Bec Fullbrook is a valued advisor on the Recognise, Respond, Refer (RRR) program, leveraging her own lived experience of domestic violence to collaborate with others impacted by domestic and family violence (DFV) as part of an ongoing consultation and design process. She shares her experience of being involved in making change.
Brisbane South PHN is fiercely committed to making a meaningful and measurable impact through collaboration and partnership with people like Bec.The RRR program is the result of ongoing engagement with a range of people impacted by DFV who courageously share their personal experiences to bring about change and strengthen the program. Many participants have expressed renewed hope and an amplified sense of purpose from their involvement in the ongoing consultation and improvement process.
‘If you aren’t checking in with the people the program is aimed at, how can you know if your efforts will actually make a difference?’ asks Bec.
It’s an excellent question, and one that underpins the co-design work done by the many PHNs participating in the Brisbane South PHN-led RRR program across the country.
This is not a case of consultation for consultation’s sake. The RRR program is agile and able to adjust where required. The team does an amazing job of recognising when an approach isn’t working, responding with changes and referring these enhancements to the program’s partners for successful adaptation.
When a friend found herself the victim of a serious DFV incident recently, Bec encouraged her to seek immediate medical attention.
‘She refused to see anyone but her regular GP. I called the clinic to explain the situation and they agreed to fit her in. On arrival, I expected the doctor to quickly treat the physical aspects and send us on our way. I was impressed to see that the doctor was empathic, and called their DFV Local Link worker to get expert advice. She spoke highly of the RRR program, and explained that by referring my friend to a DFV Local Link worker, they would work as a team to help her.’
The DFV Local Link serves as a connector between primary health care providers and the DFV sector, enabling increasing integration between these 2 sectors over time. ‘As a loved one of someone going through DFV, you can feel powerless and unable to help,’ said Bec. ‘Seeing the relief on her face when she realised she was going to be supported holistically without judgement gave me great solace. This is when I was convinced that the RRR program works. Whilst we’re making progress, so much more needs to be done. Everyone has a basic right to safety, equality and respect in our society, but we know this is still not the experience of many Australians.’
Bec explains that opening up about something like DFV is extremely difficult and takes a lot of courage. ‘With victim-blaming rife, and so much shame and stigma attached, victim-survivors are inclined to cover up any indicators of abuse. General practice staff may be the only avenue of help someone may ever encounter, so having staff attuned to pick up on the signs and trained to sensitively encourage dialogue in the right way could be life-saving. All primary health care professionals need to be aware.’
‘The RRR program has also developed RACGPaccredited training to help upskill GP staff to respond in a way that puts safety first, always. i.e. it’s critical to ask about DFV when the patient is on their own,’ said Bec.
‘My abuser was with me 24/7 including doctor appointments – in a pap smear he didn’t want the curtain shut and was there the whole time. The doctor did not know what to do.’ – Person who has experienced DFV ‘I went to a doctor with rashes all over my body. The doctor was doing lots of tests and could not get to the bottom of the health issue, so he asked me in front of my partner ‘are you stressed?’ I could not answer because my partner was there.’ – Person who has experienced DFV
It is strongly recommended that primary health care providers be aware of the circumstances of the appointment and ensure that it is safe to ask probing questions.
It is important to confirm the abusive partner is not present (Abuse and violence: Working with our patients in general practice, 2014).
So what advice does Bec have for primary health providers?
‘Domestic and family violence is happening whether you’re aware of it or not. Keep an eye out for symptoms just as you would with any other patient with a major risk factor to their health. Ask questions if something seems a bit off, monitor the situation and refer to a specialist. Learn how to Recognise, Respond and Refer. It could be the difference between life and death.’
The expansion of the RRR nationally through PHNs is just one of many steps needed to reform the health system’s response to DFV. Further work is underway to develop the program’s scope, to ensure primary care can adequately, safely and effectively work with people who use violence and control.