Women's experiences with accessing health care services after domestic abuse

Objective: There are approximately 26,000 incidences of domestic abuse (DA) reported each year in Scotland alone. Most research has focused on screening for domestic and sexual abuse in pediatric and primary care setting. This study aimed at identifying barriers and facilitators of access to universal health care services through the National Health Service (NHS) from the perspective of women experiencing domestic abuse and health professionals Method: We used a two-pronged study approach: (a) a focused concept mapping event with 15 women experiencing DA and iterative e-mail based exploration of principal barriers and core priorities with 10 community-based health professionals (nurses, primary care physicians and specialist care providers); (b) semi-structured, in-depth interviews with 20 women receiving support from Women's Aid. Qualitative thematic framework and quantitative cluster analyses were conducted. Results: Women reported difficulties with identifying general practitioners after moving from their home area with care coordination, continuity of services and access to downstream services, including dental care and mental health services. Keeping appointments and ensuring regular check-ups for their children were other challenges. Health professionals emphasised the complexity of medical and psychosocial needs. There is a significant shortage of mental health providers in Scotland that are experienced in the area of domestic abuse. Conclusions: Psychosocial, health system-related and geographical barriers impede access to health care in Central Scotland that require a concerted response from local authorities and practitioners.