Although few studies have explored people’s experiences of domestic abuse and cancer, we know the two co-occur. The few studies we do have show that cancer can trigger an escalation of abuse. But there are no published domestic abuse interventions in the cancer setting.
The key findings demonstrate that cancer and DA frequently co-occur, and that training and support intervention of hospital-based cancer staff increased the rate of DA identifications. There is an appetite for DA and cancer training amongst hospital-based cancer staff.
The evaluation contributes further evidence of the benefit of hospital-based domestic abuse coordinator roles and contributes new evidence for the feasibility of adapting the role for a specific context.
To read the article or download the paper free of charge:
Identifying and responding to domestic abuse in cancer care: a mixed methods service evaluation of a training and support intervention. Dheensa, Sandi et al. European Journal of Oncology Nursing, Volume 0, Issue 0, 102724
The UK Office for National Statistics (ONS) developed a prototype violence against women and girls (VAWG) data dashboard in 2022. The webpages presented statistics and charts on violence against women and girls in England and Wales, drawing on multiple sources. However, due to reprioritisation at ONS, maintenance of the dashboard stopped and as of April 2024 it was no longer accessible.
VISION developed a consultation to ascertain the usefulness of a VAWG data dashboard as a result. The call was open from March to May 2024, and 102 responses were received. Most participants responded in their capacity as individuals (n=61), although 25 stated that they were responding on behalf of an organisation and four on behalf of a group. Some participants both responded as an individual and on behalf of an organisation or group.
Consultation participants responded as people from across a variety of roles and sectors. The most commonly cited were working in research or education (n=40) and in policy or planning (n=28), 27 people responded as someone with lived experience and 13 as members of the public. The remainder comprised those in service provision (n=17), a campaign role (n=10) or some other capacity (8).
Consultation results
Many participants had heard of the data dashboard before the VISION consultation (n=51), although 28 reported that they had not. Of those who had heard of the dashboard before, most had made use of it (n=39).
Most participants reported that having a dashboard that brought together data on violence and abuse would help them either ‘somewhat’ (n=12) or ‘a lot’ (n=39).
Participants were asked what they found to be useful about the data dashboard:
Data discovery
Finding data and finding it faster
Breakdowns and local profiles
Comparisons
Authoritative context
Source material
Participants were asked for their thoughts on the limitations or what was missing from the dashboard:
Wider coverage in relation to topics (health, disability, suicide, law, family courts, policy), types of violence and abuse (homicide, forced marriage, sexual violence), and particular groups (men, perpetrators)
Deeper context in terms of much more nuanced contextual discussion of what the data means, ‘data without context is misleading’
Critical interrogation such as the highlight of methodological limitations
Interactive functionality with more scope for further breakdowns by local authority areas and police forces for example
Improved search function
Positive action such as a ‘section about work being done to support victims/reduce cases’
Human stories meaning to go beyond numbers and to tell the human stories that underpin them
Recommendations
Through this consultation, approximately 100 people told VISION that a VAWG data dashboard is something that they valued having and wish to have again. These included people with lived experience of violence and abuse, people working in health, justice, specialist and other services, researchers and academics across disciplines, and members of the wider public.
A violence and abuse data dashboard is needed because it has:
Symbolic value: indicating that violence against women and girls matters to the Government, and
Practical value: as a functional and easy to use tool facilitating access to high quality data spanning a range of types of violence, groups, areas and years.
In April 2024, ONS’ prototype VAWG data dashboard was withdrawn due to reprioritisation of resources within that organisation. Since then, a new Government has come into office with a stated mission to halve violence against women and girls within the decade. How progress towards this commitment is monitored will be essential to its success. General population health and crime surveys, alongside other data sources, will be key and that includes a revitalised, fit for purpose VAWG data dashboard. To instill trust and collective investment in this goal, a public platform for transparent monitoring is needed and the dashboard could be an effective, useful tool.
Next steps
VISION is a cross-sectoral consortium of academics and government and service partners working with UK data on violence and abuse. We are aware that further development and relaunching of a data dashboard will require a collaborative effort from relevant departments of state, data providers (not least ONS) and external funding. Drawing on our work in this area we aim to coordinate this effort, with three initial objectives:
Resource: Identify partners and funding source(s)
Define: Agree clear definitions to best capture and monitor subgroup and temporal trends in VAWG and violent crime in the population
Design and test a revised violence and abuse data dashboard with people from across sectors
This VISION Policy Brief proposes improvements to the definitions and measurement of violence using the Crime Survey for England and Wales (CSEW), in order to more fully capture different aspects of violent crime, including violence against women and girls (VAWG). The briefing is aimed at researchers, national statistics offices, and others involved in violence research and policy. It draws on a paper recently published in The British Journal of Criminology, Definition and measurement of violence in the Crime Survey for England and Wales.
