Family Violence: An Insight Into Perspectives and Practices of Australian Health Practitioners

Abstract

Family violence is threatening behavior carried out by a person to coerce or control another member of the family or causes the family member to be fearful. Health practitioners are well placed to play a pivotal role in identifying and responding to family violence; however, their perceived capacity to respond to patients experiencing family violence is not well understood. We aim to explore Australian health practitioners’ current perspectives, practices, and perceived barriers in working with family violence, including perceived confidence in responding effectively to cases of family violence encountered during their work with patients. A total of 1,707 health practitioners primarily practicing in the wider Melbourne region were identified, and 114 health practitioners participated in the study between March 2016 and August 2016 by completing an investigator-developed questionnaire. Descriptive, qualitative, and thematic analyses were performed. The majority of participants recognized family violence to be a health issue and that family violence would impact the mental health of afflicted persons. Despite this, only a fifth of participants felt they were very confident in screening, supporting, and referring patients with family violence experiences. Perceived barriers to inquire about family violence included time constraints and greater importance placed on screening for other health issues. Health practitioners reported that additional training on screening, supporting, and referring patients would be beneficial. Australian health practitioners need to be upskilled. Recently, in Australia, state-relevant toolkits have been developed to provide succinct information about responding to initial patient presentations of family violence, how to inquire about family violence, and how to handle disclosures (and nondisclosures) by patients. Further resources could be developed to aid health practitioners in providing assistance to their patients as indicated. These initiatives would be a step toward addressing the concerns with regard to the lack of training and could possibly optimize outcomes for patients experiencing family violence.

Keywords

mental health and violence intervention/treatment domestic violence perceptions of domestic violence

Introduction

Family violence is threatening behavior carried out by a person to coerce or control another member of the family, or causes the family member to be fearful (Family Court of Australia, 2006). Acts of family violence include physical violence, sexual abuse, emotional abuse, verbal abuse and intimidation, economic and social deprivation, damage of personal property, and abuse of power (Australian Bureau of Statistics, 2013).

Research shows that family violence is a worldwide phenomenon (Ramsay et al., 2012). It afflicts families from all socioeconomic, educational, and cultural backgrounds, and can be perpetrated intergenerationally. Intergenerational violence, where past violent behaviors of parents are normalized and are then perpetuated in current relationships with partners and children, is increasingly recognized as a contributing factor to the perpetration of current violence within families (Ehrensaft et al., 2003; Hightower, Smith, & Hightower, 2006). Chronic physical and mental health problems are common repercussions of family violence. Studies have linked family violence to adverse pregnancy outcomes, gastrointestinal disorders, chronic pain syndromes, somatoform disorder, depression, anxiety, and posttraumatic stress disorder (PTSD) (Bland & Orn, 1986; Eberhard-Gran, Schei, & Eskild, 2007; Ellsberg, Jansen, Heise, Watts, & Garcia-Moreno, 2008). Although both psychological and physical health impacts of violence last long after the violence has ceased (Xiao, Gavrilidis, Lee, & Kulkarni, 2016), survivors of family violence often express that the worst adverse consequence of family violence is the psychological effects of the abuse rather than the physical harm (Campbell, 2002). The physical and mental health issues caused by family violence result in high levels of morbidity and mortality worldwide (Rees et al., 2011; Watts & Zimmerman, 2002).

Within Australia, family violence has been described as “the most urgent law and order emergency occurring and the most unspeakable crime unfolding across our nation” (Royal Commission Into Family Violence, 2016). Family violence affects one in five Australian women over their lifetime and is the leading cause of death, disability, and illness in women younger than 45 (Department for Victorian Communities, 2005). However, as most incidents are unreported, the true extent of family violence most certainly extends past these reported statistics (Phillips & Vandenbroek, 2014).

