papers from their home of any sort i.e. NHS medical card, National Insurance Card/proof., birth certificates of self or children,  Residency confirmation. Et. Al.

Running alongside this particular  'knowledge gap’ is another gap relating to the cumulative impact upon a claimant  of  having to talk to call-handlers who about the progression of your case.    Call-handlers work on l floor, processors on another.  

For a woman who is also in the middle of a various types of court proceedings, civil as well as criminal, having to negotiate or find  housing, accessing  disability support,  working with  policing,  women’s safety/women’s aid or other agencies,  to have to negotiate with call handlers at the  DWP whilst juggling everything else can actually re-traumatise you.   You can easily become de-stablised by the DWP processes and by the structures.   

12. My experience is that negotiating to secure benefits through the DWP 'system’ without support is virtually impossible for someone fleeing their home due to domestic abuse.  

13. My personal experience of the DWP was  that it was like getting on a  'roundabout’ that never ceases turning - letters arrive telling you documents you have provided 'in  person’ do not 'exist’.  Those letters combined with telephone conversations with often the same people you have spoken to days before can completely 'throw’ you.   You try to be assertive to progress your case only to find a 'brick-wall’ and often rebuttal that you have not submitted papers or documents that you know you have provided.       If you are unable to provide a document because it has been destroyed by the perpetrator of domestic abuse - it becomes a very hard disempowering uphill struggle.

14. You might have to submit the same document 3 or 4 times. There also seems to be no logic as  to how certain 'processing’ decisions are arrived at internal to the DWP.   You might even find your case file has transferred l20 miles away for no apparent or good reason, and it returns with nothing done to it!

15. There is another knowledge gap amongst certain of  the DWP call handling staff about  the difference of claimants  being assertive and aggressive.  When you are trying to progress a claim  by being assertive and referring to previous conversations, documents et. Al.  .

16. I have witnessed extreme distress at JobCentrePlus when individuals are trying to find out where their personal claim is 'at’, through no fault of their own and most likely no fault of the person answering the telephone and their queries.    They try to assert for themselves but their assertion fails time and time again.

17. The frontline staff of JobCentrePlus (Charles House) are amazing and incredibly helpful.  Claimaints are not thought told the real length of time processing a claim is going to take.  My claiming incapacity benefit took l2-weeks.     

18. Were  it not for the intervention of one of the JobCentre Plus floor managers who helped me,  I would have been completely lost in terms of trying to assert that documents had been provided and on more than one occasion.  

19. The process of claiming is a wearing one and you begin to despair.   There are many in despair trying to find their way through the 'system.’    Some  people will be unable to cope with the strain of it and will simply 'give up’ unable to take any more emotional distress and strain.    

Possible Solutions to Filling the Knowledge and Skills Gaps in the DWP and Reducing Disempowerment Felt by Claimants who have experienced domestic abuse that might reasonably help other claimants too.

20. A relatively easy solution to current disempowerment felt by benefit claimants  might be for new partnership based 'task and finish’ focus groups to be developed from amongst claimants, and agencies, as well as the DWP to examine the very common situations as I describe  and see what might be done to change the negative into a more positive outcome.   

21. By working together we might identify and then overcome some of the very dispiriting situations in which claimants and the call-handlers or DWP staff find themselves in.  By working together towards  common goals and understanding plus identifying potential solutions we might improve the levels of trust (which seems at this moment at an all time low) between the client or service user group.  

We might also be able to improve access for those who find they are unable to negotiate through the DWP system.      The task and finish groups might reasonably look at a variety of potential 'barriers’ that exist and then work together towards eliminating and overcoming those barrier.

22. A possible solution to being unable to produce a specific 'essential’ document might be to establish a 'missing’ paper pro-forma signed as being a true statement, by the claimant, co-signed by a partner agency to the DWP, or by a solicitor, with an  explanation of why a particular document is unable to be produced that might be used as permanent 'proof’ to be added to the case-papers.   This document would be 'scanned’ into the computer case management system - for all to see that the document required of a claimant does not exist, and thus cannot  be produced and the form provides the reasons why.  This would mean at a minimum the repeated letters asking you for things you can’t produce will cease.  