Key findings:
The current definition of violent crime excludes key types: The Office for National Statistics (ONS) headline measure of ‘violent crime’ currently excludes sexual violence, robberies, threats of violence, and many incidents of violence where criminal damage was also involved.
A broader definition would better capture scale, harm and inequalities: We use a broader measure of violence that includes these currently excluded forms of violence. This broader measure not only reveals a higher prevalence of victimisation in the population as a whole, it also reveals hidden inequalities. Women are more likely than men to experience sexual violence and threats of violence: excluding these from current estimates leads to rates of violence in women, especially domestic violence, being underestimated. The proportion of people physically and emotionally harmed by violence is also better estimated using this broader definition, particularly affecting estimates for women.
Recommendation for change:
National statistics on violence in England and Wales should show violence estimates using a broader definition of violence alongside violent crime statistics to give a more comprehensive overview of violence and its societal impact.
The citation for the paper: Davies, E., Obolenskaya, P., Francis, B., Blom, N., Phoenix, J., Pullerits, M., and Walby, S. (2024), Definition and Measurement of Violence in the Crime Survey for England and Wales: Implications for the Amount and Gendering of Violence, TheBritish Journal of Criminology. https://doi.org/10.1093/bjc/azae050
Our latest research examinestwo nationally representative datasets, The Commercial Victimisation Survey (CVS) and the UK Household Panel Survey (UKHLS), to examine variance in the prevalence of workplace violence by industrial sector and occupational group.
The authors, Dr Vanessa Gash and Dr Niels Blom, found 28% of commercial businesses reported criminal victimisation on their premises in the past year, including 8% reporting violent victimisation (namely assaults, robberies, and threats).
Using individual-level data, the report also found 8% of employees had been threatened, insulted or physically attacked at work in the past year, and a similar percentage have felt unsafe at work, with public sector workers most at risk.
The authors call for enhanced recognition of the problem of workplace violence for a significant proportion of workers in multiple different sectors, alongside improved policies to minimise workplace violence going forward.
Figure 1. Prevalence of Violence and Fear of Violence in the Workplace by Sector, UKHLS data 2020-2021, weighted estimates
A report just published by the Department for Work and Pensions (DWP) further confirms high levels of trauma and mental distress among people not in employment and approaching benefits services for support. The report focuses on those in receipt of Employment and Support Allowance (ESA) aimed at people with an impairment or health condition that affects how much work they do.
VISION researcher Sally McManus, with colleagues Claire Lapham and Ann Conolly from the National Centre for Social Research, analysed the government’s main mental health study. They found that nearly one in three (30%) ESA recipients screened positive for post-traumatic stress disorder. This was more than twice the rate for Jobseeker’s Allowance (JSA) claimants (12%), and ten times that of employed people (3%). The analyses show that the claimant population experienced high levels of stress, in which self-confidence was low and anxiety high. Compared to those in employment, few ESA claimants owned their home and many faced serious debt arrears.
Sally presented findings from this study as oral evidence to the Work and Pensions Committee’s Inquiry into Safeguarding Vulnerable Claimants, including domestic violence victims. She drew attention to calls from Women’s Aid for reform they highlight is needed to make the benefits system the lifeline survivors need, rather than a source of re-traumatisation and further harm.
Women’s Aid recommendations include implementing a named domestic abuse lead in every Jobcentre Plus and ensuring staff receive regular, specialist domestic abuse training, so that work coaches and other frontline staff are better able to recognise claimants experiencing domestic abuse. Specialist domestic abuse services need to be properly funded to support and advocate for survivors in making their claims to DWP. Extending the domestic violence easement to up to a year would also help, alongside exempting those who are moving to or from refuges from repayment of Jobcentre Plus advances.
Despite a general awareness of the prevalence of harm young people are experiencing in their relationships, there is little data and evidence supporting the prevention of and responses to such harm through the adoption of a survivor centred transformative justice approach.
Talia Kensit, founder and former CEO of Youth Realities, explored adolescent domestic abuse as a Fellow with the Churchill Fellowship, a UK charity which supports individual UK citizens to follow their passion for change, through learning from the world and bringing that knowledge back to the UK.
Her travels and research resulted in Prevention, Intervention and Healing: Addressing Adolescent Relationship Abuse, a framework of best practice upheld by the theory of transformative justice. It is Talia’s recommendation that in order to address the epidemic of harm experienced by young people in their intimate relationships, we must implement polices and practice through prevention, intervention and healing.
