Paramedics encounters with children exposed to domestic violence: Identifying and overcoming barriers to sound responses

Abstract

When paramedics attend incidents of domestic violence, and children are present, they are simultaneously positioned to identify and respond to children exposed to domestic violence. Few paramedics report children exposed to domestic violence to either domestic violence or child protection services, typically citing uncertainty over reporting and referral responsibility. The spectrum of repercussions for children creates challenges as well as opportunities for paramedics to be educated and trained on optimal ways to respond. This article considers the role of the paramedic when they encounter children exposed to domestic violence. It is informed by research on parental characteristics related to mental illness, drug and alcohol misuse and domestic violence that often accompany other forms of child maltreatment. The article reports the results of a qualitative study of Queensland Ambulance Service paramedics, examining challenges and barriers impacting paramedics when they encounter children exposed to domestic violence. Research participants revealed key barriers to effective responses, these included breaching the privacy of families, their interpretation of mandatory reporting laws, limited time on scene and uncertainty on how to respond based on an absence of clear policy guidelines and training on child maltreatment in the context of domestic violence. Analysis of the experiences, and the ways paramedics understand child exposure to domestic violence, provides an opportunity to consider strategies to respond in such situations. Recommendations are made for ambulance services to develop policy incorporating education and training on the role of paramedics when they encounter children exposed to domestic violence.