In recognizing the severity of this issue, the Council of Australian Governments (COAG) has developed a 12-year plan, published in its report, “Reducing Violence Against Women and Their Children (2010-2022),” of which the most recent update has incorporated a greater focus on screening methods to better identify victims of abuse (Commonwealth of Australia, 2016). Several previous studies have shown routine inquiry to be beneficial in screening for family violence (Lee, Coles, Lee, & Kulkarni, 2012; Lee, Lee, Coles, & Kulkarni, 2012). However, due to the sensitive nature of family violence, some studies have proposed alternative interventions, such as administration of standardized screening questions. These studies have found that specific barriers, especially the lack of provider education, have resulted in patient nondisclosure. Therefore, having such questionnaires might lower rates of interpersonal misunderstanding and increase patient disclosure (Friedman, Samet, Roberts, Hudlin, & Hans, 1992; Waalen, Goodwin, Spitz, Petersen, & Saltzman, 2000). A systematic review has also concluded that training health professionals to engage in effective routine inquiry creates an avenue for greater patient disclosure (Ramsay, Richardson, Carter, Davidson, & Feder, 2002; Taket et al., 2003), although there is a lack of evidence in the health benefits, such as identification and prevention of physical and mental conditions (McLennan & MacMillan, 2016). Recent investigations support these findings and revealed that routine screening was either targeted or routine depending on the guidelines of the country (McLennan & MacMillan, 2016). In Australia, current practices include targeted screening for the general population and routine screening for women during antenatal care (Royal Commission Into Family Violence, 2016). However, in the United Kingdom, routine screening is performed and viewed as “good clinical practice, even when there are no indications of such violence and abuse” (National Institute for Health and Care Excellence, 2014).

Despite the growing efforts of the Government, the legal system, nongovernmental organizations, and the health disciplines, family violence is still pervasive in our society. Recent data reflect high levels of family violence present in Australia where nearly half of the victims are young adults aged 20 to 34 (Australian Bureau of Statistics, 2016). From a meta-synthesis, it was identified that middle aged and older women (i.e., 45+ years old) are also highly susceptible, although this group of women rarely seek help, in part due to previous unhelpful interactions with health professionals (McGarry, Ali, & Hinchliff, 2016). The reasons originate mainly from the lack of care and support after disclosure, or being doubted by health professionals postdisclosure (Lazenbatt, Devaney, & Gildea, 2013), simply due to the lack of normative language to convey their abuse (Cook, Dinnen, & O’Donnell, 2011; O’Keeffe et al., 2016). In some cases, women have suffered lifelong abuse, from childhood and continuing through marriage, and even through subsequent relationships or marriage. This is in line with a wealth of data estimating that, for women in the general population who were abused in childhood, two out of three are victimized in adulthood (Classen, Palesh, & Aggarwal, 2005). Looking at the wider population, many women describe barriers to disclosure being internal, such as feeling embarrassed or ashamed, or external, perceiving that the doctor is only concerned about physical issues (Hegarty et al., 2010). It was further found that the lifetime disclosure was 36.7% (Hegarty & Taft, 2001), which supports the notion that most incidents are unreported (Phillips & Vandenbroek, 2014). Hence, there is a need for health practitioners to be more aware and effective in identifying and managing this widespread public health issue.

While the research has tended to explore victim perspectives about family violence, there remains a lack of research assessing current practice issues in Australian general practitioners (GPs), psychologists, psychiatrist, and other health practitioners. In 2012, we have evaluated Australian psychologists’ practice, beliefs, and attitudes toward supporting women survivors of childhood maltreatment (Lee, Lee, et al., 2012). Out of the 127 psychologists surveyed, 81.8% reported meeting women survivors with mental health issues and comorbid childhood maltreatment experiences on a daily or weekly basis. Despite feeling confident and comfortable with screening, supporting, and referring women survivors when necessary, the majority of respondents would still like further training on child maltreatment and its impact (75.2%), and how to treat (75.4%), screen (66.1%), support (81.6%), and refer women survivors to appropriate services (57.3%).

This study is an extension of the study by Lee, Lee, et al. (2012), and we aim to broaden the scope of providing an insight into possible changes in perspectives and practices of health practitioners toward family violence as a whole, and perceived barriers regarding family violence. This includes perceived confidence, in responding effectively to cases of family violence encountered during their work with patients.