All those registering will receive an email by 30 October from the Violence and Society Centre with the room and building number where the launch will be held on our Clerkenwell campus.
The book’s chapters use retrospective case studies to engage with a systems approach to discover new thinking and applications that may best suit the area of domestic abuse and sexual violence (DASV). All the chapters showcase systems approaches in varying ways to ignite new inquiries and conversations about grappling with the greater complexity of problems.
Dr Adisa and Professor Bond, together with their collaborators, will launch the book at a special event at City St. George’s University of London on Tuesday, 26 November at 5.30 pm. They will explain the book and share their inspiration for the themes covered. A panel of speakers will share their collective vision for systems change in tackling DASV in different systems. The event will also feature poetry (spoken word) performances based on lived/living experiences of domestic abuse and as a survivor-centred response to the book’s themes.
Dr Adisa said:
“I am incredibly excited about the launch event. I have been overwhelmed by the positive and heartwarming reaction to the book from those committed to tackling the problem of DASV and those sadly affected by DASV. I have been impressed with the brilliant contributions made by all the authors who are deeply committed to bringing about change. This event is an opportunity to hear from some amazing speakers and forge new encounters and connections, united in our quest to reduce DASV and mitigate its devastating impact on children, families, and communities.”
Professor Sally McManus, Director of the Violence and Society Centre, and Co-Deputy Director, VISION, said:
“Dr Adisa works at the forefront of systems thinking. This new collection – co-curated with Prof Bond – brings a radical new approach to addressing violence and abuse, rooted in diverse real-world examples of challenge and change. The book houses many rich voices, distinct yet drawn together through common themes of complexity and hope.”
Please join Dr Adisa, Professor Bond, and their fellow collaborators at their 26 November book launch at The Pavilion, University Building, City St George’s, from 5:30 – 7 pm. Drinks and nibbles will be provided.
We are pleased to announce our next webinar for the VISION and Violence & Society Centre (VASC) Webinar Series on Tuesday, 1 October 2024, 1300 – 1350.
Joht Chandan, Clinical Professor of Public Health at the University of Birmingham, will present his research on measuring the global burden of morbidity associated with violence against women and children.
Joht has spent considerable time working on designing and delivering a public health approach to abuse and violence. This includes research into finding what works to support survivors of violence, abuse and maltreatment as well as methods to improve surveillance in the context of violence against women and children. For example, his research has shown that survivors of domestic abuse are nearly three times more likely to suffer from mental ill health during their lifetime and have above-average rates of diabetes, heart disease and death.
The purpose of the series is to provide a platform for academia, government and the voluntary and community sector that work to reduce and prevent violence to present their work / research to a wider audience. This is a multidisciplinary platform and we welcome speakers from across a variety of fields such as health, crime, policing, ethnicity, migration, sociology, social work, primary care, front line services, etc. If interested in presenting at a future Series webinar, please contact: VISION_Management_Team@city.ac.uk
Adolescent domestic abuse (ADA) goes by many names, sometimes referred to as toxic teenage relationships. ADA includes physical, emotional, and/ or sexual abuse that occurs between young people who are, or were, dating. It is often overlooked in research, policy and practice. As a phenomenon, abusive behaviour between adolescents in intimate relationships remains relatively invisible, due in part to the persistent yet unfounded assumption that domestic abuse is something that only occurs between adults.
The Crime Survey for England and Wales finds that women aged 16 to 19 are more likely to experience domestic abuse than older age groups (ONS, 2020), but despite the prevalence, women in this age group are less likely to be referred to support services (SafeLives, 2017).
SafeLives discovered, on average, experiencing abusive behaviour from a partner begins at age 14 or 15, (2017). Further research in Wales found that among those aged 11-16 years old experienced a range of mental health and social impacts associated with experiencing domestic abuse, including teenage pregnancy, self-harm, and violent behaviour (Young et al, 2021).
With this landscape in mind and led by the need from our partners and to ensure intersectoral collaboration, VISION set up a working group with Thames Valley Police, SafeLives, Islington Borough Council, H.O.P.E Training, Respect, Youth Realities and others to investigate ADA via three activities:
ADA rapid systematicreview to synthesise existing research and data on ADA in teenage relationships (January 2024; funded by the City St George’s, UoL, Policy Support Fund).
ADA workshop: ‘Too Soon, Too Late’ organised by VISION with SafeLives Changemakers and young people who experienced abuse in their relationships when they were aged 13 to 16 (March 2024; funded by the City St George’s, UoL, Participatory Research Fund).