23. Another simple possible solution to the endless 'paper enquiry about benefits’ might be to develop a new  'on-line enquiry’ tool that you, me or any claimant or their advisor if they are fortunate enough to have one, can link into at JobCentrePlus, or if you have access to a computer at home, via your own computer or a friend’s computer.    You would be issued an 'on-line password’ and your personal details are only known to you in any event.  At this moment in  time a claimant is unable to access information about their claim online, even if they have the resources to do so.  There simply is no process available to enable them to do so.     

24. A cost-benefit analysis of keeping the system as it is -v- changing the 'system’ might reasonably uncover savings and ways in which the quality of working life for DWP staff might be improved for the better and claims processed less fraught with anxiety.       .  

25. A simple matrix based 'tool’ would tell you what has and has not been received, when it has been received, and where the claim is geographically, what is and what is not on the record, and what you or your advisor might need to do next to move the claim along.    

26. When people are in crisis they do not think clearly.   It can be very difficult talking to DWP staff about your claim particularly if you are asked again and again for the documents you have already provided to the DWP 'again and again that have been 'lost’ or not linked to your file.   The DWP staff must be inundated with paperwork and it must be very difficult for the staff - an on line enquiry tool from JobCentre Plus could reasonably release time amongst DWP staff to enable speedier processing and support to be made available to claimants.  A simple 'dial-in’ computer based 'tool’  should  make the quality of working life for call handlers and processors an easier process.    

27. The psychophysiological impact of domestic abuse is enormous - it also is as variable as it is different.           People with limited or no money are going  to be in crisis - it makes good sense to train call-handling and front line  DWP staff about the differences between assertiveness and aggression and how the DWP staff might unintentionally cause a re-traumatisation of the claimant simply by being ill-prepared on how emotional distress the claimant is experiencing surfaces or is triggered’.   Some DWP staff might need to examine their  attitudes too, as attitudinal and stereotypical beliefs about domestic abuse when transferred to a claimant will have a disempowering and potentially discriminatory impact on claimants.     

This may not be the fault of the staff but the DWP system seems stretched beyond capacity.

28. If the claim might take l0-l2 weeks, it is better to tell people, so that they might claim crisis loans.   People hope their claim is going to be processed quickly.  Regretfully that does not happen.    Thus at the earliest of opportunities advising claimants about the necessity to claim emergency or crisis loans might be better than individuals contacting call-handlers who cannot provide answers as the 'paper trial’ has only just begun!  

29. Were it not for the personal kindness of one of the DWP processors I would have been completely at a loss within the 'system’ of benefits.   I  literally treasure her call to me on a Saturday morning whilst she was working overtime to clear a 'backlog’.   I will always remember her kindness to me when I was at one of my lowest ebbs.    There are staff in the DWP with exceptional skills and abilities - they are let down by a 'system’ that seems completely unable to cope.   They seem as frustrated as the claimants.

30. The costs to the DWP of having to listen to claimants about their delayed claims, looking for files, looking for misplaced or lost paperwork,  having to check, check and then phone must be enormous.  A cost-v-benefit analysis should reasonably discover whether a simplistic on line 'tool’ could empower claimants and the staff to be better placed to process claims in a timely and professional manner.

31. The emotional strain on DWP staff, some of whom seemingly come to the end of their 'tether’ very quickly must be significant in terms of stressful working and its impact on health and wellbeing.   Simple new more inclusive working processes might reasonably make a difference.

32. Another solution for de-stressing the staff at the DWP in the front line might be to have compulsory -focused practitioner based training for DWP staff to enable them to become much more aware about the physiological and psychological impact of domestic abuse (or other abuse) and how best to deal with it in the job.    This might  reasonably enable DWP staff to  be less stressed when dealing with claimants who are very distressed.   

33. Understanding how emotional distress manifests itself physiologically and psychophysiologically  might also enable DWP staff and others who deal with very distressing cases to improve the quality of service they provide and improve their own health and wellbeing.

Another Gap & A  Recommendation to Consider Developing a new Multi-Agency Computer Based Diagnosist 'Tool’ to Assess  and Support Survivors of Domestic Abuse and Who is Low, Medium or  High Risk in relation to their Health & Wellbeing.

