Clinical Forensic Medicine (CFM) is concerned with the provision of forensic medical services, primarily to the living, and the collection and interpretation of information for the purposes of civil and criminal law, the judiciary and the police. Dr Maria Nittis works as a Senior Staff Specialist at the Western Sydney Local Health District Forensic Medical Unit and explains what impact COVID-19 has had on cases of domestic violence.

“The NSW Forensic Medical Unit saw a decrease in numbers of domestic violence presentations during the COVID-19 pandemic. However, support services and police believe that assault numbers may actually have increased, but reporting has dropped. Causes for this are likely to be multi-factorial but could include, patients not requiring urgent medical attention not attending Hospital Emergency Department for fear of contracting COVID-19, or concern about taking up the time of health care staff who are busy with the pandemic. Some people may also have been influenced by the knowledge that they could have nowhere to live after reporting.

“Alternatively, this reduction in case numbers could be due to a decrease in stress experienced by some people. For example, through working from home, decreased social activities and sport commitments, as well as potentially reduced alcohol consumption because of reduced social gatherings,” said Dr Nittis.

Definitions of domestic violence can differ between responding organisations and across different Australian Jurisdictions. NSW Health defines domestic violence as a pattern of sustained coercive and controlling behaviours in both current intimate partner relationships and after separation. It may involve physical and sexual assault, emotional abuse and financial exploitation.

Other examples of domestic violence includes psychological or emotional violence (demeaning another), spiritual violence (using spiritual or religious beliefs to hurt, scare or control), social violence (limiting contact with family / friends / community), legal violence (using the law or legal threats to scare and control), reproductive violence (stopping another making their own choices about their reproductive system), neglect (denying a person the things needed to live a safe, comfortable healthy life), and stalking.

“During the first wave of the pandemic, our unit also saw a decline in sexual assault presentations which may be due to similar reasons mentioned previously. There is no doubt that the decrease in social gatherings, parties and hook ups was probably a major contributor for this.

“There is also the possibility that there has been an increase in barriers to reporting. For example, in child abuse cases, the fact that many children have been absent from school for extended periods of time might mean there were less people outside of the immediate family who could identify abuse and report it,” said Dr Nittis.

CFM deals with both the medical and legal aspects of patient care. It may incorporate injury interpretation, forensic medical assessments of sexual assault / non-sexual assault victims and persons of interest (interpersonal violence), assessment for fitness to undergo a police interview, health care assessment and provision in a forensic setting, assessment of fitness to drive, clinical toxicological assessments and, in some cases, assistance with medico-legal death investigation.

1800RESPECT is a confidential information, counselling and support service. It is open 24 hours to support people impacted by sexual assault, domestic or family violence and abuse. For more information, visit https://www.1800respect.org.au.