Assisting clients experiencing family violence: Clinician and client survey responses in a child and family health service.

AIMS AND OBJECTIVES To determine baseline levels of training, knowledge and confidence working in the area of family violence in staff at a public child and maternal health service in Melbourne, Australia, as well as staff perceived barriers to working effectively in this area. This study also aimed to explore client perception of existing screening practices. BACKGROUND Family violence is a global concern with pregnancy and the postnatal period times of particularly high risk. Child and maternal health services are well placed to screen for violence, yet clinician and client perceptions of screening remain poorly characterised. DESIGN Thirty five staff and 15 mothers participated in this cross sectional, mixed method study, via an online survey. Strengthening the Reporting of Observational studies in Epidemiology (STROBE) cross-sectional guidelines were used. RESULTS The majority of staff screened clients for family violence, at least some of the time, with over 50% often or always screening. However, only half of staff respondents indicated that they believed they knew how to screen appropriately. Screening occurred most often over the phone or at the first service visit. The most commonly reported barriers to screening were suspected perpetrators being present during consultations and language barriers. Most clients reported being screened for physical violence and safety in the home with few being asking about financial and sexual abuse, or psychological violence and coercive control. Clients who disclosed violence reported being well supported. CONCLUSION While some baseline staff knowledge and skills have been identified, further support for clinicians is needed to ensure best practice and improve services and outcomes, particularly in regard to screening for different types of violence across the spectrum. RELEVANCE TO CLINICAL PRACTICE This study helps to inform clinical screening practices in Maternal Health Services through an exploration of facilitators and barriers in the screening process.