The Royal Australian and New Zealand College of Psychiatrists (RANZCP) South Australian Branch warns that trauma is being under-recognised, under-diagnosed and under-treated across South Australia's domestic violence response systems.

"Domestic violence victim-survivors frequently report experiencing retraumatisation at multiple stages in the criminal justice process, with court proceedings often exposing them to triggering experiences that leave them feeling further disempowered, stigmatised, and shamed," said Dr Patrick Clarke, Chair of RANZCP SA Branch. 

"Trauma-informed practice, from prevention through to recovery and healing, recognises that these cause overwhelming fear, stress and anxiety for victim-survivors. 

“They need safe environments and relationships of trust, not procedures that retraumatise them or misidentify them as perpetrators.

“The best way for the Government to develop these safe spaces and build trust in the community is to listen to the voices of those with lived experience. 

“While domestic violence can affect anyone it is an inherently gendered issue with women making up the majority of victim-survivors. Other priority populations are also more likely to be victim-survivors of domestic, family and sexual violence including people with disability, those in regional areas, LGBTQIA+ and Aboriginal and Torres Strait Islander people. These individuals and communities who are disproportionately impacted and need to be heard, understood and supported,” Dr Clarke said.

The RANZCP welcomes the SA Government's swift acceptance of key Royal Commission recommendations, including recommendations 11 and 12 which prioritise lived experience voices, and its commitment to the 5-year strategic plan in Recommendation 10. 

“While each of the four pillars identified by the Commission for the plan are crucial, they all must have mental supports integrated at every level to provide the best possible wrap around support for victim-survivors, family, carers and support networks, and perpetrators,” Dr Clarke said.

The College's submission to the Royal Commission highlighted the significant mental health dimensions of domestic violence that are not being adequately addressed.  

Mental illness can act as a barrier to reporting domestic violence, with victim-survivors commonly experiencing post-traumatic stress disorder, depression, eating disorders and substance misuse. These symptoms can inhibit their capacity and willingness to report incidents or even recognise reporting as an option.

Research also shows 33.3% of domestic violence homicide perpetrators have a history of mental health issues, 50.4% have problematic substance use, and 17.1% have suicidal ideation.

"Mental illness doesn't drive or excuse domestic violence. But many offenders do have treatable mental health conditions, so proper assessment and treatment would be an important way to prevent future violence," Dr Clarke said.

"South Australia's mental health services don't have enough funding or staff to meet demand. People who need help face long wait times and poor continuity of care, which is of major concern.

“We recommend that all individuals identified by police as potential or actual domestic violence perpetrators be considered for mental health assessment. 

“We're also calling for funding for Local Health Networks and Primary Health Networks so all health settings can access specialist psychiatric consultation services for both perpetrators and victim-survivors," Dr Clarke said.

The College says a best practice approach towards responding to domestic, family and sexual violence is holistic, multipronged and interconnected and in line with the best trauma-informed and culturally safe practice, as well as targeted towards priority populations.

“Confronting the devastating impact of domestic, family and sexual violence requires a coordinated response across health, criminal justice and social services.

“We hope this Royal Commission report will be a meaningful step toward the system-wide change that victim-survivors deserve. They have generously shared their stories, and we must ensure their voices translate into real action," Dr Clarke said. 

The RANZCP SA Branch welcomes many of the recommendations made by the Royal Commission, and in particular:

• Recommendation 37 to increase police officer skills for dealing with domestic violence incidents. However, the RANZCP urges SAPOL and the SA Government to ensure that trauma-informed and culturally safe mental health practices be included in the upskilling of SAPOL members
• Recommendation 101 to increase the accessibility and equity of youth mental health services. The RANZCP urges the SA Government to develop these services to address the gaps highlighted by victim-survivors in the Silence and Inaction Report released by the Royal Commission last month

The RANZCP SA Branch also welcomes the recommendations designed to address the social and health determinants that drive the cycle of domestic, family and sexual violence, including:

• Recommendation 81 to provide referral pathways for mental health support for perpetrators in supported accommodation  
• Recommendation 83 to develop diversionary justice programs which include mental health and addiction support services

ENQUIRIES: For more information, or to arrange an interview call Dishi Gahlowt on +61 437 315 911 or email media@ranzcp.org.  

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org. 

In Australia: If you or someone you know needs help, contact Lifeline on 13 11 14 or www.lifeline.org.au or the Suicide Callback Service on 1300 659 467 or www.suicidecallbackservice.org.au. 

In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or www.lifeline.org.nz/suicide-prevention.