‘It felt like there was always someone there for us’: supporting children affected by domestic violence and abuse who are identified by general practice

Jessica Roy*, Emma Williamson, Katherine Pitt, Nicky Stanley, Mei-See Man, Gene Feder, Eszter Szilassy

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

5 Citations (Scopus)
90 Downloads (Pure)


One in five children in the UK are affected by domestic violence and abuse. However, primary care clinicians (GPs and nurses) struggle to effectively identify and support children and young people living in homes where it is present. The IRIS+ (Enhanced Identification and Referral to Improve Safety) training and advocacy support intervention aimed to improve how clinicians respond to children and young people affected by domestic violence and abuse.

IRIS+ training was delivered as part of a feasibility study to four general practices in an urban area in England (UK). Our mixed method design included interviews and questionnaires about the IRIS+ intervention with general practice patients, including children and young people as well as with clinicians and advocacy service providers. We collected the number of identifications and referrals by clinicians of children experiencing domestic violence and abuse through a retrospective search of medical and agency records 10 months after the intervention.

Forty-nine children exposed to domestic violence and abuse were recorded in medical records. Thirty-five children were referred to a specialist domestic violence and abuse support service over a period of 10 months. Of these, 22 received direct or indirect support. The qualitative findings indicated that children benefitted from being referred by clinicians to the service. However, several barriers at the patient and professional level prevented children and young people from being identified and supported. Some of these barriers can be addressed through modifications to professional training and guidance, but others require systematic and structural changes to the way health and social care services work with children affected by domestic violence and abuse.

What is known about this topic:

Domestic violence and abuse can have significant and long-lasting impacts on children

Clinicians are well placed to identify and respond to children affected by domestic violence and abuse but there is a lack of training to support them

What this paper adds:

The implementation of IRIS+ (a specialist training and support service) led to a substantial number of children being referred for specialist support by clinicians

Children and young people benefitted from direct and indirect support (via their mother) from the IRIS+ specialist service

There were a significant number of children who could have been supported through the service but were not. These missed opportunities reflect entrenched barriers to children receiving support in their own right around domestic violence and abuse
Original languageEnglish
Pages (from-to)165-174
Number of pages10
JournalHealth and Social Care in the Community
Issue number1
Early online date7 May 2021
Publication statusPublished - 1 Jan 2022


  • Domestic violence
  • children
  • general practice
  • primary care
  • feasibility study


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