Invisible and Silenced: Improving Healthcare Screening Tools for Women Experiencing Domestic and Family Violence in Rural Communities

By Cleo Wee, Curtin University, WHA, 2023

Executive Summary

Domestic and family violence (DFV) affects people of all ages, genders and backgrounds, but it predominantly impacts women and children and has a significant impact on physical and mental health (Australian Institute of Health and Welfare (AIHW), 2022). Women in rural and remote Australia face additional barriers such as lack of services and inadequate screening/assessment of DFV risk factors that are specific to rural/remote communities.  

This policy paper aims to identify and discuss additional barriers that DFV victim-survivors living in rural/remote Australian communities face. This paper recommends:

Australia's National Research Organisation for Women’s Safety (ANROWS) establishes an additional DFV screening and risk assessment tool that is specifically tailored for rural communities, beginning with a pilot program in Western Australia with WA Country Health Services (WACHS). Conduct an audit after 12 months to determine the efficacy of implementing this tool in detecting DFV and referring patients to appropriate further services. 

Success of this recommendation would be defined as a statistically significant quantitative increase in DFV detection in rural communities and subsequent referral of patients to further DFV services. Funding of approximately $359, 000 should be sourced from the National Plan to End Violence Against Women and Children in order to hire the appropriate researchers, coordinators and auditors from WACHS, ANROWS and the Australian National Audit Office (ANAO).

Identified barriers include inadequate training for healthcare staff which in turn leads to a lack of routine DFV screening/assessment. Suggestions to overcome this include implementing a nationally accredited training program as part of paid professional development leave for healthcare workers.

Problem Identification

In Australia, 1 in 4 women experience violence by an intimate partner or family member, compared to 1 in 16 men (ACT Government, 2022; Mission Australia, n.d.). Nearly one third of Australian women live in rural, regional or remote areas, which is defined by the AIHW as all communities “located in areas outside of Australia’s major cities”, as per the Australian Standard Geographical Classification, and are more likely than their metropolitan counterparts to experience DFV (AIHW, 2022; National Rural Women’s Coalition, 2021). For the purpose of this policy paper, the terms ‘rural’, ‘regional’ and ‘remote’ will be used interchangeably. 

Despite a large proportion of women living in rural/remote communities, DFV screening tools are often designed with a 'metro-centric' focus and may not fully consider the additional barriers women living in rural locations face (Australian Government Department of Health and Aged Care, 2022). Current screenings and assessments of DFV are usually questionnaires that are conducted by healthcare workers. These screening and assessment tools could be improved by incorporating rural-centric risk factors into the assessment, enabling a more thorough and accurate assessment of the severity of a patient’s situation; particularly those who live in rural/remote communities.

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