34. My experience  tells me that there also is a 'gap’ in the system of analysis of the health and wellbeing of survivors or victims of domestic abuse.   There is a health and safety risk assessment that can be carried out by a number of partner agencies, simple to do, effective and providing safety information to intended protect a man, woman or children. When the agencies come together with common purpose and work towards common goals within this setting they are able to make a significant difference to the outcomes or potential outcomes of peoples’ lives.  (MARAC).

35. There is running alongside the MARAC process  no 'assessment’ tool  indicating whether myself, or another is at 'high, medium or low’ risk of developing a longer term psychological or mental health condition, a psycho -physiological  health condition, a physiological condition, short-medium or longer term disability,   or exacerbation of  a pre-existing medical condition which might cause multiple and/or complex health conditions to arise now or in the future..  

36. There is now within the NHS a new early intervention  'diagnostic tool’ for  diabetes - why not create something similar here to help the agencies and organizations dealing with victims or survivors of domestic abuse.   This could  have a significant impact upon the quality of life experienced by survivors of domestic abuse.

Perhaps examination of psychological wellbeing, physiological wellbeing within a simple online assessment 'diagnostic tool’ could be  developed and trialed here in Wales.    Such a multiaxial assessment tool  should cover  the potential to assess clinical disorders and other health conditions that may be the focus of particular need and benefit from early intervention and support.     

A new Wales diagnostic 'on-line’ tool combining  a Global Assessment of Function (GAF) which assesses from l - 100 could be very helpful indeed.    GAF assessments relate as follows:   l00 presents no symptoms - 10 persistent dangers or severely hurting self or others, e.g. recurring violence or persistent inability to maintain personal hygiene or suicidal act with clear expectation and foreseeability of death.    

A diagnostic tool might reasonably include a number of other 'assessment methodologies’ and processes, and over the longer term create a new  holistic, reliable  and much needed assessment methodology that all agencies can utilize and share to benefit the target group.     The time saved by utilizing such a 'tool’ could enormously benefit all those who need support and help from agencies and practitioners themselves.

37. There are some things you can change and make lifestyle choices about and others that regretfully it’s too late - early intervention and raised awareness about the whole issue of domestic abuse and short-medium-and longer term health effects should be driven up the political agenda here in Wales.

Domestic Abuse - Current Knowledge in the Practitioner Field - and Transferring Information from Other Disciplines into Practitioner support on Domestic Abuse

38. There is much written about the impact of stress on working lives, about survivors stories of those who have survived and overcome adversity howsoever caused.  There  is less written in a down to earth, easy to understand and practical way about the physiological and psychological impact of domestic abuse.

39. There is also discussion within the practitioner field about whether you are a victim of domestic abuse or a survivor.   In this submission, I use the word victim linked as it is into the criminal law system, and when the domestic abuse is continuing.   

40. use survivor to denote that a person has left the abusive relationship and has taken a positive option of changing their life by leaving or having the perpetrator of domestic abuse removed from the property.

41. There is a parallel regarding the language of domestic abuse within the practitioner industry  to the language of the stress industry,  Both are now industries, evolving, funded in various ways but industries nevertheless.

42. There are varieties of definitions of stress (which is not a medical condition or diagnosis - although many think it is particularly doctors).   That the term 'stress’  is used in different ways by different people, there is a cognitive definition and from my own ISMA membership an ISMA definition.   We perhaps should be regarding stressors as the key word rather than 'stress’.   

43. Stressors are the things that cause us problems - domestic abuse is a stressor beyond all others - because it  comes upon you unbidden, hidden, and often purposefully, and is part of a general and intended cause of events.    Domestic abuse is perpetrated by those whom once you trusted and when your trust is betrayed - quite literally you will be devastated as well as potentially hurt or injured, or worse.   

44. That devastation causes enormous psychological distress to primary, secondary and tertiary victims and survivors.  Families are affected, work is affected, childrens futures are affected.  The enormity of being in a situation of domestic abuse cannot be under-estimated.  