Method

Participants and Procedure

A total of 1,707 health practitioners primarily practicing in the wider Melbourne region, who were listed on a database held by the Monash Alfred Psychiatry Research Centre (MAPrc), Melbourne, Australia, were identified; 1,607 were sent an electronic copy, and 100 were sent a hard copy of a survey on clinicians’ practices and attitudes relating to family violence. A total of 114 health practitioners (response rate of 6.7%), comprising of psychiatrists, psychologists, GPs, mental health nurses, social workers, counselors, occupational therapists, and practice nurses participated in this study by completing the survey between March 2016 and August 2016. Participants were provided with a cover letter inviting them to complete the four-page anonymous questionnaire either by responding via the link embedded within the received email, which took them to Qualtrics (Snow & Mann, 2013) (an online survey delivery tool), or by mailing their responses back to MAPrc had a hard copy survey been supplied. Being an exploratory study, convenience sampling was utilized to maximize the data pool. Consent was implied on completion of the survey, and their responses were collated within the survey software and transferred to a statistical analysis software—IBM SPSS 23 (Field, 2013) for further analysis. This research project was approved by Alfred Research Ethics Committee (Project Number 532/15).

Questionnaire

The investigator-developed questionnaire used in the present study was based on a questionnaire developed in our previous study that evaluated Australian psychologists’ practice, beliefs, and attitudes toward supporting women survivors of childhood maltreatment (Lee, Lee, et al., 2012; Richardson et al., 2001). From Lee, Lee, et al.’s (2012) 41-item questionnaire, 39 items that related to characteristics of practice, attitudes, beliefs, and confidence of health practitioners in assisting women who have experienced family violence were included in the present study. Where necessary, the wording of questions was tailored to the questions and aims of the present article. The questionnaire was then reviewed and evaluated for appropriateness of items included, relevance to the study aims, and format of data to be collected by authors J.K. and E.G. Following this internal review, two of the initial items were excluded, and 15 items were added to address specific clinical questions, including nine items allowing for “additional comments” to ensure respondents could express their views in an open-ended format. The remaining six additional items explored existing practices and resources available at the practitioner’s practice to assist women who experience family violence.

The final questionnaire consisted of 54 structured and open-ended items, with seven items evaluating participant’s demographic information, 21 items exploring participant’s attitudes and clinical practice with regard to family violence, 19 items exploring confidence levels of participants in dealing with family violence, and seven items querying need for further training and perceived barriers by participants to screening for family violence.

Analyses

Data analyses was conducted with IBM SPSS Statistics 23 (Field, 2013). Descriptive analyses were utilized to demonstrate cumulative responses of health practitioners. Qualitative data derived were analyzed using thematic analysis (Braun & Clarke, 2006).

Responses in relation to “barriers perceived by health practitioners” were systematically analyzed by authors H.J.S. and C.G., and initial themes were generated. H.J.S. later conducted an in-depth review of the data, and further defined and named the themes. Responses were then independently reviewed and coded according to themes by H.J.S. and C.G. A measure of interrater reliability between the two coders was calculated using Cohen’s kappa, with levels from 0.63 to 0.76 indicating substantial agreement between raters. The top five themes were coded with almost complete agreement, with kappa levels of 0.87 (95% confidence interval [CI] [0.78, 0.96]), p < .0001 (Viera & Garrett, 2005); the remaining themes were coded with a lower rate of agreement, and hence, only the top five themes are reported on.

Results

Participants consisted of mental health nurses (32.5%), psychologists (20.2%), psychiatrists (16.7%), GPs (11.4%), and other professions, which made up the remaining 19.4%. Majority of participants were female (66.7%), and the average age of all participants was 45.7 years (SD = 11.3). Participants had an average of 17.1 years in clinical practice (SD = 10.1), and most were working in urban areas (93.0%). Overall, participants completed their training in Australia (84.2%) and were currently working in public hospitals (54.4%) (Table 1).

Table 1.

Participants Demographics.

