Improving women’s health with a trauma-informed approach to family violence education
Associate Professor Jennifer Neil rarely encountered family violence in her GP practice, until she learned how to look for it. “I had no idea of the scale of the problem or how commonly family violence presents to health professionals without it being obvious,” she said. “Once I started asking my patients with indicators of potential violence about their experience, a huge number of survivors suddenly came out of the woodwork. They’d always been there; I just hadn’t been asking the right questions.”
Now, Associate Professor Neil has made it her mission to teach health professionals to recognise and respond to family violence in their practice. In her role as curriculum and assessment lead in the Department of General Practice at Monash, she’s led the development of a trauma-informed medical education approach, in which medical students are taught about family violence in their second year and fourth year of studies so they’re prepared for what they’ll most likely encounter in hospitals and the community throughout their clinical rotations.
Having a trauma-informed approach to education is critical when teaching sensitive topics such as family violence, particularly when both students and staff may bring their personal experiences into the classroom, Associate Professor Neil believes. She’s undertaken research in the area and is also currently completing a PhD on how GP survivors of family violence are affected when they come across it in their practice. “All clinical environments, universities and workplaces should be trauma-informed,” she said. “If we keep our education environments both physically and psychologically safe for students, their engagement, skills and knowledge acquisition are likely to improve. So, when they do encounter survivors of abuse as doctors, they’ll be much better prepared.”
Associate Professor Neil has also trained hundreds of Australian GPs in responding to family violence, and leads national and international special interest groups on the topic in her roles as Deputy Chair of the Royal Australian College of General Practitioners (RACGP) specific interest group on abuse and violence in families and the Secretary for the World Family Doctor Organization (WONCA)’s Special Interest Group on Family Violence Steering Committee. She’s authored multiple curricula and has co-authored two chapters and a supplementary chapter in the RACGP’s ‘White Book’ Guideline on abuse and violence. She also led a review and update of the PACTS program, widely used across Monash to educate students about family violence, to ensure its relevance and currency, particularly after the introduction of telehealth during the COVID-19 pandemic.
Collaborations are an important part of Associate Professor Neil’s approach, and she’s now embarking on a cross-faculty review of the family violence curriculum across Monash Medicine, Nursing and Health Sciences undergraduate and postgraduate course offerings with Siobhan Hardiman from Monash Social Work. “We’re aiming to ensure that our educators can work together, share materials, and incorporate interdisciplinary learnings into their teaching,” she said. “A health response to family violence takes all health professionals to understand the family violence dynamic and to work together to improve outcomes for women who are survivors.”
Associate Professor Neil believes that violence is a critical women’s health issue. “We know that for women aged between 18-45, violence is the highest health risk factor, more than smoking, diabetes and obesity, “ she said. “So many presentations that my colleagues and I see are actually because of violence. And it’s not always what people imagine; it’s not always black eyes and fractures, but chronic pain, chronic headaches, alcohol misuse, depression, post-traumatic stress disorder, miscarriage. Trauma and family violence are often interconnected with many women’s health issues. It takes a trained and perceptive GP to read between the lines and pinpoint that violence might be the main causal factor, and respond in a trauma-informed way.”
The GP clinic can often be the only safe environment a survivor can access for help, and even more so for marginalised women from vulnerable communities. “We know that survivors want to be asked about family violence by health professionals because they know if they’re asked, it’s likely that the person asking them will be non-judgemental and empathetic; otherwise, why would they be asking?” Associate Professor Neil said. “If we can create that safe environment, we can offer validation, work out the person’s needs and concerns, make referrals to support services and help them feel less isolated.”
Associate Professor Neil is passionate about helping women to live their lives free of violence and coercive control, in no small part due to her early life experience of growing up in a controlling sect. “Women were held back and were not allowed to make their own decisions,” she said. “I was told that I shouldn’t finish my medical degree because I was a woman and also a mother. Once I left, I realised I could do anything, and that being a woman shouldn’t stop me from achieving what I wanted to achieve. One of the reasons why I love my work so much is because I fought so hard to be able to work, and I understand what it is to be controlled and oppressed.”
Given the scale of the problem of family violence in our communities, described as a national shame and crisis following a spike in women’s deaths from male violence earlier this year, Associate Professor Neil also strongly believes more funding is needed to address the health impacts of violence against women. “If it’s the highest health burden for younger women and impacts 1 in 4 women throughout their lifetime, what are we doing to fund it?” she said. “Survivors often cannot leave because if they do, they may become homeless, have no money, and may fear that they will lose access to their children,” she said. “It will take a multi-pronged approach as a society for us to tackle this difficult issue. But, even if, in a small way, I can increase the safety of women who are survivors and work with them through recovery and healing, then I feel that I will have made a difference.”
Associate Professor Jennifer Neil is part of the Monash Women’s Health Alliance. Follow the Monash Women’s Health Alliance on LinkedIn, Instagram and their website to stay in touch with our women’s health research and impact.
About Monash University
Monash University is Australia’s largest university, with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.
With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.
As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.
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