Changing our perceptions of domestic violence and so-called ‘honour abuse’

The terms ‘honour abuse’ or ‘honour-based violence’ should not be used, and domestic violence should be redefined as a public health issue.

These are two main conclusions of a new report, ‘No Honour in Abuse’ from the Centre for Social Justice.

The report says that in the UK, domestic abuse affects more than two million people. Redefining it as a public health issue reflects research that suggests that more victims disclose to their GP and other health professionals (nearly 500,000) than to the police (405,000).

Speaking to Social Work Today, Cristina Odone, Head of Family Policy at the CSJ said ‘Social workers certainly have a role to play — from the Serious Case Reviews to child care services and statutory safeguarding, they are key. How many feel well-equipped to identify and refer victims or perpetrators?’ She added that while it was beyond the scope of the report, ‘a national survey of social workers would be really interesting.’

The report says that female victims use health care services more than non-abused women and report that health care workers are the professionals they would be most likely to speak to about their abuse.

Currently ‘The failure by health professionals to identify and refer victims of domestic abuse is driving serious health inequalities: patients affected are left to suffer in silence, with no support for their recovery.’

As part of its investigations for the report, the centre analysed 46 SCRs [Serious Case Reviews] published in 2021. Eighty per cent contained elements of abuse and within 70 per cent of these cases, abusers or victims presented to health agencies with possible signs of abuse, but this was neither recognized nor explored further.

The CSJ says that this is even more likely when the person is from a community in which the abuser’s view is that the victim has offended the rules of that community.

The SCJ says that the term ‘honour abuse’ includes female foeticide, forced marriage, forced abortion, rape, 24/7 monitoring, forbidding access to higher education, and other forms of social coercion.

‘With its implication that the victim has trespassed a traditional moral code, or “disrespected” a cultural legacy, the recognition of “honour abuse” in the public discourse risks legitimising these practices. Instead, they are forms of physical and / or mental violence that traumatise victims and their children.’

Cristina Odone added, ‘The only term we should be using in this context is abuse. Not “domestic" abuse, which makes it sound pedestrian, almost cosy; and not “honour” abuse, which risks legitimising the heinous crimes committed.’

One of the contributors to the report, Natasha Rattu, of the Leeds-based charity Karma Nir, says ‘therapeutic counselling for familial abuse victims is particularly complex as they have been disowned by family and community, so a bespoke service is needed.

‘By and for services do not always appeal to this group – they are fearful of their community.

‘Victims in predominantly South Asian communities will be reluctant to report to police because they are bound to be South Asian too, and then will side with the family and the perpetrator.‘

Another contributor, Janie Codona, who trains police and other statutory services to identify victims of abuse in the Romani Traveller community, says: ‘Because of their suspicion of services – the social worker may snatch their children away, the police have been offensive to their men -- the victim will often have to be drawn into disclosure. But that requires an understanding of their context that is not often evident among services.’

Also in the report, Punam Kharbanda of the Asian Women’s Resource Centre (AWRC), says, “there are risk factors that should signal immediately that these individual needs safeguarding. In our experience, instead, women are going repeatedly to GPs and are in contact with social services without anyone asking if there is an issue at home.”

Natasha Rattu agrees: ‘There is little professional curiosity. We ask that when a woman is accompanied by her husband or her mother-in-law to her scans during pregnancy, the health professionals should be studying the pregnant woman’s demeanour at the 20-week scan. Have them on your radar. Expecting a girl or a child with disabilities may be a terrifying prospect, triggering familial violence and blame.’

The report also highlights concerns at the difficulties facing male survivors of abuse. One in three victims of is male but the report says that male victims often fear that they were more likely to be arrested than their partners.

‘Research on male survivors in the UK found that they encountered hostility and disbelief from police and social services. One contributor, a 47-year-old male said, ‘They did nothing. I reported abuse to police several times and they took no positive action. Social workers took matters very lightly and even took the perpetrator’s side, as if they didn’t believe me.’

The report adds, ‘Equally unhelpful is signposting for the victims of child to parent abuse, with social service agencies pushing parents to the police, which ends up criminalising traumatised children.’

It says Adverse Childhood Events (ACEs) are important signposts to potential abuse. ‘Viewing domestic abuse through the lens of ACEs is useful in the identification of [an abuse] survivor, as well as in working out a strategy for their recovery: the ACEs framework places family relationships at its core which can be useful in designing and delivering interventions in children’s services.

‘ACEs can be a useful tool if front line workers including schools, GPs, [and] social workers are willing to ask “why” and look into the individual’s backstory. We have seen however that this is far from being the case among GPs and other health care professionals.’

However, despite widespread acceptance of the importance of ACEs, implementation has been inconsistent. ‘The devolved nations are ahead of England in adopting an ACEs framework. As of 2017 Scotland has embedded ACEs prevention across all areas of public service, including education, health, justice, and social work. It has committed £1.3 million to professional training and has convened a multi-sectorial ACE hub, to develop the public health approach to ACEs. Public Health Wales has raised ACE awareness through the publication of six reports describing the prevalence of ACEs in England and Wales.

The government is also currently offering trauma-informed training to many of its frontline workforces, including health visitors, the housing sector, and police force.

The Northern Ireland Executive also recognises children and young people’s resilience to ACEs as a specific government goal. It too has implemented training in trauma informed care for a wide variety of frontline workforces.