There are some months I wrote a forum on the care of victims of violence, the great forgotten public policy.
Since then, many things have happened : the work of the Interministerial Mission for the protection of women victims of violence and the fight against trafficking in human beings ( MIPROF ) on the training of health professionals , the conference on the care of victims and support authors organized by the Ministry of Women's Rights 2 and 3 September 2013 ( mission conference in which I participated ) , and the new three-year plan to fight against violence against women has been announced Ms Najat Belkacem Vallaud the Minister of women's Rights and government spokesman .
It seems that finally a consideration of this serious public health problem is emerging .
An important first step
For the first time , Najat Belkacem Vallaud said that women victims of violence should be able to quickly access free care by trained professionals , and that violence against women would be considered a public health priority . With a national protocol addressed the regional health agencies in order to strengthen the links between health services, police and justice.
In this international day of struggle for the elimination of violence against women is a very important first step to be welcomed , it will be necessary in many others for all victims of violence traumatized finally have the opportunity receive appropriate care throughout the French territory and the DOM- TOM .
Abandonment without protection or care of the vast majority of victims of violence is a public health scandal . Especially as we have for over 10 years from all national and international knowledge about the reality of violence and the severity of their consequences psychotraumatic .
We know that the consequences are very common ( they affect 60 to 80% of victims of intra- familial, marital and sexual violence are the most numerous and least recognized , the law of silence and denial ruling over them) and that impairment is not only psychological, but also with significant neurological dysfunction emotional circuits and memory , visible on MRI. We know for many years the psychological mechanisms and neurobiological .
Childhood , a critical period
We know very well clinically psychotraumatic describe these disorders, diagnose, and treat them effectively we know (with recovery of neurological damage due to the neuroplasticity of the brain) , we also know that having experienced violence in childhood is particularly a main determinants even the main determinant (when violence occurred in childhood) the health status of people even after 50 years . [1]
And we know that leaving victims traumatized careless violence is a risk factor for reproduction of violence closer and closer and generations , victims with a significant risk of violence again , and also to commit to a small number of them ( which is enough to feed the endless cycle of violence) . Fight against violence through the protection and care of victims.
However, at present , physicians and other health professionals are still not trained or initial training : in a recent survey of medical students over 80 % said they had not received training on violence and 95 % requested training to better support victims of violence [ 2] or in training , and the provision of appropriate care is very rare.
Accessible health care for all victims
Most often the diagnosis is incorrect and treatments are only symptomatic , with sometimes abusive term care and represent a lost opportunity for the victims. Unfairly , in violation of their rights , victims will have to organize their own survival in the face of violence and their consequences.
It remains - and this is a major project - to implement this provision of care and to make it accessible to all victims .
The course women, but male victims and the most vulnerable victims and most discriminated against , even ignored , while those that are present most psychotraumatic consequences :
- Children who pay a very heavy price to violence , especially within their families through their close upon their fetal life with domestic violence during pregnancy and at birth ( neonaticidal , shaken babies) and throughout their childhood with abuse and sexual abuse (minors suffer more sexual violence than adults must not forget )
- The elderly and the sick,
- People with disabilities who experience three times more violence
- People without papers,
- Asylum seekers ,
- People who are on the street,
- Victims of sexual violence ( not to mention the victims of incestuous sexual abuse, domestic sexual violence, sexual violence in institutions and at work , sexual violence in the context of prostitution ) .
Ten points are essential to get there
1 - A real public health policy on the prevention , screening, support and care for victims of violence , as part of a comprehensive policy to fight against violence and against impunity and protection Children and all victims of violence.
2 - An emergency training of health professionals and all other professionals involved in the care of victims of violence : to train the reality of violence, their identification, their effects on physical and mental health victims and witnesses , to the knowledge of the dangers and the victim protections put in place urgently , without forgetting the forensic setting (certificates and appraisals ) .
3 - The development of recommendations of the High Authority of Health on the care of victims of violence and the treatment of their psychotraumatic consequences.
4 - The establishment by decree with the support of regional health centers multidisciplinary health for victims of violence ( and for children who witness domestic violence , as well as relatives) , accessible to all victims whatever their age, disability , social status and providing free care , and anonymous if necessary , by qualified and trained professionals in each department with a comprehensive care ( medical, social, legal and associative ) and provision of information and documentation.
5 - Campaigns of public information on the consequences of violence and the possibility to treat , prevention campaigns and the development of prevention tools and information.
6 - The creation of a national observatory on the impact of violence and support victims.
7 - The development of investigation and research on the impact of violence on health and ways to prevent and treat these consequences.
8 - The establishment of a telephone reception center expertise, advice , guidance and documentation for health professionals and all stakeholders supported.
9 - Provision for victims of violence a health book informative indicating their traumatic disorders taken to avoid inappropriate expense and misdiagnoses , and allowing networking quality .
10 - Protection of health professionals who report abuse of minors or vulnerable persons , and establish forensic certificates for victims of violence.
