domesticviolence.

Barber CF (2008) Domestic violence against men. Nursing Standard. 22, 51, 35-39. Date of acceptance: February 19 2008.

application of physical force to an individualwithout their consent (Martin and Law 2006).The term battered spouse implies a physical event– the battery. In recent years the term ‘batteredspouse’ has no longer been widely accepted asabuse takes on many forms aside from physicalviolence and occurs between different groups ofindividuals in all social and sexual groups, notjust between those who are married. The termsdomestic violence and abuse can go beyond theseparameters and include couples who are notmarried but are living together, and also coupleswho are in same-sex relationships. Lawrence(2003) defined domestic violence as verbal,sexual and emotional intimidation or financialabuse. A similar definition was provided by Kelly(1999) who defined it as the emotional, physical,sexual, psychological or economic abuse ofpower. Domestic violence can also be viewed asan abusive exercise of power and control overothers, which leaves individuals feeling scaredand intimidated.

The Home Office (Undated) defines domesticviolence as: ‘any incident of threateningbehaviour, violence or abuse between adults whoare or have been in a relationship together, orbetween family members, regardless of gender orsexuality… it is a pattern of abusive andcontrolling behaviour through which the abuserseeks power over their victim.’

There is a distinction between domesticviolence and domestic abuse. Domestic violencesuggests physical aggression, while domesticabuse encompasses a far wider range ofbehaviours including financial, sexual, emotionaland psychological abuse based on powerstructures. However, some authors use the term‘domestic violence’ to encompass a wide range of abusive behaviours. For example, Sniechowskiand Sherven (2004) define domestic violence asthat which relates to verbal, physical, sexual andemotional intimidation or financial abuse.

Despite the various definitions, domestic

Domestic violence against men

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INFORMATION RELATING to domesticviolence has largely focused on women as thevictims and men as the perpetrators. Domesticviolence against men tends to go unrecognisedsince men are less likely to admit to or report suchincidents because of embarrassment, fear ofridicule and lack of support services. It is a taboosubject that is often ignored or trivialised bysociety, which means that the extent of theproblem remains unknown. As a result, malevictims of domestic violence may not have theirhealth and social care needs met by healthcareprofessionals (Du Plat-Jones 2006).

Defining domestic violence

A battered spouse or co-habitant is defined as anindividual subjected to physical violence by ahusband, wife or co-habitant (Martin and Law2006). Battery is defined as the intentional

SummaryThis article reviews the literature relating to domestic violenceagainst men and examines some of the reasons why men arereluctant to report violent episodes. The article focuses on men asthe victims and women as the perpetrators of domestic violence and identifies gaps in service provision. The role of the nurse insupporting male victims is also discussed.

AuthorChristopher F Barber is an agency nurse and NVQ assessor,Birmingham City Council. Email: [email protected]

KeywordsDomestic violence; Men’s health; Support services

These keywords are based on the subject headings from the BritishNursing Index. This article has been subject to double-blind review.For author and research article guidelines visit the Nursing Standardhome page at nursingstandard.rcnpublishing.co.uk. For relatedarticles visit our online archive and search using the keywords.

If you would like to contribute to the art and science section contact: Gwen Clarke, art and science editor, Nursing Standard, The Heights, 59-65 Lowlands Road, Harrow-on-the-Hill, Middlesex HA1 3AW. email: [email protected]

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TABLE 1

violence encompasses unwanted violence,aggression, humiliation and intimidation. It is interesting to note that contemporarydefinitions of domestic violence use genderinclusive or gender neutral language to addressthe changing dynamics of domestic violence,which can occur between all social and sexualgroups (Hester and Westmarland 2005, Du Plat-Jones 2006).

Prevalence of male victims

Leonard (2003) suggests that it is difficult toestablish reliable estimates of male victims ofdomestic violence because few men are willingto admit that they are being abused andtherefore do not seek professional help. The2001/02 British Crime Survey found that 19% of domestic violence incidentsaffected male victims, and that about half ofthese incidents were committed by women(BBC 2005). The 2004/05 British Crime Surveyfound that partner abuse was the mostcommon form of intimate violence; 28% ofwomen and 18% of men had experienced oneor more forms of partner abuse (Finney 2006).