	Total (n = 114)	Psychiatrists (n = 19)	Psychologists (n = 23)	Mental Health Nurses (n = 37)	GPs (n = 13)	Others (n = 22)
Age (M, SD)	45.7 (11.3)	43.8 (9.6)	53.1 (10.0)	43.2 (11.6)	51.2 (8.4)	40.7 (10.8)
Range of age	25-66	29-58	36-66	25-61	32-61	26-62
Years in clinical practice (M, SD)	17.1 (10.1)	17.0 (9.8)	16.5 (7.5)	16.7 (11.2)	24.7 (9.0)	14.2 (10.1)
Range of years in clinical practice	1-40	5-34	2-35	1-40	6-35	2-35
Variable	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)
Gender
Male	38 (33.3)	12 (63.2)	7 (30.4)	15 (40.5)	3 (23.1)	1 (4.5)
Female	76 (66.7)	7 (36.8)	16 (69.6)	22 (59.5)	10 (76.9)	21 (95.5)
Country of training
Australia	96 (84.2)	16 (84.2)	21 (91.3)	30 (81.1)	9 (69.2)	20 (90.9)
Others	18 (15.8)	3 (15.8)	2 (8.7)	7 (18.9)	4 (30.8)	2 (9.1)
Current area of workplace
Urban	106 (93.0)	19 (100.0)	22 (95.7)	37 (100.0)	7 (53.8)	21 (95.5)
Regional	5 (4.4)	0	1 (4.3)	0	3 (23.1)	1 (4.5)
Rural	3 (2.6)	0	0	0	3 (23.1)	0
Description of current workplace
Public hospital	62 (54.4)	16 (84.2)	1 (4.3)	27 (73.0)	0	18 (81.8)
Community health center	11 (9.6)	1 (5.3)	1 (4.3)	6 (16.2)	1 (7.7)	2 (9.1)
Government mental health services	4 (3.5)	0	1 (4.3)	3 (8.1)	0	0
Nongovernment mental health services	5 (4.4)	2 (10.2)	1 (4.3)	1 (2.7)	0	1 (4.5)
Private hospital	0	0	0	0	0	0
Private medical clinic	6 (5.3)	0	1 (4.3)	0	4 (30.8)	1 (4.5)
Private practice (sole practitioner)	14 (12.3)	0	13	0	1 (7.7)	0
Private practice (2-5 practitioners)	7 (6.1)	0	4	0	3 (23.1)	0
Private practice (6-10 practitioners)	5 (4.4)	0	1 (4.3)	0	4 (30.8)	0

Note. GP = general practitioner.

Of the 44 Likert-type scaled items, 10 items contained missing data, and these ranged from 0 to 12 responses from a total of 114 participants. Figure 1 illustrates the participants’ current perspectives regarding family violence and their perceived confidence in responding effectively to cases of family violence encountered during their work with patients.

Figure 1.

Practitioners’ current practices, attitudes, and confidence toward family violence.

The majority of participants reported that they recognize family violence to be a health issue (52.0% strongly agreed, 44.1% agreed) and that family violence would affect the mental health of afflicted persons (83.3% strongly agreed, 15.7% agreed). The majority of participants agreed that family violence screening should be routine (28.4% strongly agreed, 53.9% agreed), and 12.7% strongly agreed (and 35.5% agreed) that they had done so. In all, 66.7% participants expressed that screening of patients for family violence was very important, 90.2% expressed that supporting patients was very important, and 74.5% expressed that referring patients to appropriate services was very important. In relation to health practitioners’ confidence in dealing with family violence, 20.6% reported being very confident in screening, 16.7% stated they were very confident in supporting, and 22.5% stated they were very confident in referring patients with family violence experiences.

The questionnaire also featured items on perceived barriers to working with family violence and possible solutions (Figure 2). In all, 41.2% felt that they did not have adequate family violence patient resources to refer patients, while 36.3% felt they were uncertain. In addition, 28.9% expressed that they do not have sufficient patient education resources, while 43.0% of participants were uncertain. Most participants felt they did not have adequate knowledge (37.3%) or were uncertain (37.3%) about referral sources for patients in their community. In addition, with regard to further training, majority of participants (60.8%) expressed that specific training toward family violence and its impact would be helpful. A total of 69.6% felt that training on screening patients would be beneficial, 72.5% felt that training on supporting patients would be beneficial, and 76.5% felt that training on referring patients would allow them to aid their patients better (Figure 2).