Since then, many things have happened : the work of the Interministerial Mission for the protection of women victims of violence and the fight against trafficking in human beings ( MIPROF ) on the training of health professionals , the conference on the care of victims and support authors organized by the Ministry of Women's Rights 2 and 3 September 2013 ( mission conference in which I participated ) , and the new three-year plan to fight against violence against women has been announced Ms Najat Belkacem Vallaud the Minister of women's Rights and government spokesman .
It seems that finally a consideration of this serious public health problem is emerging .
An important first step
For the first time , Najat Belkacem Vallaud said that women victims of violence should be able to quickly access free care by trained professionals , and that violence against women would be considered a public health priority . With a national protocol addressed the regional health agencies in order to strengthen the links between health services, police and justice.
In this international day of struggle for the elimination of violence against women is a very important first step to be welcomed , it will be necessary in many others for all victims of violence traumatized finally have the opportunity receive appropriate care throughout the French territory and the DOM- TOM .
Abandonment without protection or care of the vast majority of victims of violence is a public health scandal . Especially as we have for over 10 years from all national and international knowledge about the reality of violence and the severity of their consequences psychotraumatic .
We know that the consequences are very common ( they affect 60 to 80% of victims of intra- familial, marital and sexual violence are the most numerous and least recognized , the law of silence and denial ruling over them) and that impairment is not only psychological, but also with significant neurological dysfunction emotional circuits and memory , visible on MRI. We know for many years the psychological mechanisms and neurobiological .
Childhood , a critical period
We know very well clinically psychotraumatic describe these disorders, diagnose, and treat them effectively we know (with recovery of neurological damage due to the neuroplasticity of the brain) , we also know that having experienced violence in childhood is particularly a main determinants even the main determinant (when violence occurred in childhood) the health status of people even after 50 years . [1]
And we know that leaving victims traumatized careless violence is a risk factor for reproduction of violence closer and closer and generations , victims with a significant risk of violence again , and also to commit to a small number of them ( which is enough to feed the endless cycle of violence) . Fight against violence through the protection and care of victims.
However, at present , physicians and other health professionals are still not trained or initial training : in a recent survey of medical students over 80 % said they had not received training on violence and 95 % requested training to better support victims of violence [ 2] or in training , and the provision of appropriate care is very rare.
Accessible health care for all victims
Most often the diagnosis is incorrect and treatments are only symptomatic , with sometimes abusive term care and represent a lost opportunity for the victims. Unfairly , in violation of their rights , victims will have to organize their own survival in the face of violence and their consequences.
It remains - and this is a major project - to implement this provision of care and to make it accessible to all victims .
The course women, but male victims and the most vulnerable victims and most discriminated against , even ignored , while those that are present most psychotraumatic consequences :
- Children who pay a very heavy price to violence , especially within their families through their close upon their fetal life with domestic violence during pregnancy and at birth ( neonaticidal , shaken babies) and throughout their childhood with abuse and sexual abuse (minors suffer more sexual violence than adults must not forget )
- The elderly and the sick,
- People with disabilities who experience three times more violence
- People without papers,
- Asylum seekers ,
- People who are on the street,
- Victims of sexual violence ( not to mention the victims of incestuous sexual abuse, domestic sexual violence, sexual violence in institutions and at work , sexual violence in the context of prostitution ) .
Ten points are essential to get there
1 - A real public health policy on the prevention , screening, support and care for victims of violence , as part of a comprehensive policy to fight against violence and against impunity and protection Children and all victims of violence.
2 - An emergency training of health professionals and all other professionals involved in the care of victims of violence : to train the reality of violence, their identification, their effects on physical and mental health victims and witnesses , to the knowledge of the dangers and the victim protections put in place urgently , without forgetting the forensic setting (certificates and appraisals ) .
3 - The development of recommendations of the High Authority of Health on the care of victims of violence and the treatment of their psychotraumatic consequences.
4 - The establishment by decree with the support of regional health centers multidisciplinary health for victims of violence ( and for children who witness domestic violence , as well as relatives) , accessible to all victims whatever their age, disability , social status and providing free care , and anonymous if necessary , by qualified and trained professionals in each department with a comprehensive care ( medical, social, legal and associative ) and provision of information and documentation.
5 - Campaigns of public information on the consequences of violence and the possibility to treat , prevention campaigns and the development of prevention tools and information.
6 - The creation of a national observatory on the impact of violence and support victims.
7 - The development of investigation and research on the impact of violence on health and ways to prevent and treat these consequences.
8 - The establishment of a telephone reception center expertise, advice , guidance and documentation for health professionals and all stakeholders supported.
9 - Provision for victims of violence a health book informative indicating their traumatic disorders taken to avoid inappropriate expense and misdiagnoses , and allowing networking quality .
10 - Protection of health professionals who report abuse of minors or vulnerable persons , and establish forensic certificates for victims of violence.
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