Barriers and facilitators for General Practitioner Doctors to report domestic violence cases to the authorities

Problem

Domestic Violence (DV) is a serious, prevalent and yet preventable public health problem. The Portuguese law defines it as ‘actual or threaten physical, psychological or sexual harm perpetrated by a current or former partner or against someone of particular vulnerability with which the aggressor co-habits’. Since 2000 in Portugal DV is a public crime, which means that everyone that is aware of it has the duty to report it. Although the number of reports has been growing in the last few years there are anecdotal impressions that only a small number of cases are denounced to the authorities.Evidence shows that DV has a considerable heath impact, in short and long term physical and mental health of the victims. When it comes to provide assistance to potential victims and their family, general practitioners (GPs) are in a particularly central position to detect and report cases of DV to authorities. However, they may be faced with a complex decision-making position. In fact, little is known about what drives doctors to present, or not, an official report.

Approach

To address this question, a national qualitative study has been conducted in Portugal, to further understand what leads GPs to present or not, a report of DV when they become aware of such cases in their clinical practice. Semi-structured interviews were conducted to GPs of each of the five Heath Regional Administrations of continental Portugal and Madeira and Azores Regional Offices. The interviews were transcribed, coded and analyzed using thematic analysis.

Findings

The preliminary results show as common themes: concerns about breaking doctors-patient confidentiality, the victims safety before and after making a report and doctors personal safety. Doctors have also expressed many doubts about the right procedures and availability of means.

Consequences

The presentation of these preliminary results is key to further discuss and reflect from the ongoing analysis. Hopefully with a better understanding in this matter we can define new strategies to guide GPs when dealing with patients suffering from DV.