Violence against Women
A literature review commissioned by
the National Group to Address Violence Against Women
- Violence against women is widespread, and may affect women of any age, class, race, religion, sexuality, or ability. Factors which may increase women's vulnerability to some types of violence include age, disability, and poverty. Across all forms of violence and abuse, women are most at risk from men they know.
- Significant numbers of women experience more than one type of violence. Prevalence surveys which address violence against women in all its forms may yield more information than 'single issue' surveys about the meaning and impact of violence in women's lives. Few studies have been designed specifically to record the experiences of marginalised groups of women, including black and minority ethnic women, women with disabilities, lesbian women, women working in prostitution and homeless women. Attempts to document the experiences of marginalised groups of women must go beyond merely ensuring their 'inclusion', numerically speaking, in general population studies.
- Recurring themes in women's descriptions of male violence include the use of tactics of control, humiliation and degradation, the abdication of responsibility by the male abuser, and the attribution of blame to the woman. These are found regardless of the woman's relationship to the perpetrator, and regardless of whether the experience is a discrete event or part of a pattern of abuse.
- Violence against women has a significant impact on the health and socio-economic status of women. It affects the health and wellbeing of children and young people who witness violence against their mothers and other women. The costs to society of responding to violence against women, and the overall economic impact, are significant and measurable. However, there is a need for improved data collection systems across all agencies involved in responding to women who have experienced violence.
- Although there has been an increase in the number and range of services available to women who have experienced violence, there is relatively little evaluative research. The available research suggests that women value advocacy and support, and want service providers to be more proactive in offering these. Research into interventions tends to focus on discrete aspects of violence against women, reflecting the way in which women's experiences are compartmentalised by service providers and policy makers. Although some comparative research has been undertaken, no studies were identified which evaluated interventions to respond more broadly to women's experiences of violence.
- Research on interventions with rape survivors is primarily focussed on medico-legal responses, with some literature on therapeutic interventions, but little on interventions by primary care workers. Rape crisis provision is still poor across Scotland , and there is a lack of independent evaluation of the approach. There is a similar lack of evaluation of sexual assault referral centres (SARCs), although a forthcoming report from the Home Office should address this.
- Much of the literature on women working in prostitution is taken up with questions of definition and agency, and in this, it reflects early debates about how far women 'choose' to stay with violent partners. There is also a significant body of literature which considers crime management interventions. There is little on interventions which support women abused in prostitution, or assist them in leaving.
- Research on interventions with adult survivors of childhood sexual abuse is primarily found in the mental health literature. Although some work has been carried out which explores the links between childhood sexual abuse and chronic physical health problems, no research was identified which addressed how healthcare staff should acknowledge this or respond to it. No research into the criminal justice response to adult survivors of childhood sexual abuse was identified.
- By comparison, research on interventions with domestic abuse survivors cuts across several sectors, including criminal justice, acute and primary care health services, social work services and outreach and advocacy services.
- The scarcity of research on interventions for black and minority ethnic women, women with disabilities, lesbian women, and older women affected by male violence against women is perhaps a reflection of the dearth of services for these groups.
- Research on violence against women cuts across academic boundaries, and is found in several fields, including law, social sciences and health. This is a reflection of the diverse range of responses violence against women demands. However, multidisciplinary research is rare, and consequently opportunities for 'cross-fertilisation' are missed.
- Services for children and young people affected by violence against women are still relatively scarce. Although not addressed directly in this review, an early trawl of the literature identified little research on effective interventions. The existing body of research focuses primarily on the impact of domestic abuse on children and young people.
- It is acknowledged that the involvement of women survivors of male violence in contributing to the development and design of services increases effectiveness and accountability. However, there are still few examples of how this is achieved in practice.
- In describing the acts of abuse perpetrated by different men, at different points in their lives, women survivors of male violence consistently make the connection between child abuse, rape, domestic violence and commercial sexual exploitation. There are demonstrable links between different forms of violence against women, in the nature of the violence, the consequences of it, and the interventions required. Whether or not these links are made visible in policy and practice is to some extent governed by how far violence against women is regarded as symptomatic of wider gender inequalities in society, and how far initiatives to tackle violence against women are located within this context.
Women make connections between the different forms of violence they have experienced. They also make connections between the violence they experience and the way they are treated in other areas of their life. Most of the policy, research and practice reviewed takes a more compartmentalised approach, dealing with discrete aspects of violence against women. Promotion of an integrated response to violence against women should be considered as a priority.