Figure 2.

Practitioners’ perceived barriers and solutions.

The final section of the questionnaire asked participants, “What are the barriers to screening for/asking about family violence in your practice?” to better understand what the perceived barriers to inquiring about family violence with patients were. As this section was open-ended, only 63 health practitioners responded and gave their opinion. The most frequent response pertained to time constraints (n = 20) due to the pressure of limited consult times. Practitioners also described that there was a greater importance to screen for other issues (n = 8) during the consult because of the patient’s primary presentation. Inexperience of professionals (n = 8) due to a lack of understanding within the multidisciplinary team and the lack of training was another issue that was raised. Participants also acknowledged that screening was not part of the routine (n = 7), and there were no appropriate protocols (n = 2). Many participants also felt that patients were reluctant to share (n = 7) as “stigma” was still prevalent (n = 3). Furthermore, knowing appropriate avenues to refer patients was difficult (n = 3). Responses describing the most commonly reported perceived barriers were grouped, and the five most common themes in order, from most to least frequent, are presented in Table 2.

Table 2.

Practitioners’ Top Five Perceived Barriers.

Perceived Barriers by Practitioners	Number of Responses	Sample Quotes From Practitioners
1. Time constraints	20	1. “It is often not the presenting issue. Sometimes time constraints (session time, and number of sessions) means [that] not everything can be addressed as fully as one would like. People may be hesitant to disclose family violence until they are comfortable with the therapist and feel very safe. [This] can take many sessions for some women.” 2. “Time constraints and not having up to date resources available when you need them.” 3. “Time and confidence in being able to adequately respond . . . as we do not have [that] capacity . . . so we end up not being able to help.”
2. Greater importance to screen for other issues	8	1. “Often time pressure, workload and the specific circumstances i.e., relationship/engagement with the consumer, alcohol and other drugs (AOD) intoxication or withdrawal can be factors that affect screening.” 2. “Other issues that are more urgent. Time pressures and the lack of consideration of the issue.” 3. “Ways in which to ask if there is no indication of family violence [when] the client’s agenda is to meet you about other particular issues.”
3. Inexperience of professionals	8	1. “If it’s not in the referral details, it is not at the forefront of my mind. [For instance, I will] ask about sexual abuse if [it is] relevant. But having it at the forefront . . . would help me remember to ask more specific questions to rule it out. So, I guess inexperience is the main barrier.” 2. “It depends whether the clinician feels confident in doing so and if they are aware of resources/services available.” 3. “Lack of experience and understanding. A nurse once talked to me about an abusing partner of a patient and she said, ‘I don’t believe it, he’s such an attractive man.’” 4. “Lack of training in this field. [It] seems that this area is very female dominant and evidence based practice is unclear.”
4. Family violence screening not part of routine	7	1. “Funnily, unless there have been obvious indicators, it hasn’t come up on the radar for [the] routine Psychiatric Assessment Screening.” 2. “There is just no screening tools tailored to inpatient mental health psychiatric units.” 3. “No one in the multi-disciplinary team is responsible for following up such issues.”
5. Patient reluctance	7	1. “It all depends on the amount of disclosure from the client/patient. We are guided by their needs.” 2. “Privacy concerns. Patients are hesitant to open up [due to] fear of reporting perpetrators.” 3. “People are uncomfortable about the issue . . . [There is] a lot of victim blaming—deters people from speaking up, and also professionals might believe it is a private matter—too hard to discuss.”

Discussion

This study aimed to explore Australian health practitioners’ current perspectives, practices, and perceived barriers regarding family violence, including perceived confidence in responding effectively to cases of family violence encountered during their work with patients. We found that the vast majority of participants in this study agree that family violence is a health issue, although most practitioners reported lacking confidence in their perceived ability to screen, support, and refer these patients appropriately. The study also provided preliminary data reflecting the most common perceived barriers to better understand the current limitations.

