What can we do about domestic violence?

Domestic violence is a complex issue at both an individual and public healt h level. Barriers to disclosure often lie with the doctor rather than the victim. Assessment of risk and devising a safety plan are important steps for the d octor to undertake with the victim. Recommendations for joint counselling or marriage guidance for the couple a re usually not appropriate. The efficacy of population screening for domestic violence has not yet been demonstrated. More limited opportunistic screening is recommended, especia lly in the emergency department, mental health and obstetric settings, and general practice. Health professionals can be a bridge to resources within the community, but this requires knowledge of and liaison with those services.