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Screening women for domestic violence 'cannot be justified' on current evidence

Should health professionals screen women for domestic violence? Systematic review BMJ Volume 325, primary care pp 314-8


The Department of Health now recommends that health professionals should consider "routine enquiry" of women patients about whether they have experienced domestic violence. However, a study in this week's BMJ concludes that implementation of screening programmes in healthcare settings is not justified by current evidence.

Researchers at Queen Mary's School of Medicine reviewed 20 studies to assess the evidence for the acceptability and effectiveness of screening women for domestic violence in healthcare settings.

They found that screening by health professionals increases the identification of domestic violence, and many women do not object to being asked. However, most health professionals were not in favour of screening. Other studies have shown that lack of education in or experience of screening, fear of offending or endangering patients, and lack of effective interventions are given as reasons for not routinely asking women about domestic violence. Little evidence also exists to show whether screening and intervention can lead to improved outcomes for women identified as abused. It would therefore be premature to introduce a screening programme for domestic violence in healthcare settings, say the authors.

However, these conclusions should not be interpreted as a denial of domestic violence as an important issue for healthcare providers, stress the authors. Doctors and nurses should not abandon the goal of identifying and supporting women experiencing domestic violence.

Health professionals need education and training to remain aware of the problem if they are to recognise women who experience domestic violence, while health services, local authorities, and the police need to coordinate their responses to domestic violence. Further research is also essential to develop and evaluate interagency policies.

Research within the NHS on the effectiveness of screening and on care for women experiencing abuse is a priority, they conclude.


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