45. The symptoms, effects and processes of overcoming  stressors  and traumatic stress health conditions when you are on the  receiving end of domestic abuse are little written about.   Where there is information it tends to be in mainly academic books as against easy to read and digest material that does not frighten you.

A Knowledge Gap Amongst Practitioners &Survivors  on the Impact of Emotiomal Distressed caused by Domestic Abuse on Health and Wellbeing.

46. There appears to be knowledge gap and a lack of understanding about the physiology of the stress reaction  caused by domestic abuse.

47. There seems to be a  knowledge gap in Wales about the range of different models of stress, anxiety and traumatic stress reactions caused by domestic violence and categorisation of them.      This is also probable across the whole of the UK.   There are many different models of stress and different ways of description.  There may well be a knowledge gap in amongst gps and allied multi-agency professionals of the variety and extent of potential self-help processes  that might be available to survivors of domestic abuse.  

48. There seems to be little knowledge of processing models for stressors experienced - ie.  the Yerkes-Dodson/Human Function Curve,   General Adaptation Syndrome, Cognitive/psychological Models. transactional Models, Micro-/macro-stressors Model, Demand-Control-Support Model, Person-Environment Fit Model, Cybernetic Models (ISMA).

49. There may also be a knowledge gap  on the visual, auditory, sensory, tactile or kinesthetic  ways in which we all process events including the event/s of incidents of domestic abuse to which we might be subjected.   We do all process things slightly differently as we are all unique individuals, however there are 'core’ reactions and variable reactions.   If we understood them better we could deal with them better.  

50. Sensory modalities are for many the strongest - however visual pictures of traumatic events,  threats to kill,  of perpetrator violence towards us, our family members, children,  family pets et al can become trapped in the mind like a 'photograph’ that comes out unbidden at any time. There is little to explain what is easy to explain and to understand if it is put over in a non-threatening way.

51. There appears to be a knowledge gap on the psychophysiology of the anxiety and stress responses we might experience when on the receiving end of domestic abuse.

52. There certainly is a knowledge gap amongst survivors of domestic abuse of how the body and the biology of the body processes incident/s and ongoing abusive processes that might be perpetrated against us, on our family members or family pets.  Much of what can be explained is really simple to understand.     It makes for better health care options and outcomes if everything is better understood - you can take choices if you know what the range of options are available for you to consider.     

53. Perhaps new work and new booklets/online information to improve our understanding of normal responses  might help us develop greater awareness as well as better self-health management.

As it is both probable and likely that if you are or have been experiencing domestic  abuse that you are going to a physiological or psychological health problem.    

You  can  recognise signs and symptoms of anxiety, stress or depression (ASD) in  oneself, or in another, but it is extremely important to realize that if  ASD continues unabated ASD will affect affect health outcomes over the longer term, performance, functional working, memory, et al.  

ASD and traumatic stress affects us all in different ways, just as one person is susceptible to a cold or another is susceptible to a problematic bowel or stomach problem when under pressure or stress. .

There are appears to be a knowledge gap amongst practitioners and gps on basic anatomy and physiology and how domestic abuse affects homeostatis, cardiovascular, respiratory, skeletomuscular, digestive, renal, immune, endocrine and reproductive systems.   

If  a person has received a severe injury for instance that results in a necrotised muscle due to being punched how the impact of that injury is likely to affect  posture, gait and mobility by way of example over the longer term and how to cope with that disability as you begin to age.   Also what is the psychological effect of having an injury that creates disability, a disability that might actually last for the rest of the person’s lifetime?

54. There appears to be a knowledge gap  on how  the peripheral and central nervous systems  works, including the autonomic nervous system: parasympathetic and sympathetic nervous system and how being on the receiving end of domestic abuse causes a variety of different of nerve disorders and damage, including how Nerves, nerve impulses, synapses and neurotransmitters work or fail to work after non accidental injury due to domestic abuse.

55. Domestic abuse in whatever format causes emotions to become raw and cognitive processes to be diminished - a basic understanding of the impact of how the brain works when under threat, or when  in constant fear might better help us and practitioners explain the impact of domestic abuse.    In reality,  our internal brain processes  protect  us.

