Time to tackle domestic violence: identifying and supporting families.

Domestic violence and abuse (DVA) is a serious societal and public health issue that takes place within family-type intimate relationships and forms a pattern of coercive and controlling behaviours, which can escalate over time. DVA rarely exists in isolation from other social 'ills' and can have an enormous impact on people's health and wellbeing. Recently, family violence has become more visible to health visitors and increasingly presents challenges to practice. Some are practical challenges faced by practitioners who seek to comprehend the evolving phenomenon and others involve the clinical dilemmas surrounding service delivery. The deeply vexed question is how health visitors can work towards ending the cycle of DVA, especially where there are unclear parameters between the victim and perpetrator, and when clients are accepting of, and dismissive about, DVA. The recent government strategy-based move towards greater emphasis on prevention has provided an opportunity for health visitors to intervene in DVA. In light of the nature of safeguarding responsibilities, and a wider public health role as providers of universal health services, health visitors are well placed to offer early support to families.