One of the most vulnerable groups in our society are women from refugee and migrant backgrounds. Around one-third of these women are estimated to experience violence from their partners. As they’re less likely to disclose, they are also more likely to remain in abusive relationships than other women.

Their vulnerability during resettlement is compounded by family separation, pre-arrival trauma, and limited support networks. Language, visa status and little knowledge of services all create additional barriers.

So how do we better help this vulnerable cohort? Our research, the first of its kind in Australia, shows universal screening at settlement services helped women speak up and get help.

Identification is key

Identifying intimate partner violence is crucial to women taking steps toward safety. One way to do this is through universal screening.

Universal screening for intimate partner violence involves asking all women attending a service some short, validated questions about current or recent experiences of being hit or hurt by their partner. Universal screening of all women attending key health services, such as antenatal clinics, has been introduced in a range of settings globally. This helps women to disclose experiences of abuse and receive support and links to services.

World Health Organization guidelines support routinely screening women in high-risk groups and providing ongoing support after they speak up.

One of the most important places refugee women receive support is at settlement services. These are funded by the government alongside mainstream service providers to help people from refugee backgrounds to resettle in Australia. Women from refugee backgrounds access these frequently.

There had previously been minimal research into evidence-based ways to identify and respond to intimate partner violence experienced by refugee and migrant women. We tested an intervention specifically designed for settlement services.

Helping women seek help

Safety and Health after Arrival (or SAHAR, also an Arabic woman’s name) is the first Australian study to test universal screening for intimate partner violence and response in settlement services.

This three-year project, led by the University of Wollongong, was funded by the Australian Research Council and SSI, one of Australia’s largest resettlement organisations. We introduced and evaluated culturally tailored screening for intimate partner violence at four settlement support services.

In practice, this meant routine screening for abuse and giving women a wallet-sized information card in their language with key messages and useful contact details, irrespective of whether they had disclosed abuse.

Of the 312 women screened during the four-month study period, 89 (29%) disclosed intimate partner violence. This rate is consistent with Australian survey findings of women from refugee backgrounds. It’s higher than the 11% median rate reported in a review of violence screening programs by frontline healthcare staff.

High disclosure rates are a sign of confidence in services, and not automatically an indicator of higher rates of abuse. Where violence was identified, women were offered a referral to a designated caseworker for risk assessment and safety planning, using a booklet adapted from a US intervention, translated into five community languages. They were also referred to other services as needed.

The importance of language

An important criterion for introducing any screening program into the community is acceptability by those who use it. We assessed this through a follow-up survey conducted three months after a participant’s visit to settlement services.

We gauged acceptability through two survey questions. The first was about how comfortable they were with being asked about being frightened, controlled or hurt by their husband or partner. The second was on women’s agreement with settlement services asking the questions.

The survey results showed both high levels of comfort with services asking the questions and high levels of agreement, particularly among women who disclosed abuse. Settlement workers also found that screening helped facilitate disclosure and increased awareness about intimate partner violence.

We found refugee women place a high value on being able to talk with someone who speaks their language. Language matching and culturally sensitive service environments were important enablers for refugee women deciding whether to disclose and seek help.

Settlement services are key for making women comfortable. Refugee women valued the proximity, accessibility and care shown by staff, as well as cultural safety and the ease of being able to communicate in their language for conversations about complex issues, including abuse.

Given the rates of disclosure and how comfortable the women were with the process, universal screening is a viable way to identify intimate partner violence among women from refugee and migrant backgrounds. This is especially important as this abuse is often hidden. This research shows there are ways to reach and help particularly vulnerable women.

Joanne Spangaro, Professor of Social Work, University of Wollongong; Jacqui Cameron, Associate Professor in Social Work, University of Wollongong; Jeannette Walsh, Research Fellow, University of Wollongong, and Nigel Spence, Research Fellow, School of Health and Society, University of Wollongong

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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