Abuse and violence: Working with our patients in general practice (white book)

This publication has been designed for the purpose of assisting general practitioners and their staff in recognising women, men and children who are survivors of abuse and violence, or who are currently involved in violent situations. This is a sensitive issue, both for patients and GPs. However, this guideline may assist GPs to intervene in a positive and empowering manner.

In the context of this guideline, abuse and violence refers to:

• intimate partner abuse (domestic violence)
• perpetrators of intimate violence
• child abuse
• bullying
• adult survivors of child abuse
• sexual assault, and
• elder abuse.

This guideline encompasses issues experienced by specific groups, for example, Aboriginal people and Torres Strait Islanders, same sex couples, those with a disability, and cultural and linguistically diverse people.

Rigorous debate surrounds screening and mandatory reporting and there is scant evidence regarding effective interventions for those experiencing violence. There is a danger that the patchy evidence base for how GPs should respond to issues of abuse and violence can result in inaction by GPs. However, it is possible to articulate an appropriate response for GPs when faced with disclosure of abuse, or when they suspect that abuse is occurring. This will empower GPs to act appropriately when dealing with patients suffering past or present abuse.

The issue of violence and abuse involves many services in our community, including children’s services, education, health, and police, as well as the legal and court systems. This is an issue that is often difficult to confront and discuss. It is reflected in the difficulties GPs have in asking about violence and abuse, and the difficulties our patients have in telling their stories. It could be said that at times abuse and violence is a hidden part of the consultation. Because evidence suggests that abuse and violence may have a very damaging effect on patients’ health, this guideline will help GPs play their part in responding to abuse and violence within the community.

This third edition of Abuse and violence: Working with our patients in general practice has been funded by The Royal Australian College of General Practitioners and produced with the generosity of the many contributors who gave freely of their time.