1. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package 8. Risk Assessment & Safety Planning 1

2. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Aim of this module Provide the knowledge and skills to Understand the importance of risk assessment and safety planning Support the patient in –identifying risk factors for repeating or increasing intimate partner violence –in developing a safety plan 2

3. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Outlook Risk factors for repeating/escalating violence Risk assessment Safety planning 3

4. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Risk factors for repeating or escalating intimate partner violence 4

5. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Risk factors IPV: Isolated occurrences of violence are rare Chances of repeated offenses are high Risk of violence increases during separation/divorce Most murders or serious acts of violence are committed when a survivor attempts to leave a violent partner So, understanding potential risk and supporting the survivor is paramount to her survival The more factors that apply in a specific case, the higher the risk is that acts of violence will be repeated or that violence may increase/escalate. 5

6. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Specific risk factors Previous acts of violence against the woman or family members Previous acts of violence outside the family Separation and divorce Acts of violence committed by other family members Possession and/or use of weapons Threats Extreme jealousy and possessiveness Extremely patriarchal concepts and attitudes Persecution and psychological terror (stalking) Danger for children Non-compliance with restraining orders by courts or police Possible triggers H29 6

7. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Risk assessment 7

8. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Assessment tools Enables criminal justice authorities to decide on actions against the perpetrator Enables service providers to support the patient in identifying measures to increase her safety and to raise her awareness of the risk Many tools have been developed, e.g. Danger Assessment by Campbell (2004) –1) a calendar, on which the woman should mark frequency and severity (on a scale from 1-5) of violent incidents that happened in the past year –2) a list of 20 questions, to be answered with yes or no H30 8

9. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Risk assessment Undergo training on applying risk assessment tools. Ask the victim about her own assessment of the situation. Lower level risk cases should not be used as a basis to deny access to services. Adapt risk assessment tools to the local regional/country context. H31 9

10. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Acronyms for risk factors – example from UK (SPECSS). S Separation/child contact: In London, 76% of domestic abuse murder victims had recently ended the relationship. P Pregnancy (pre-birth and under 1s) 30% of domestic violence and abuse starts in pregnancy. E Escalation of violence Previous domestic violence: 35% of households have a 2 nd incident within 5 weeks of the first. C Cultural factors Language barriers, immigration status, isolation S Stalking More dangerous behaviours by intimate relationship stalkers vs. non-intimate relationship. S Sexual assault Where abusers use both physical and sexual violence, victims are at an elevated risk. 10

11. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Safety planning 11

12. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Safety planning assistance (1) Developing a safety plan may help the woman prepare to leave the relationship safely. Health providers should help the woman find affordable safe places to go to like –homes of friends or relatives –referral to women's shelters or women's organizations Low-income women and those from rural or ethnic minority communities often lack resources to leave the abuser or afford alternative places to stay. H32 H33 12

13. Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Safety planning assistance (2) Health facilities should network with such groups and establish referral pathways. In the absence of shelters, consider practical solutions like offering women short-term stays in the facility. 13 H34