ADA conference, an event to bring together practitioners, people with lived experience, police, researchers, and policymakers working in the ADA environment (April 2024; funded by the City St George’s, UoL, HEIF KE Fund).
The report, Summary of the VISION Adolescent Domestic Abuse activities and events in 2024, is available online. It summarises the findings and recommendations of the review, workshop and conference for a roundtable of police, local government, academics, practitioners and specialist services working in the field held in June 2024. It was produced for the working group as an aid to distil the thinking thus far across the three VISION activities.
ADA Rapid Systematic Review
The VISION review investigates ADA by examining the terminology and related terminology used in the literature. The paper focuses on the perpetration and victimisation as it concerns adolescents, especially those under 16 years old, and the factors that act as protective and recovery mechanisms for young people experiencing ADA.
VISION researchers, led by Dr Ruth Weir, conducted a systematic rapid review of 79 papers from databases for peer-reviewed literature.
The team discovered definitional issues, an overemphasis on quantitative studies, and a lack of attention to ADA when it intersects with cultural factors, gender differences, criminalisation, and poor mental health. Many of the studies report on school-based settings, with limited reporting and understanding of the role of neighbourhood factors in acting as protective and recovery mechanisms. Additionally, literature on impacted adolescents and their help-seeking behaviours is sparse. The review revealed that evidence on abuse affecting adolescents in the UK remains patchy.
Highlights from the VISION ADA rapid review: Gaps, limitations & considerations for future research
ADA workshop:Too Soon, Too Late
Dr Polina Obolenskaya and Dr Annie Bunce, VISION Research Fellows, collaborated on a consultation project, “Too soon, too late”, with the SafeLives Changemakers and with young people who experienced abuse in their relationships when they were aged 13 to 16. The main aim of the consultation was to develop a robust, methodological framework for a future adolescent domestic abuse (ADA) research proposal.
Together with SafeLives, a charity working to end domestic violence, they co-developed the material for the online workshop, a focus group, with young people, which took place in March 2024, and was facilitated by the ‘Changemakers’, a group of young people passionate about amplifying the voices of survivors of domestic abuse. They work alongside SafeLives providing a young person’s expertise on the charity’s work, conducting research, and working to influence policy change.
Some of the preliminary themes from the workshop include:
Lack of recognition amongst young people of both domestic abuse (DA) in general, and ADA specifically.
Young people don’t easily identify their own experiences of ADA as DA.
Young people’s understanding of ADA changes over time.
Young people highlighted the wide variation in experiences of ADA and professional responses to it.
Young people can identify clear priorities for future ADA research.
Young people see school as a key point of early intervention, but feel that improvement is needed in terms of better education around healthy relationships and school cultures that encourage open discussion around DA whilst actively challenging attitudes and behaviours conducive to ADA and sexual violence.
Further information can be found in the report available for downloading online.
ADA Conference
The Adolescent Domestic Abuse conference held on 18 April brought together 161 academics, practitioners, and policy makers to share existing research, policy and practice. Dr Ruth Weir, Senior Research Fellow at the Violence & Society Centre and the VISION research project at City, and Katy Barrow Grint, Assistant Chief Constable at Thames Valley Police, welcomed the delegates.
Louise Rolfe, OBE, Metropolitan Police and National Police Chief Council lead for Domestic Abuse was a keynote speaker. Louise spoke about the national context of domestic abuse, highlighting the most harmful abuse that is seen is coercive control and that domestic abuse accounts for more than 30% of violent crime. She also spoke about the role of the media requiring scrutiny and the need for sustainable long-term systemic solutions.
Professor Christine Barter, Co-Director of the Connect Centre for International Research on Interpersonal Violence and Harm, University of Central Lancashire, also gave a keynote. She provided an overview of her 15 years of research exploring the prevalence, subjective impact and risk factors associated with abuse in young people’s relationships in her presentation, Researching abuse within teenage relationships: A critique of a decade’s work and what we could do better. Her mixed-method body of work addressed both victimisation and perpetration for young people aged 13 to 17.
There were panels on Teenage relationships and abuse: What the research says; Sexual violence in teenage relationships; and Specialist services and local government. Presenters included academics sharing their ADA research from Loughborough University and Durham University and specialist domestic violence organisations like SafeLives, Refuge, and Women’s Aid. Islington Borough Council, representing local government, discussed their work on a multi-agency model project to identify, intervene and protect teenagers experience ADA.
Violence against older people is often overlooked. As a society, we often associate violence with young people, gangs, unsafe streets, and ‘knife crime’. However, violence also takes place behind front doors, perpetuated by families and partners, and victims include older people.
