INTRODUCTION
There are many different types of violence that may be inflicted upon people by others with whom they have some kind of relationship, such as (ex-)partners, parents, other family members, teachers, colleagues, neighbours, carers, and spiritual/religious guides.1 Such violence is most often referred to as ‘domestic violence’ or ‘abuse’, and there are specific names for specific types, such as ‘neglect’ and ‘exploitation’. Whatever the type, violence can be of an emotional, physical, sexual, and/or financial nature, or witnessing any of these. We refer to all these types and forms of violence jointly as ‘violence’ in this article.
Victims and perpetrators of violence regularly meet a range of different professionals, such as health workers, teachers, day-care workers and other child carers, social workers, youth workers, and people who work in the legal system. Such meetings provide opportunity for identifying violence that is taking place and for taking appropriate steps to help people get out of a violent situation. Unfortunately, this is an area in which there are many missed opportunities at the moment. People and children who are subjected to violence often encounter professionals without the violence being identified or reported. This is especially the case for lesser-known types of violence, such as human trafficking,2 elder abuse,3 and female genital mutilation.4 For example, while up to 88% of people who are trafficked into sexual exploitation encounter a health worker during their exploitation, less than 20% of health workers know enough to identify and appropriately support this group.5,6
LISTING THE DIFFERENT TYPES OF VIOLENCE
To improve this situation in our own country, the Netherlands, we collaborated with more than 50 organisations to improve guidance for Dutch professionals on: 1) identifying ALL types of violence, including lesser-known types, and 2) what to do when you encounter signs of violence as a professional.
This collaboration has had two results. First, an overview of various types of violence relevant to the Dutch context was created (Figure 1). Some of these are well known, such as (ex-)partner violence and child abuse. Others may be lesser known to professionals, such as: parent abuse (children who abuse their parents), male abuse (violence that targets men), honour-based violence (violence that is committed to protect or defend the honour of an individual, family, or community, such as forced marriages, forced abandonment, or forced isolation), online sexual intimidation (various forms of sexual intimidation, such as shame-sexting, grooming, revenge porn, and sextortion), stalking, human trafficking, female genital mutilation, and various specific types of child abuse, such as violence against an unborn child, shaken-baby syndrome, paediatric condition falsification, youth prostitution, and witnessing of high-conflict separations. Similarly, violence can take place in certain subpopulations, with specific characteristics. Examples are: violence against/among migrants, against people with intellectual disabilities, and against people who are cared for by an informal carer.
Figure 1. Overview of types of violence.
Source: licensed under CC BY 4.0.
Figure 1 is not an exhaustive list, but is meant rather as a starting point for discussion on how we can make sure that all relevant groups are included in violence policies and protocols. Such discussions should be repeated in different contexts. For example, the signalling and reporting of violence committed by paid professionals (for example, health workers or teachers) is governed by separate legislation in the Netherlands, so it was excluded for this project.7 It may well be included in other contexts.
FACTSHEETS AS AN AID TO IDENTIFYING VIOLENCE
The second result of our collaboration is a set of 24 factsheets that helps professionals with identifying specific types of violence, plus with acting appropriately when they do. Each factsheet was led by one or more organisation(s) in our collaboration who had specific expertise in that type of violence, while others contributed on the content. We expect these factsheets to be helpful because each type of violence may present in different ways. For example, the signs of violence that professionals may encounter can differ, the risk factors that make people vulnerable to violence may differ, and there are different points of attention for professionals around each type, such as:
some types typically present very late, necessitating swift action (for example, parent abuse and honour-based violence);
with some types of violence, criminal networks may be involved, leading to different safety issues (for example, human trafficking and youth prostitution);
with some types, the considerations around breaking confidentiality to report the violence are different as compared with violence against adults (for example, child abuse and violence against adults with mental disabilities);
with some types, considerations about who to involve in conversations about the violence and when to do so require extra careful consideration (for example, honour-based violence8 and human trafficking); and
some types frequently involve people who do not speak the same language as the professional, in which case it is important to speak to the suspected victim alone via an independent translator (for example, honour-based violence or cross-border human trafficking).
We hereby make all 24 factsheets freely available in Dutch and in English as Supplementary Appendix S1.
THE POLICY CONTEXT AND FACTSHEETS
Informational materials for professionals such as these are only a small part of the solution to enabling professionals to appropriately identify, refer, and help people who are subjected to violence. It is vital that countries have policies, protocols, and organisations in place to this end and that these are inclusive of all types of violence. In the Netherlands, for example, many of our factsheets fall within the policy framework for ‘violence in dependent relationships’, a term that was consciously chosen by the government to be inclusive of ALL types of violence between people who have some sort of dependent relationship with each other.1,9–11 This inclusivity is important because it means no types of violence are left out. A common framework also keeps things simple for professionals. It should always be simple and straightforward which steps professionals should take when seeing signs of violence, regardless of the type of violence, and indeed these steps are the same in the Netherlands for each type.7
The factsheets that we make available here fulfil two functions as part of this broader policy context. First, they make explicit the different types of violence that exist (Figure 1). This is important as it helps to increase awareness among professionals of lesser-known types of violence. Second, they serve as a starting point for professionals who are looking for more in-depth information about specific types of violence (see Supplementary Appendix S1).
We invite everyone to use and improve these factsheets. The factsheets are tailored to the Dutch context but can be easily modified to fit other contexts. We invite everyone to do so and to adapt and modify them to the context of their own country or region.
Notes
Funding
This project was funded by grants from
the Dutch Ministry of Health, Welfare and Sports and by contributions from the organisations working on the project.
Provenance
Freely submitted; externally peer reviewed.
Competing interests
The authors have declared no competing interests.
- © British Journal of General Practice 2022