Using time as a marker, Fontes (1999)suggested that while men abuse their femalepartner every 15 seconds in the United States(US), females abuse their male partner every14.6 seconds. This male/female equality issupported by Gelles (1999), suggesting thatviolence between genders is equal. The figuressurrounding the occurrence of domestic abusein men vary and this may be exacerbated byresearchers and practitioners who use differentdefinitions or criteria to measure the problem.

Despite the acknowledged prevalence andgrowing numbers of male victims of domesticviolence, Lawrence (2003) suggests the evidencesurrounding domestic violence indicates thatthere may still be many male victims who do not report such incidents because of the fear ofridicule, social isolation and humiliation.

Literature review

Although the author acknowledges thatdomestic violence occurs in all social and sexualgroups, this article explores the issuessurrounding domestic violence carried out bywomen against men. Search parameters for theliterature review included a time frame of 15years. Search engines such as Google were usedand literature databases included the BritishNursing Index (BNI) and Ovid. The following

keywords were used: domestic abuse, domesticviolence, male victims of domesticabuse/violence and domestic abuse/violenceagainst men. Where the use of these keywordsdirected the author to references and websitesrelating to domestic violence against women,the information was disregarded unless itprovided basic statistics with which to comparefigures relating to male victims of domesticviolence. For the purpose of this article the term‘domestic violence’ is used to encompassphysical, emotional, sexual and financial abuse.

Because of the lack of information availablerelating to domestic violence against men, web-based information was used as part of theliterature review. Although the authenticity andaccuracy of the material may be questionable,Coad et al (2006) suggest that the use of ‘greyliterature’ (unpublished or internet material) can be a source of useful information. Forms of violence and the post-abuse experienceGeorge and Yarwood (2004) and Du Plat-Jones(2006) focused on the forms of violenceexperienced by men (Table 1 and Box 1) andpolice response (Table 2). Men experiencedsimilar types of physical abuse as women.

Although George and Yarwood (2004)highlighted the physical violence that menexperienced, little attention was given to the

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&art & science literature review

Percentage of male victims

Assaulted once a month or more frequently

Assaulted more than ten times

Threatened with a weapon

Received severe bruising

Kicked in the genitals

Burnt or scalded

Stabbed

(George and Yarwood 2004)

BOX 1

�Stabbing.

�Teeth knocked out.

�Injuries to the genitals.

�Verbal, emotional and psychological cruelty.

(Du Plat-Jones 2006)

Frequency and forms of domestic physicalabuse against men (n=100)

75

More than66

50

40

33

16

10

Forms of domestic violence experienced by men

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emotional, financial, sexual and psychologicalabuse associated with domestic violence. It maybe that these forms of abuse are more difficult toidentify and quantify in comparison to physicalviolence.

It has been suggested that the effects ofdomestic violence are the same for both maleand female victims (BBC 2005, Du Plat-Jones2006, Hidden Hurt (undated). Commonanecdotal experiences include feelings of shame,fear, isolation, guilt, confusion and a loss of self-worth and confidence.

Dewar (2008) found that male victims ofdomestic abuse were less likely than females to report violence or abuse and that many wereeither arrested or threatened with arrest, soperpetuating a culture of blaming the victim. In some cases, male victims were ignored by thepolice. Also when they did report domesticviolence they often experienced discriminationor prejudice. Few female perpetrators ofdomestic violence were arrested and even fewerwere charged or convicted (Dewar 2008).Reluctance to report Social prejudices There aremany reasons why domestic violence againstmen may go unrecognised and why men may bereluctant to report such incidents. Much of theliterature relating to domestic violence focuseson women as the victims of abuse and does notaddress domestic violence against men. Cook(1997) and Lewis and Sarantakos (2001)suggested that female violence directed againstmale victims was largely ignored by society andthe media because it is a taboo subject. A UKgovernment resource manual on domesticviolence made little reference to men as potentialvictims of domestic violence and instead focusedon the experience of women (Department ofHealth (DH) 2005). The Royal College ofNursing’s (2000) guidance on domestic violenceonly briefly mentions men as potential victims of such violence. This attitude towards domesticviolence may perpetuate the commonassumption that women are the victims and men are the perpetrators of such violence.