Some older people may be particularly vulnerable due to poorer physical health, disability, dependence on others, and financial challenges after retirement. Policy rarely addresses the safety of this population, with even health and social care professionals sometimes assuming that violence does not affect older people. For example, doctors may dismiss injuries or depression as inevitable problems related to old age and miss opportunities to identify victims (1). In addition, older people may be less likely to report violence and abuse because they themselves may not recognise it, do not want to accuse family members, or out of fear (2).
Given victims of violence often remain invisible to health and social services, police, or charities, the most reliable statistics on violence often come from national surveys such as the Crime Survey for England and Wales (CSEW) conducted by the Office for National Statistics. However, for a long time the CSEW self-completion – the part of the interview with the most detail on violence and abuse – excluded those aged 60 or more, and only recently extended to include those over 74. Some national surveys specifically focus on older people, but these ask very little about violence and abuse. Additionally, despite people in care homes or other institutional settings experiencing a higher risk of violence, it can be challenging to collect information from them. Therefore, many surveys only interview people in private households, which excludes many higher-risk groups.
We need a better grasp of the extent and nature of violence and abuse in older populations. First, reliable figures can improve the allocation of resources and services targeted at the protection of older people. Second, better statistics can identify the risk factors for experiencing violence in later life and the most vulnerable groups.
In the VISION consortium, we used the Adult Psychiatric Morbidity Survey (APMS 2014) to examine violence in people aged 60 and over in England (3). While we found that older people of minoritised ethnic backgrounds are at higher risk of violence (prevalence of 6.0% versus 1.7% in white people in 12 months prior to the survey), more research needs to be done to distinguish the experiences of different ethnic groups. Our research also showed that loneliness and social isolation were strongly related to violence in later life. Older people may experience social isolation due to limiting health issues or economic situations, and perpetrators can exploit this (4). Moreover, isolation of victims is a tool commonly used by perpetrators, especially in cases of domestic abuse (5). Knowing about these and other risk factors can help us better spot and protect potential victims.
Additionally, more needs to be learnt about the consequences of life course exposure to violence for health and well-being in later life. This is still a relatively unexplored area due to limited data and a lack of reporting from older victims and survivors. It is sometimes more difficult to establish the link between violence and health problems because the health impacts are not always immediate but can accumulate or emerge in later life (6). Also, as people develop more illnesses as they age, it is more challenging to distinguish health issues attributable to violence. Therefore we are also using the English Longitudinal Study of Ageing (ELSA) to examine temporal relationships between lifetime violence exposure and health in older age.
Dr Sophie Carlisle, Evaluation Researcher at Health Innovation East Midlands, and former VISION researcher, also reflects on violence against older people and includes an analysis of our study’s strengths and weaknesses in her 10 December 2024 blog on the Mental Elf website, Violence against older people – linked to poor mental health #16DaysOfActivism2024. Sophie highlighted how the study reported that violence against older people is often perpetrated by an intimate partner and is strongly associated with poor mental health.
In an inclusive society, every member should be able to lead a life where they feel safe and respected. We are delighted that the CSEW has removed the upper age limit to data collection on domestic abuse, which is one step towards making older victims and survivors heard. Continuous work on uncovering the ‘hidden’ statistics and examining the effects of intersectional characteristics on violence is crucial in making our society more inclusive, equal, and safe for everyone. For example, one VISION study (7) has demonstrated that the risks of repeated victimisation in domestic relationships had opposite trends for men and women as they aged. We are committed to support the Hourglass Manifesto to end the abuse of older people (8), and are willing to provide decision makers with evidence to enable a safer ageing society.
1. SafeLives U. Safe later lives: Older people and domestic abuse, spotlights report. 2016.
2. Age UK. No Age Limit: the blind spot of older victims and survivors in the Domestic Abuse Bill. 2020.
3. Fadeeva A, Hashemi L, Cooper C, Stewart R, McManus S. Violence against older people and mental health: a probability sample survey of the general population. forthcoming.
4. Tung EL, Hawkley LC, Cagney KA, Peek ME. Social isolation, loneliness, and violence exposure in urban adults. Health Affairs. 2019;38(10):1670-8.
5. Stark E. Coercive control. Violence against women: Current theory and practice in domestic abuse, sexual violence and exploitation. 2013:17-33.
6. Knight L, Hester M. Domestic violence and mental health in older adults. International review of psychiatry. 2016;28(5):464-74.
7. Weir R. Differentiating risk: The association between relationship type and risk of repeat victimization of domestic abuse. Policing: A Journal of Policy and Practice. 2024;18:paae024.
8. Hourglass. Manifesto A Safer Ageing Society by 2050. 2024.
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