Consistent with the literature, most health practitioners in this Australian sample strongly agree that family violence also affects mental health (Ramsay et al., 2012; Rees et al., 2011; Watts & Zimmerman, 2002), and therefore, mental health of women should be screened routinely. This approach could not only serve to mitigate the mental health effects of violence but also has the potential to evaluate the presence of specific mental health issues that may indicate the presence of family violence. Identification signifies the first stage of a critical opportunity to interrupt the cycle of violence, and therefore, screening, in this context, becomes crucial as it acts as a marker, increasing the opportunities to identify family violence even in the absence of a disclosure (Riggs, Caulfield, & Street, 2000).

When surveyed, women have agreed that health care providers should screen female patients for family violence (McCord-Duncan, Floyd, Kemp, Bailey, & Lang, 2006; McNutt, Carlson, Gagen, & Winterbauer, 1999; Snyder, 2016). Depending on the country of practice, practitioners either perform targeted or routine screenings. When performed, considerations should be given to different practitioner groups who may have distinct perceived responsibilities and face practice pressures unique to their profession. As expressed by 20 practitioners in our survey, time constraints were one of the top perceived barriers. For instance, a general consultation time for a GP is approximately 15 min and often related to a specific physical health presentation. By contrast, a consultation with a mental health practitioner is likely to span over 45 minutes, allowing more time for detailed exploration to underpin the presenting issue in a holistic manner (Lee, Coles, et al., 2012). Therefore, perceived onus regarding the identification and management of family violence would be influenced by professional training, time, and funding constraints along with other barriers mentioned in Table 2, such as having a succinct handbook or further training.

In Australia, traction has been made with the development of state-relevant toolkits that are valuable desktop resources accessible to health practitioners (Grigg et al., 2015; Support Help and Empowerment, 2015; Women’s Legal Services New South Wales, 2013). These resources contain succinct information about responding to initial patient presentations of family violence, how to inquire about family violence, and how to handle disclosures (and also nondisclosures) by patients. Since it has been estimated that only 36.7% of women disclose experiences of family violence (Hegarty & Taft, 2001), and less than half (48.2%) of health practitioners report that they do enquire routinely about family violence (Figure 1), these user-friendly toolkits can aid practitioners to be more confident in identifying and responding effectively to women who are experiencing family violence. Moreover, they can be downloaded as desktop resources for easy reference. Another concern raised was that many health practitioners refer family violence victims to a myriad of organizations without sufficient guidance, resulting in a poor follow-up and in women not obtaining the help they need. These toolkits have complied important state-specific information on outreach services, hotlines, and legal services for health practitioners to refer women to, which would serve to provide women the appropriate help they need. By providing easy accessibility to specialist organizations, along with information on how these organizations are able to assist women who have experienced family violence, the toolkits help to address the barriers of “time constraints” and “inexperience of health professionals” as stated in Table 2.

A strength of this study was that the findings provided an insight into the current practices of a sample of 114 health practitioners, and their attitudes, and confidence in screening, supporting and referring women who have experienced family violence, which has not been looked at previously. The results of this study were consistent with prior literature suggesting the necessity for further training to provide better care to these women (Lapidus et al., 2002; Pagels et al., 2015). This study also highlights the myriad of barriers perceived by health professionals, which can serve to inform future research into possible solutions for practitioners to optimize response to family violence encountered within their line of work.

The low response rate of 6.7% was a limiting factor. As the majority of surveys were sent electronically, many potential participants could have failed to respond due to personal time constraints, perceived low salience of the study, or otherwise failing to receive the invitation to participate (e.g., deleting the electronic mail). However, surveys remain an important tool in health service research, providing cost-effective sources of data collection. Future studies evaluating health practitioners’ perspectives on family violence could consider the design of the survey used, with shorter length and use of more closed-ended items possibly yielding higher response rates (VanGeest, Johnson, & Welch, 2007). Another limitation of this study was that the questionnaire was investigator-developed. This was necessary due to the lack of previous literature relevant to the present study’s aim. However, this questionnaire was able to explore the attitudes and perceptions of Australian health practitioners through qualitative research methods.