Men are traditionally viewed as beingphysically stronger than women. Consequently,male abuse victims may not report incidents ofdomestic violence or seek help because of thefear of being perceived as weak and subjected to ridicule (Du Plat-Jones 2006, Hidden Hurtundated). Men feel unable to define theirexperiences of domestic violence because of theperception that society has of men as beingphysically and emotionally stronger thanwomen (Hidden Hurt undated). Societyperceives male victims as ‘wimps’, who are notbelieved and refused the status of victim. Menwho attempt to report incidents of domesticviolence are often met with discrimination and

disbelief by health professionals and society ingeneral (Men Cry Too 2006).

Staffordshire Police (2008) suggest that menoften find it hard to admit to themselves thatthey are being abused. Gelles (1999) suggeststhat male victims may not seek help becausecare agencies often deny the existence ofviolence against men where the wife or femalepartner is the perpetrator. It is suggested thatmen are not encouraged to report abuse, theyare conditioned not to ask for help and may feel disempowered by those in authority andare therefore less likely to report incidents ofdomestic violence (Cook 1997, Du Plat-Jones2006). Disbelief by the victim, a culture ofvictim blaming and the reluctance of the policeto produce and action crime reports ondomestic violence against men contribute tothe unwillingness of men to report abusiveepisodes (Lawrence 2003).Inadequate support networks Lawrence (2003)suggests that support resources and networksthat are available for female victims of domesticviolence are not available for male victims. Forexample, there are shelters and safe homes toassist in protecting women from violent partners,but these are not available for men. There are,however, a limited number of resources andsupport networks available to male victims ofdomestic violence as highlighted in Box 2.

The nurse’s role

Male victims of domestic violence need to besupported and encouraged to seek help andreport incidents of violence. Gelles (1999)highlights the importance of recognising thatmen can be victims of domestic violence and thathealth professionals, including nurses, mustdemonstrate an understanding of, and sensitivitytowards, the experience of male victims. Violenceagainst men, whether physical or psychological,should not be dismissed. Domestic violencecovers a range of behaviours which may includephysical, emotional, sexual or financial abuse.


TABLE 2

Percentage of male victims

Threatened with arrest

Ignored by the police

Arrested

Reported that the violent female partner had beenarrested

(George and Yarwood 2004)

Police response to domestic abuse (n=100)

47

35

21

3

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BOX 3

Male victims may experience broken limbs,bruising, knife wounds, teeth marks, deepscratches and lacerations, inappropriatecomments, fear and intimidation, tearfulness and refuse to be physically examined by nurses,particularly female nurses.

Male victims of domestic abuse often do notseek help from support services or healthprofessionals because they fear that they willnot be believed (Gelles 1999, Men Cry Too2006). Lawrence (2003) suggests that healthprofessionals are not sensitive enough indealing with male victims. Health professionalsneed to show humility, compassion andsensitivity when addressing male victims ofdomestic violence to encourage them to discusstheir situation. It is important to listen to thevictim and offer reassurance rather thanignoring or dismissing the problem. Malevictims of domestic violence may be toonervous, afraid or embarrassed to talk aboutwhat is happening to them. Sensitivecommunication on the part of healthcareprofessionals is crucial in eliciting informationfrom male victims (James-Hanman 1998,Campbell-Bliss et al 2000, Du Plat-Jones2006). Healthcare professionals also need to be supportive, non-judgemental and addressissues of dignity, privacy and confidentiality.

Just as it is helpful for nurses to have access tobest practice and up-to-date evidence relating todomestic violence against women, it is equallyimportant and valuable for staff to have access tobest practice and up-to-date material relating todomestic violence against men.

Nurses are often the first health professionalwith whom male victims of domestic violencecome into contact. As well as providing treatmentthe nurse may be able to provide helpfulinformation regarding where the individual cango to for further help and support. Nurses couldhelp to organise practical help such as housing formale victims who need a safe place to stay afterleaving their partners. Sensitive provision ofappropriate information and advice on self-advocacy groups, welfare benefits, the courts andchild access issues in collaboration with socialservices would also be helpful for male victims.