56. The physiological and psychological symptoms when injured by non accidental injury and domestic abuse can reasonably be explained in ways that really help individuals to develop their own coping processes in the best way they can - but if they are not explained in any way at all, a person begins to think that they have gone mad when actually they haven’t.

57. Most of us don’t understand why we respond in the ways we do to various situations we are presented with - it would be much easier for us all if we did - and even if we did understand we most likely couldn’t stop some of the physical, mental and behavioural symptoms occurring - if though we understood what could happen, we would be better placed to manage the stressors as they present seeking such positive choices as we might find available to help us through the worst of the times we experience.

58. There are a number of different ASD responses when in a domestic violence or abuse situation, there are fight, flight and 'freeze’ responses - the freeze is often referred to as the 'bunny in the headlights’ response - when the body literally gets caught in a moment in time - for some that response becomes one that lasts for the rest of their lives - and can be the causation of post-traumatic stress, other  stress disorders, or a multiplicity of other physical health conditions or a combination to a lesser or greater degree.

59. When under extreme emotional distress there are also  resistance/adaptation responses that simply happen to our bodies.    We will have chemicals surging around the body attempting to prevent further harm occurring to us -  there is Adrenaline, Noradrenaline and Cortisol - chemicals that quite literally change a healthy body into being an unhealthy body.

60. Do we as practitioners or survivors know what are the normal -v- abnormal in the situations in which we find ourselves or others who might be supporting us.   I assert not

61. Psychoneuroimmunlogy and psychoneuroendocrinology are little known about by practitioners and gps.    They are even less known about by the survivors of domestic abuse.   If we know more, we learn more and we can adapt ourselves with support to minimize the impact on our bodies of our experience of domestic abuse.

62. Do practitioners and gps know about the biological mechanisms of the effect of prolonged and escalating incidents of domestic abuse?   

An example could be the impact on the  immune system suppression or how  coronary heart disease is likely to increase amongst those who have experienced domestic abuse - most probably not.     

There are many stress related disorders that could impact on the healthy working of the heart, respiratory system, digestive, Musculoskeletal, immunological health and wellbeing, including cancer, infections and allergies, diabetes, skin disorders, fertility. et al.   Better information makes for better life choices.   If perhaps we realized the physiological impact of domestic abuse in our own lives we might make better informed choices about leaving the abusive relationship, rather than staying.   Domestic abuse always escalates - if we knew that, and that alone, perhaps we would be better able to change our lives for the better.

What new research might  there be in Wales to improve  domestic abuse services and establish a better baseline of information to empower survivors of domestic abuse.

Just as within the MARAC information now shared by agencies, maybe we should be looking at new forms of action research to examine the health and wellbeing of survivors of domestic abuse.    If it both probable and  likely that individuals who have experienced domestic abuse, particularly over the longer term are going to experience a number of personal  health challenges., thus can we examine health challenges currently being experienced, and how those health conditions might also be minimized,   or prevented.

63. Maybe there could be action research around analyzing different types of  physiological and psychological health conditions people who have experienced domestic develop.  Cost-v-benefit analysis gives us crucial information upon which we can then develop strategies and pathways to change.

64. Domestic abuse is the stressor that causes physiological deterioration of health and psychological health to deteriorate.   It is not rocket science  to join up the knowledge gaps - could the many lessons and significant research on managing stress (or ASD) in the workplace be examined and transported into the practitioner field of improving the quality of life of victims and survivors of domestic abuse here in Wales.     Most likely so.

65. What is the impact of life events whilst at the same time being a victim or survivor of domestic abuse?    How does that experience relate to the Homes-Rahe Events Rating Scale when it comes to surviving domestic abuse.     Do we need some new modern 'scales’ of analysis and assessment - most likely so.

66. How does a combination of other relationship difficulties being experienced and cultural and diversity issues impact when domestic abuse is also being experienced - what escalations in health conditions might be experienced.  Perhaps this is something that might reasonably be considered in Wales to move the issue into the mainstream of our culturally diverse communities and into the forefront of action for change to improve the quality of life of the people of Wales.