Looking forward, further research could target more specific evaluations of different health disciplines to further evaluate variance in perspectives and practices regarding family violence. Further resources such as hand-outs and toolkits along with mental health training programs could be developed to aid health practitioners in providing assistance to their patients as indicated. In a systematic review as described by Turner et al. (2017), pre–post surveys have shown that various interventions have been effective in improving the knowledge, attitudes, and competence of health practitioners toward family violence and abuse. These interventions could be hospital implemented, such as 30-min didactic sessions or a training curriculum given over multiple weeks, to a systemic-level intervention such as the New Zealand Family Violence Intervention Guidelines. (Turner et al., 2017). Although the magnitude of improved attitudes and competence is challenging to estimate, implementing such initiatives would increase awareness and is a step toward addressing the concerns with regard to the lack of training. In the long run, this could possibly optimize outcomes for patients experiencing family violence.

Conclusion

This study provides important insight into the current perspectives and practices of Australian health practitioners who, in the course of their work, come into contact with women who have experienced family violence. Findings confirmed that most practitioners are not confident in screening, supporting, and referring women who may be suffering from family violence, and would like further training in the area. As an important point of contact for many women experiencing family violence, upskilling health practitioners in the identification of, and response to, family violence is essential to optimizing the health and mental health outcomes of these women and their families.

Supplemental Material

Supplementary_Material_Health_Professional_Feedback_Questionnaire_V2_Mar_2016.pdf – Supplemental material for Family Violence: An Insight Into Perspectives and Practices of Australian Health Practitioners

Supplemental material, Supplementary_Material_Health_Professional_Feedback_Questionnaire_V2_Mar_2016.pdf for Family Violence: An Insight Into Perspectives and Practices of Australian Health Practitioners by Han Jie Soh, Jasmin Grigg, Caroline Gurvich, Emmy Gavrilidis and Jayashri Kulkarni in Journal of Interpersonal Violence

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Supplemental Material

Supplementary material for this article is available online.

ORCID iD

Han Jie Soh

Author Biographies

Han Jie Soh is a final year medical student undertaking the MBBS(Hons) at Monash University. He became involved in the Monash Alfred Psychiatry Research Centre (MAPrc) during a medical placement at The Alfred Hospital as a means of furthering his interest in the effects of violence against women. He is currently working with the Women’s Mental Health Team on a project that aims to identify the key attitudes that are likely to affect health professionals’ behavior toward victims of family violence.

Jasmin Grigg is a current research fellow at Monash University and was previously a postdoctoral researcher at the MAPrc in 2016. She has contributed to the field of family violence through developing two documents published by MAPrc—“When She Talks to You About the Violence” (A General Practitioner [GP] toolkit for identifying and responding to family violence). She also has a keen interest in the impact of hormones on brain functioning and aims to contribute to research that provides further understanding of their role in enhancing recovery from mental illness.

Caroline Gurvich is a senior research fellow and a clinical neuropsychologist at MAPrc. She is the research leader for the Women’s Mental Health division at MAPrc and leads the “Cognition, hormones and genes” research unit within the Women’s Mental Health division. Her research explores the interplay between biological factors (such as genetic effects and hormones) and lifestyle factors (such as trauma and stress) on cognition in mental illness. She has also recently established a clinical neuropsychology service that runs through MAPrc.

Emmy Gavrilidis is the women’s mental health division research manager at MAPrc. Prior to this, she was the women’s mental health division coordinator (2011-2017) and research assistant (2007-2011). She has extensive research experience and is involved in many aspects of research, such as project development, grant applications, and setup of new studies including ethics, honors student project supervision, conference management, budgeting, and finance aspects of research. She is responsible for supporting strategic and operational processes with the goal to ensure growth and success of the division in research, teaching, learning, and engagement.

Jayashri Kulkarni is a professor of psychiatry at The Alfred and Monash University, and is the director of MAPrc. She is internationally and nationally renowned for the promotion of research in women’s mental health. In particular, she has pioneered the use of estrogen as a new treatment in schizophrenia and is internationally recognized for this significant innovative achievement. She has developed many new treatments including tamoxifen treatment for bipolar disorder and tibolone treatment for depression. She was instrumental in securing the bid to host the 9th World Congress on Women’s Mental Health in 2021.

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