Responding to complexity: improving service provision for survivors of domestic abuse with ‘complex needs’

Abstract

This paper discusses the findings of a mixed-methods research study conducted in an English city, Nottingham. The study examined the ‘Response to Complexity’ (R2C) project, aimed at increasing support for survivors of domestic and sexual abuse with ‘complex needs’ (defined by services as: substance and/or alcohol misuse and/or mental health and/or English as a foreign language). In-depth interviews with practitioners and survivors; participant observation of R2C Steering Group meetings; and statistical outcome data was used to evaluate R2C. One of the successes of the project was the provision of wrap around support that met the needs of the women, rather than the women being further marginalised trying to meet the needs of the service. Additionally, the work of the R2C Steering Group provided an example of best practice in multi-agency partnership working to ensure better service provision for survivors. The focus of this paper is to provide discussion of the qualitative element of the study, which explored the needs and experiences of survivors of domestic abuse and what their experiences of a new service might mean in relation to policy in terms of defining and responding to ‘complex needs’ and multi-agency partnership working.

Violence Against Women in Intimate Partner Relationships and Institutional Response to Women’s Needs

“…This type of control is structural in na-ture and consists of destructive forms of deprivation (money, food, and other life resources), imposing choices, micro-regulation of everyday behaviour, a limitation of options and sources of support, which extends to all behaviours and spaces (he also decides and controls where she goes, who she socializes with, how she dresses, how much money she has at her disposal, what jobs in the home, outside and related to the children she effectuates, and in what way, determines access to information, or bans it, sets standards, monitors and punishes) (Stark, 2007). In particular, the abuser exploits the victim's multiple, complex, and interdependent needs and experiences (disability, mental illness, substance abuse) in order to enhance coercive control (Harris & Hodges, 2019).…”

“…Mental health problems, though they often remain undiagnosed, also present a risk of violence (Harris & Hodges, 2019;Warshaw & Barnes, 2003). The spectrum of conditions ranges from (brief) stress reactions, through symptoms of post-traumatic stress disorder, to complex syndromes of long-term, recurrent trauma (Herman, 1996).…”

Protecting women with multiple and complex needs from gendered violence: impediments to obtaining and maintaining safe and secure accommodation in a European context

“…The interviews indicate that professionals in some support services view women with multiple needs as difficult or, as Harris and Hodges (2019: 3) observe, they can be seen as 'problematic people'.. Prejudice is clearly a challenge as highlighted by a Spanish support worker: 'gender-based violence against this group of women is ignored because, rather than being victims …, they are crazy, they are drug addicts, they have lost all the dignity because they are on the streets.'…”

“…There is an increasing body of evidence that women with 'multiple and complex needs' are amongst the most vulnerable to gender-based violence and that this rather distinct group of women have particular barriers to getting the support they need in all areas of their lives (Harris and Hodges, 2019). However, there has been surprisingly little work that focuses on their accommodation needs and how to sustain their tenancies, particularly within the European context, where there is an increasing focus on reducing violence against women.…”

“…The provision of safe, affordable housing as Clough et al (2013) argued, is the foundation for any initiative that seeks to improve the life experiences of the most vulnerable women in society and a means of exiting situations of violence. The term 'multiple and complex needs', as Harris and Hodges (2019) have argued, has seldom been defined with any clarity, primarily because of the complexity of the issues covered by the term. The conceptualisation by Rosengard et al (2007) highlights the multiplicity of terms that indicate the complexity of the challenge in providing support from this group of individuals.…”