67. We know what suicide rates there are amongst people experiencing domestic abuse, also that there are higher incident rates of suicide amongst asian girls by way of example.    Perhaps we need to examine change in a more radical way to move Wales into the forefront of prevention and pro-active campaigning to change things for the better.

68. Any of us experiencing domestic abuse would want to move away from it and into recovery but domestic abuse is highly complex as a process - is it a paraphilic process like a hate crime?   If not why not?   If domestic abuse has been perpetrated by design should domestic abuse not be moved up the pecking order of hateful crimes done to another because of power and control.

69. What emotional intelligence do we need to  overcome how we think and feel if we believe we are a victim -or a survivor - of domestic abuse.   From adversity should come opportunity but domestic abuse creates a real 'hole’ from which you literally have to dig yourself out of.  

70. What coping and resilience processes developed by other 'survivors’ of cancer, of racism, or homophobic hate crime or other life challenging events might we call upon  to 'transfer’ into the field of support provision for survivors of domestic abuse.  There must be a core of commonality.   

71. If we are to minimize our pain or harm until such time as we have both the confidence and the resources to EXIT whatever our plight  and experiences of domestic abuse   - what easy to develop personal strategies and 'action plans’ might we develop to help us in a self-help sense?   These formulate preventative processes that we and others who follow us could benefit from.    If we 'change l thing’ at a time - what might we systematically do to create and underpin the confidence and build  self-esteem to empower individuals to move beyond living with abuse into survivorship.   

72. We cannot change what has happened to us but we can develop self-acceptance,  self esteem and psychological acceptance or what has happened to us.     Then begin to build our coping and resilience and examine how we might pattern change our behaviours so that it does not happen again!

73. What about domestic abuse  perpetrated on  a Type A behaviour person - how does that then impact in terms of creating a higher level of potential health reactions over the longer term.    We do really need to know and if we are a Type A person in how we present, we may well be at higher risk than another of developing a long term disabling health condition.    It is better to know and be told that not to know at all.

74. You and I interpret events differently it is the nature of our being the same but different - we will though have core reactions that if we better understood them would go some way to our understanding that we did not choose to become victims of a perpetrator of domestic abuse - rather the other way around.

Referral Processes from Primary Health  Care to Secondary Health Care

75. There seems to be an inflexible situation relating to referral from primary health care to secondary health care.   Will a specialist in secondary health care ask for an assessment by a psychologist?   Or  will the referee 'bounce back’ to the gp surgery without any intervention of any sort.   It seems at this moment in time  to be 'pot’ luck.  I recommend that  should be certainty and a minimum standards framework upon which we can rely that tells us what we might expect and the timeframe within which our expectations might reasonably be met as within the Swedish System of health and wellbeing  management

What is Criminal - What is Civil ?

76. Working out  what might be a civil matter or could be a criminal matter is really difficult to work out.   It would be helpful for there to be a  simplistic guide.

77. The civil courts system is another disempowering one - again it is not the fault of the staff who are very efficient and supportive.   The civil court system may be required in particular situations, however it might be more appropriate for there to be 'Tribunal’ system in place.    Tribunals  that are cost-effective for working out civil remedies as against the judicial court based and expensive system that currently exists - would enable individuals to seek and secure redress without the potential for enormous personal financial loss.   If we make things easier and less 'judicial in some areas, maybe we will develop better access to justice and remedy than currently exists.

Domestic Abuse and Its Impact on Family Pets and Animals & Agencies Collaborating to Help Family Pet Owners where Domestic Abuse Has Occurred within the Family

78. There is a definite lack of knowledge about the impact of domestic abuse within the family on family animals and how a perpetrator might use family  animals as bargaining tools when the survivor takes action, and leaves using a court process or otherwise.    

79. It is traumatising for  individuals  when they have to leave family pets  because of domestic abuse.      The levels of  guilt  experienced by the person who has to leave cause bereavement reactions.    There  will be those who remain in what could be regarded as a dangerous situation because of family pets.    There should be a new innovative process of supporting survivors of domestic abuse with family animals they want to take with them.     Taking family animals to spite the ex-partner who has gone to the police seems to be a 'standard’ and preventing them from seeing them too seems to be another standard.  It is heartbreaking.

