Barriers to Access

Many people who experience abuse do not seek support, or only seek support after abuse has been ongoing for years. This is not the fault of the survivor, as there are many factors that can make it difficult or even unsafe to get support. Below, we discuss some of these “barriers to access”, as well as how the NHS and Domestic Abuse services in the community can reduce barriers to access.

What Stops People From Getting Help?

Emotional/Psychological Barriers

-Fear of abuser

-Fear of child removal/intervention from family services

-Embarrassment, shame, or self-blame

Abuser's Control

-Abuser’s physical presence

-Controlling behaviour

-Manipulation of potential interveners (e.g., healthcare workers)

Organizational/Systemic Barriers

-Don’t know where/how to get help

-Fear that service will report to police/immigration authorities

-Sense that “it’s not the place or time” to disclose

Stigma and Stereotypes

-Victim Blaming

-Misogynistic beliefs

-Belief that “X type of person can’t be abused”

Minority Status

-Gender, sexuality, and relationship minorities

-(any kind of) Disability

-Religious, ethnic, or racial minority 

Multiple Disadvantages/Intersectionality

-Any combination of the above

-e.g., unsettled migration status and social isolation

-e.g., substance use and being blamed as the victim

What Can Service Providers Do?

Health Care/NHS

Researchers and healthcare professionals have identified several factors that prevent healthcare workers from identifying people experiencing abuse. These include a lack of education/training centred around recognizing signs of abuse and asking patients about abuse, a lack of private space to ask patients about abuse, and a lack of policy/guidance on how and when to talk to patients about their experiences of abuse. Health services can increase the ability to serve patients suffering abuse by rectifying these above issues and making abuse screening a standard part of medical assessment.

Community DA Services

Researchers, policymakers, and Domestic Abuse service providers have identified strategies that can help Domestic Abuse services decrease barriers to access for their end-users. Specifically, end-users like when service providers (and people developing/planning services) have lived experience with Domestic Abuse as they feel it decreases stigma and improves empathy. Further, trauma-informed approaches that recognize the many challenges a person faces when fleeing abuse (mental health, substance use, housing, etc.) are essential to encourage access. Finally, some groups are negatively affected by strict inclusion/exclusion criteria for service access, and constantly changing services.

Domestic Abuse services, therefore, would benefit from more secure, long-term funding to allow consistent service offerings and more flexibility in clientele serviced. Further, multiagency programming helps people experiencing multiple disadvantages get the help they need, and it is therefore essential that the government encourage and fund collaboration between community-based services, police services, and health care.