Working on this review has provided a timely reminder that, although there is much still to be done, a lot has changed in the last 30 years. It has also been telling to note that, although there is a lot of good work happening in Scotland , it is largely undocumented. Some of this is undoubtedly tied to under-resourcing, some of it to the undeniable need to focus on the provision of the service. Building the capacity of frontline organisations to document the work being done would not only be useful for literature reviewers. Sharing examples of good practice would also save some duplication of effort - how many local partnerships have spent time working out the best way to produce and disseminate information resources for women?
The lack of evaluative research has been a theme throughout this review. There are many interventions, but not many assessments of how effective they are. Although no-one disputes the need for service developments to be evaluated, in practice evaluation tends to be done in-house, with a focus on process rather than outcome. Few services have the resources to commission independent evaluation.
Increasing collaboration between researchers, practitioners and policy makers might go some way to ensuring that services remain effective and responsive, and that research on violence against women is beneficial to service users and service providers. The 'Alliance of Five Research Centres on Violence' has provided a valuable focus for the development of research on violence against women in Canada, and this model would bear exploration to see how it could be developed in a Scottish context. The Centre for Research on Families and Relationships has gone some way down this route, and the proposed Scottish Centre for Criminal Justice Research will make use of a 'virtual department' model to improve the co-ordination and development of research on justice issues in Scotland. Both of these initiatives promote closer working links between academic researchers, policy makers and practitioners/service providers.
Supporting any research programme or service development programme, there is a need to address the collection and collation of data in relation to all forms of violence against women. In order to assess the effectiveness of any work we undertake to improve the situation of a particular group in the population, it is necessary that we are first of all able to 'see' that group in official statistics. Some of the issues which seem specific to violence against women are in fact cross cutting. Gender disaggregation would help to provide the baseline statistics which are crucial to evaluating the work being undertaken to challenge violence against women, but would also support more general work undertaken to reduce inequality. Concerns about data sharing and data protection are common across all areas of work which involve an interagency response, including homelessness, child protection and substance misuse. Sharing best practice in data collection across sectors might have other benefits, given the links between violence against women and, for example, homelessness.
In relation to service provision, the development of the National Strategy to Address Domestic Abuse, backed by the establishment of the Domestic Abuse Service Development Fund (DASDF), has ensured that the "patchy and inconsistent" services identified in the Henderson report of 1997 are beginning to be more consistent and a little less piecemeal. The role of the DASDF in supporting the work of local domestic abuse partnerships should not be underestimated. Alongside this, there has been an unprecedented development of refuge provision, and the national helpline has increased its hours year on year since its inception. Awareness of the prevalence and effects of domestic abuse is increasing in all public sector agencies, and most local partnerships have already begun to develop local training strategies. Work is also underway to improve criminal and civil justice system responses to domestic abuse, and to increase legal protection for women and children.
Across the other aspects of violence against women, the picture is still somewhat "patchy and inconsistent". The recent allocations of funding by the Scottish Executive will go some way towards improving service provision, particularly in relation to rape and sexual assault. However, there is a need to develop more stable and consistent approaches to funding services which respond to all forms of violence against women, nationally and locally.
The development of a funding strategy should be located within a broader strategic framework on violence against women. The National Strategy to Address Domestic Abuse in Scotland is due for review. The basic principles of the current strategy are applicable across all forms of violence against women. It would seem an appropriate opportunity to expand the terms of reference of the strategy and incorporate broader aspects of violence against women. Specific work would seem to be indicated in relation to sexual violence.
Broadening the strategic framework on violence against women might include consideration of the types of services on offer to women, and how to ensure that they reflect what women are looking for from services. Research has indicated, for example, that women value a more proactive approach to follow-up support and advocacy. A review of the mechanics of multiagency partnerships might also be worth some consideration. Some of the themes identified by Dutton and Cavanagh in relation to multiagency responses to sexual violence would bear further exploration, as more partnerships begin to develop in response to sexual violence.
Many women disclose in the first instance to people they know - family, friends, workmates - and so more attention should be paid to the development of information and support for the general public. Providing information and support through workplace campaigns, awareness raising programmes in schools and general public education campaigns could greatly enhance the level and quality of informal support available to women from those closest to them.
There are significant gaps in the research literature. Research which addresses the experiences and needs of black and minority ethnic women experiencing violence is scarce, perhaps reflecting the dearth of services for this group of women. There is a similar lack of understanding of the needs of women with disabilities and of lesbian women. There is little assessment of effective interventions for children and young people who have experienced violence themselves, or who have witnessed violence against women. Dedicated literature reviews may be required in each of these areas.
Finally, but most importantly, the views of women themselves should be sought. There is an absence of consultative mechanisms which enable women to input directly to the development of services which might meet their needs. This is a gap which should be filled as a priority before very much more work is developed.