Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694499493975.pdf (Australia)
nd 22 ​ July 2020 Committee Secretary House of Representatives Standing Committee on Social Policy and Legal Affairs Dear Committee Secretary Re: DAVTW response to the Parliamentary Inquiry into family, domestic and sexual violence Doctors Against Violence Towards Women (DAVTW) welcomes the opportunity to provide input into the inquiry into Family, Domestic and Sexual violence by the House Standing Committee on Social Policy and Legal Affairs.
DAVTW is an organisation comprised of multiple medical specialists throughout Australia and New Zealand.

Its focus is in identifying and drawing attention to the systemic issues that contribute to domestic violence in Australia particularly within the health care sector.

DAVTW is comprised of more than 800 doctors, and almost 5000 followers on social media.
This submission relates to the following terms of reference: a, d, e and f a) Immediate and long-term measures to prevent violence against women and their children, and improve gender equality.

DAVTW has identified several opportunities to prevent violence against women and children, and improve gender equality.
Page | 1 Inquiry into family, domestic and sexual violenceSubmission 77 ​ ​ ● Teaching children from an early age, and within the school curriculum about what healthy relationships should look like, and identifying all forms of domestic violence including coercive control should be mandatory in all schools.
As doctors, we have found that many of our patients are unaware that their experience constitutes domestic abuse, and do not identify behaviours such as isolation, financial abuse and degradation as forms of domestic violence.

● Improved responses from police – as doctors we often assist our patients in attending the police to make reports only to be told that there is not enough evidence for their claim.
● JUDICIAL response – whilst the NSW Sentencing Council 2015 led an inquiry into sentencing of Domestic Violence Crimes there was no consultation with stakeholders in this evaluation.

The use of general charges such as for Common Assault ​ Domestic Violence is inappropriate in the context of domestic violence and in no way reflects the reality of domestic violence.
● Recognition of the cycle of violence and the fact that victim-survivors of abuse are often at higher risk of further abuse due to the impact of trauma.

Prophylactic measures such as treating the PTSD is ESSENTIAL to reducing this phenomena.

● Recognition of the fact that many victims are often seen by their health care provider for other issues, e.g.
antenatal care, vaccinations, pap smears and doctors should be able to opportunistically use this time to provide appropriate care and support without being financially penalised.

● Recognition that fulfillment of basic human needs must be able to be provided for if we, as a society are going to expect women to leave violent relationships – safety, accommodation, food, shelter are first line needs to allow a woman to leave.

Additionally, a consideration of children, pets, and other special needs.
Further to that, trauma informed psychological support, affordable legal support, a non-punitive child protection service is essential ● Recognition that the current paradigm of child services working against a mother who is experiencing violence contributes to child abuse and violence.

Child protection must recognise that protecting the mother is necessary to protect the child.
Child protection service workers need to be trained in providing trauma-informed care to family members impacted by violence ● Recognition that a criminal court that determines a perpetrator should remain away from a victim or her children, should not be undermined by the Family Courts desire to grant access to children by perpetrators Page | 2 Inquiry into family, domestic and sexual violenceSubmission 77​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ● Family court report writers need to be appropriately qualified and held accountable for their recommendations ● Recognition of the well -recognised tactic of DV perpetrators using a victims children to hurt or punish their victims.
Courts need to make custody decisions with this risk in mind.
● Appropriate funding of social workers, crisis teams within all Emergency Departments to ensure women arriving with injury are offered appropriate counselling services and follow up particularly with respect to potential head injury and asphyxiation ● Emergency departments to better document the context around assaults in admission notes and ensure adequate follow up plans made for victim-survivors ● Complete funding for victims of domestic abuse or sexual assault to access mental health support , employment assistance programs etc to empower women to stay out of dysfunctional relationships.
d) The way that health, housing, access to services including legal services, and women’s economic independence impact on the ability of women to escape domestic violence.

DAVTW acknowledges that ● Women in DV situations are frequently unable to access money or work, this makes the practical aspects of leaving even more difficult.

The National Response should prioritise supporting victims of Family Violence transition safely to stable alternative accommodation.
● Women in DV situations often require complex legal involvement – particularly if her children are at risk.

It may be safer to remain with an abuser than risk losing her children altogether or leaving her children alone with the perpetrator.

DAVTW recognizes legal costs can be prohibitive and strongly supports efforts from government to assist in providing free legal support for all women and children at risk of harm.
● DAVTW recognize that women experiencing or previously experiencing family violence are frequently suffering from PTSD.

They experience low moods and anxiety.

These symptoms may then be used by the family law court to deny her custody of her own children.

Family courts may use psychiatric diagnoses Page | 3 Inquiry into family, domestic and sexual violenceSubmission 77​ ​ ​ ​ ​ ​ to declare her unsafe or inappropriate to parent and award custody to the abuser.
PTSD symptoms may make a victim think she herself is incapable of living alone.

DAVTW supports enhanced training, rebate and support for all mental health workers.

● Women in DV situations require a dedicated, trauma informed space to address these issues.

This concept is currently being developed by the Illawarra Women’s Health Centre in consultation with a number of members of DAVWT.
e) All forms of violence against women, including, but not limited to, coercive control and technology-facilitated abuse.

The main forms of abuse are not illegal .

It is mostly extreme physical abuse that receives legal attention.

This has resulted in a large proportion of the population being unaware of what constitutes abuse and normalising dangerous and or controlling behaviours e.g.

financial abuse.
financial abuse.

f) The adequacy of the qualitative and quantitative evidence base around the prevalence of domestic and family violence and how to overcome limitations in the collection of nationally consistent and timely qualitative and quantitative data including, but not limited to, court, police, hospitalisation and housing.
Novel interventions by definition do not have large evidence bases, and bureaucratic measures significantly delay or even completely thwart attempts at addressing systemic failings.

This means that unhelpful or even dangerous practices may be used preferentially as no better interventions are readily available.

An example would be a Trauma focused centre such as the proposed Trauma Recovery Centre in the Illawarra.
The Trauma Recovery Centre will provide multi-sector wrap-around trauma informed care to women with Post Traumatic Stress Disorder and complex PTSD.

DAVTW strongly endorses the development of the Trauma Recovery Centre as a practical component of the National Plan to Reduce Violence against Women and their Children.

This is delayed despite the obvious absence of a specialised trauma support for victims of violence.
Page | 4 Inquiry into family, domestic and sexual violenceSubmission 77 ​ ​ Yours sincerely Dr. Karen Williams BMedSci MPH MBBS FRANZCP Consultant Psychiatrist Trauma Specialist Founder of Doctors Against Violence Towards Women Member of the RANZCP Committee Family Violence Network Page | 5 Inquiry into family, domestic and sexual violenceSubmission 77 ​