80. There seems hardly any information or research about the different  types of  abusive patterns of behaviour that might be carried out on family pets.    For some  people there are no boundaries. In the absence of the main 'victim’ secondary and tertiary victims replace the primary victim. Recyled hate crime.   

81. Where a primary victim or survivor has 'left’, a perpetrator can examine the scene around them and then choose another secondary victim or tertiary victim to continue their perpetrator behaviour.  It could be another person or a family pet

82. Animals are very much like young children - they deserve to  be respected, protected and supported - they are helpless when in a situation where abuse is going on around them and become extremely disturbed by dysfunctional behaviours in the perpetrators they once perceived to be their protectors.  How does it affect them?

83. The psychological impact on family pets of victrims/survivors of domestic abuse requires examination.   

New Therapeutic Inteventions, Coping & Resilience Processes

84. Might we in Wales scope and examine the range of potential interventions that would enable a better quality of life to be experienced by survivors of domestic abuse.

85. Individual coping and resilience processes change - for everyone according to the circumstances, however within the world of work occupational psychologists have long examined how best to increase coping and resilience processes amongst key occupational groupings.   Can some of those lessons from the world of work be examined and transported across to the field in which the Inqury is examining - that of domestic abuse.

86. There is a great breadth of knowledge about how different therapies work, how psychotherapy works and benefits many and in particular occupational groups, there must be key advisory points we can take into the field of supporting and empowering survivors of domestic abuse to benefit the field in which we work or are involved in some way.   

How might those therapeutic approaches be developed within group and other settings to benefit survivors and victims alike.   Perhaps a scoping exercise and examination of new processes relating to pattern changing behaviour and positive ways in which self-esteem and assertiveness might be

developed is called for.

87. If there were to be an assessment tool,  - for those who need specialist support a fastrack system could help reduce the likliehood of going onto further serious harm.  Using Behaviour and Problem-solving psychotherapy has  been underpinned by substantial amounts of academic research which highlights their effectiveness in dealing  with clinical disorders such as depression, anxiety, panics, phobias, Post Traumatic Stress Disorder et al.

88. If you have been undermined as a victim or survivor of domestic abuse you are likely to have an extreme lack of self confidence - to the point that you can feel incapable or carrying out even simple tasks/following instructions, etc.

89. So eroded might be your self-belief that you have no self-belief at all.   Practitioner training to understand how de-stabilising it is when you are trying to overcome the criminal act or acts you have endured could create an attitudinal shift amongst many who seemingly do not appreciate the level of difficulties you might be experiencing - whether psychologically, physically, or psychophysiologically.

90. Empowerment, coping and resilience to overcome what has happened is or can be hard to develop. There is no one rule that fits all - but unless we challenge existing structures including giving consideration to changes in DWP and other partnership organisations processes and structures people needing help won’t be able to get it.

91. Finally, most of us who leave a domestic abusive family home have pay-as-you-go phones, linked to a provider charging by the minute - 0870, 0845 and 0800 numbers are expensive to call - there are telephone service providers earning very significant profits from those least able to afford to make the telephone calls.   

I recommend that the Welsh Assembly Government Inquiry take action and consider representation to the telephone service providers - as most of those in my situation may be of no fixed abode, in a Refuge or waiting to have some level of permanency by way of housing.     

The Welsh Assembly Government might reasonably want to take further evidence on the disproportionate impact of telephone calls to providers of services, government and agency alike that increases the spiral of poverty that some of us are experiencing, for many of us for the very first time in our lives.   

Domestic abuse respects no-one.   Enabling domestic abuse to continue will most likely make it get worse and escalate.   We should all be able to live in our own homes free from fear.   Domestic abuse is a violation of human rights - it cannot be justified, legal or acceptable and should never be tolerated in any society.   We do need to take action for change in Wales and improve the lives of the many in so doing.

By taking personal, local, regional and government action to improve the quality of our lives and our rights to live free from domestic abuse we can empower not only ourselves but those who come after us to develop dignity in all of our lives and in our relationships.   It is time for a significant change and an attitudinal shift.