Evaluation of the Portsmouth Domestic Violence Early Intervention Project (EIP)

January 1, 2002

EIP is a pilot project based in Portsmouth that aims to reduce repeat victimisation by providing support and information about the options available to anyone experiencing domestic violence at the point of crisis. It seeks to do this by training hospital staff in Accident and Emergency and Maternity Departments to screen patients in order to identify if domestic violence is present in their lives and placing dedicated Project workers within the hospital setting to whom hospital staff can refer. Project workers offer a range of services including information on options, support, safety planning, referral, advocacy and liaison/accompaniment to other relevant services. Employing a multi-methodological strategy, this Evaluation assessed the impact and effectiveness of this hospital-based intervention, and involved the following:

• the development of a relational database to monitor and track cases across the service;
• questionnaires and focus groups with hospital staff in order to evaluate the training that they had received to respond appropriately to domestic violence;
• focus groups with Project staff to explore issues arising from the implementation of the intervention;
• structured telephone interviews with multi-agency partners to assess the need for, impact and effectiveness of the Project;
• questionnaires or telephone interviews with service users to gather information on their use and experience of the Project and other related domestic violence services, and to establish the need for further services;
• a number of in-depth case studies involving service users, Project staff and any other relevant agencies, which explored the operation of the Project ‘on the ground’.

Summary of Findings:

Training:

• The training is increasingly attracting participants from other departments in the hospital and from external agencies;
• The majority of training participants noted that the training had fulfilled its objectives and providedparticipants with the skills to screen for and respond to domestic violence;
• Roughly one third of participants raised concerns about practical difficulties in relation to screening, notably lack of privacy and time in busy hospital departments;
• Almost all training participants reported that they understood the services EIP could provide and were supportive of the Project;
• A number of participants recommended expanding the availability of training to include other health professionals.

Health Professionals:

• Only a small minority of health staff ‘always’ ask patients about domestic violence. Over three quarters ‘seldom’ or ‘never’ ask; Some staff were making decisions on ‘relevance’ before screening questions;
• Despite this, the majority say they are ‘comfortable’ or feel ‘ok’ about doing so;
• Where domestic violence has been disclosed, hospital staff report that it was they who broached the subject, in contrast to service users, who say that they did so;
• Where disclosure occurs, referral to EIP has become routine;
• EIP was seen as a useful service by these hospital staff;
• Hospital staff do not think that the profile of the Project is high enough within the hospitals.

Hospital Staff Focus Groups:

• Compulsory training for new staff, ‘refresher’ sessions and/or drop-ins were recommend by focus group participants;
• Participants who had undergone the training supported routine screening but confirmed that it has not become routine, particularly within A&E;
• Similar barriers to screening identified by hospital staff questionnaire respondents were also noted here: fear, lack of experience, presence of the perpetrator and lack of time and/or privacy;
• All staff who participated were aware of, appreciated and supported the continuation of EIP.

Service Users:

• Just over half of EIP clients were referred from hospital departments;
• The overwhelming majority of clients were female, over half aged between 20 and 39 years and were White British. Two thirds have children;
• 40% had been in a relationship for less than five years;
• 95% of perpetrators were male;
• 82 % reported physical violence and for almost two thirds the violence had happened ‘constantly’ or ‘often’, for almost half it had happened throughout the relationship;
• 30 female clients had experienced violence during pregnancy;
• Just over one third of clients had experienced post separation violence;
• The Police had been involved in over three quarters of cases but only a minority (13%) of perpetrators had been subject to a prosecution for a domestic violence related offence;
• The majority of clients (71%) had between one and five contacts with EIP, however five had been in contact more than 50 times, raising concerns about ‘heavy need’ clients requiring long term support;
• Almost all clients wanted generalised ‘support’ and ‘information’;
• There was a very high level of telephone support provided to clients by EIP staff;
• Referral to other agencies continues to be a major strand of the support provided to clients;
• The Project appears to have successfully reduced repeat visits to the A&E department for domestic violence related injuries.

Service User Questionnaires:

• Only a minority of Service User Questionnaire respondents who attended a hospital department reported that they had been asked about domestic violence;
• The majority said that hospital staff had been supportive and believing when told about domestic violence;
• Almost all supported routine screening for domestic violence;
• All respondents welcomed EIP and supported a hospital based service;
• The vast majority valued the support/listening and information they had received from EIP and all were positive about the service they had received;
• Respondents use of EIP and the large range of other agencies involved highlights the multiple types of support/action that victims of domestic violence need.

Service User Focus Groups:

• Service User Focus Group participants welcomed and supported EIP and were particularly appreciative of the pro-active approach of the Project;
• There was support for routine screening.

See Research Report: Final Report of the Portsmouth Domestic Violence Early Intervention Project (EIP) Evaluation

Grant Holder: CWASU

Sponsor: Consortium of local agencies/Urban Renewal fund