In the handbook Responding to DomesticAbuse, the DH (2005) summarises the nurse’srole in responding to women who haveexperienced domestic abuse. This informationcan also be applied to caring for men in similarsituations and includes:

�Maintaining the safety of the person involved.

�Providing appropriate information andreferral.

�Promoting an opportunity to speak about the experience.

�Offering support and reassurance.

�Being non-judgemental.

The DH (2005) also points out that nursing staffshould adhere to their NHS trust’s domesticpolicy and provides an overview of some of thepractical things nurses can do to assist those whohave experienced domestic violence (Box 3).

To enable nurses to engage successfully inthese activities, they should become involved in multi-agency working with other careprofessionals in social services, schools (whenthere are children involved), GP practices and

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&art & science literature review

�Be aware of local support services.

�Create a supportive environment in which the person can talk.

�Be aware of the signs that could indicate domesticabuse.

�Know what questions to ask to encourage the person to feel safe to confide in you.

�Validate and support the person who reveals abuse.

�Provide information about the relevant support agencies.

�Maintain detailed and accurate records but do notwrite this information in hand-held records.

�Ensure confidentiality and if you need to shareinformation follow trust guidelines.

�Address any health needs.

(Department of Health 2005)

Key areas nurses need to consider when dealing with domestic abuse

�Men’s Advice Line: 0808 801 0327

�UK National Domestic Violence Helpline: 0808 2000 247

�Male Advice and Enquiry Line: 0845 064 6800

�Hidden Hurt: www.hiddenhurt.co.uk/

�BBC website Hitting Home: www.bbc.co.uk/relationships/domestic_violence/menhh_index.shtml

�Men Cry Too: http://mencrytoo.homestead.com

�MPower: www.male-rape.org.uk/

(Information correct at time of going to press)

Resources and support networks for malevictims of domestic violence

BOX 2

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also the police (Mirrlees-Black 1999). Creatingsuch links with various care professionals willhelp to raise awareness of domestic violenceagainst men and encourage the development ofsupport services.

It may also be helpful to create a clinical nursespecialist or consultant nurse role specialising inworking with male victims of domestic abuse.The nurse in this role would have an awareness of local, regional and national trends relating todomestic violence, and provide appropriatetraining for all care, nursing, medical and socialservice staff on how to support and deal withvictims of domestic violence.

Conclusion

Male victims of domestic violence, wherewomen are the perpetrators of such violence,


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Coad J, Hardicre J, Devitt P (2006)How to search for and use ‘grey literature’ in research. Nursing Times.102, 50, 35-36.

Cook PW (1997) Abused Men: TheHidden Side of Domestic Violence.Praeger Publishers, Westport CT.

Department of Health (2005)Responding to Domestic Abuse: AHandbook for Health Professionals. The Stationery Office, London.

Dewar D (2008) Plight of Male Victims of Domestic Abuse. www.dewar4research.org/DOCS/PlightofMaleVictimsSummaryMay08.pdf (Last accessed:August 18 2008.)

Du Plat-Jones J (2006) Domestic violence: the role of health professionals.Nursing Standard. 21, 14-16, 44-48.

Finney A (2006) Domestic Violence, SexualAssault and Stalking: Findings from the2004/05 British Crime Survey. http://rds.homeoffice.gov.uk/rds/pdfs06/rdsolr1206.

pdf (Last accessed: August 18 2008.)

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References

are neglected and often ignored by society.Because of the taboo nature of violence againstmen, victims may be reluctant to reportincidents of domestic violence for fear of beingrejected, humiliated and ridiculed by careprofessionals, including nurses who often donot have the training to deal with or supportmale victims appropriately.

There is a lack of information and a lack ofsupport services available for male victims ofdomestic violence. Although it would be valid tocall for more thorough and in-depth research tobe carried out into domestic violence against men,there is a need to go much further than this. Tobring about a change in attitudes and approachesto male victims and to improve service provision,society needs to increase its awareness ofdomestic violence against men and encourage andsupport men to report such violence NS

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domesticviolence.

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