Gendered violence: evaluating coordination between healthcare, social assistance and policy agencies

Vázquez-Portomeñe Seijas, Fernando / Regueira Diéguez, Antía / Guinarte Cabada, Gumersindo / Ordóñez Mayán, Lucía / Pérez Rivas, Natalia / Fernández Rodríguez, María Teresa / Muñoz Barús, José Ignacio / Concheiro Carro, Luis / Rodríguez Calvo, María Sol (2011): “Gendered violence: evaluating coordination between healthcare, social assistance and policy agencies”. 11th Annual Conference of the European Society of Criminology. Criminology, Vilnius, 21-24 september 2011 [Póster] This license requires that reusers give credit to the creator. It allows reusers to copy and distribute the material in any medium or format in unadapted form and for noncommercial purposes only. • BY: Credit must be given to you, the creator. • NC: Only noncommercial use of your work is permitted. Noncommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. • ND: No derivatives or adaptations of your work are permitted. Gendered violence: evaluating coordination between healthcare, social assistance and policy agencies © 2011 by Vázquez-Portomeñe Seijas, Fernando / Regueira Diéguez, Antía / Guinarte Cabada, Gumersindo / Ordóñez Mayán, Lucía / Pérez Rivas, Natalia / Fernández Rodríguez, María Teresa / Muñoz Barús, José Ignacio / Concheiro Carro, Luis / Rodríguez Calvo, María Sol is licensed under CC BY-NC-ND 4.0 This proyect was supported by Grants from Xunta de Galicia (SI427C 2011/33) and Ministerio de Ciencia e Innovación (FEM 2010-22350-C02-01 and FEM 2010-22350-C02-02) GENDERED VIOLENCE: EVALUATING COORDINATION BETWEEN HEALTHCARE, SOCIAL ASSISTANCE AND POLICY AGENCIES Vázquez-Portomeñe Seijas, Fernando1; Regueira Diéguez, Antía2; Guinarte Cabada, Gumersindo1; Ordónez Mayán, Lucía2; Pérez Rivas, Natalia3; Fernández Rodríguez, Maria Teresa4; Muñoz Barús, José Ignacio2; Concheiro, Luis2; Rodríguez Calvo, María Sol2 1Institute of Criminology. 2Department of Pathology and Forensic Sciences. 3Department of Criminal Law. 4Hospital University Complex of Santiago. University of Santiago de Compostela, Spain This proyect was supported by Grants from Xunta de Galicia (SI427C 2011/33) and Ministerio de Ciencia e Innovación (FEM 2010-22350-C02-01 and FEM 2010-22350-C02-02) INTRODUCTION: The development of catalogues of comprehensive services, based on action protocols organized in intervention areas, is the main coordination mechanism between basic primary social services and specialized social services. The polyvalence of the services and the need to give quickly, integral and personalized answers to victims of different types and problematics (unemployed, dependents, with addictions, with children or family burden etc.) makes it necessary to take into account other work and data collection tools what can make the derivation from the different implied services easier. SPECIFIC AIMS: SA1. To evaluate the advantages and disadvantages of the so called "social file", as instrument of intra-institutional coordination, making compatible and easier the polyvalent and specialized assistance required by the victims of gendered violence. SA2. To define the profile of the victims who can experience a situation of further abandonment due to the lack of coordination between basic primary social services and specialized social services. SA3. To propose a model of management of the available resources in the field of the social and sanitary resources, that it should allow to integrate quality, efficiency and speed in the attention to the victims of gendered violence. METHODOLOGY: The research has been developed across three phases, using a methodology that included quantitative and qualitative aspects. In the first phase it was designed a data collection form related to the coordination level between the diverse services offered and provided to the victims of gendered violence in the municipalities of Mondoñedo and Santiago de Compostela, as well as in the University Hospital Complex and in the Healthcare Center Concepción Arenal, also in Santiago de Compostela (NW Spain). During the second one, we contact with the professionals destined in the implied areas and agencies. Finally, we proceeded to evaluate the information and to identify the problems that the system presented resulted of the lack of coordination between the different services. SOCIAL SERVICES (SS. SS) DRUG ADDICTIONS HELPING SERVICE (U.M.A.D.) FAMILY SUPPORT SERVICE (U.A.F.) MIGRATIONS SUPPORT SERVICE (U.A.M.) WOMEN INFORMATION CENTER (C.I.M.) DERIVATION TO SPECIALIZED RESOURCES ACCESS SOCIAL PRIMARY ATTENTION SYSTEM ALTERNATIVE HOUSING PSYCHOLOGICAL SUPPORT CHILDHOOD SUPPORT DIFFERENCIATED CAPACITIES EMIGRATION SUPPORT LEGAL ORIENTATION ECONOMIC RESOURCES, HOUSING, EMPLOYMENT AND FORMATION OPPORTUNITIES PRIMARY CARE Outpatient Center Point of continued assistance SPECIALIZED CARE Mental Health Unit Emergency Department Family Orientation Unit Fig. 1 Derivation of victims of gendered violence cases between different social services KEY CONCEPT: The integrated social file represents a key informatic tool to obtain a major and better coordination in the area of the social services, and in consequence, an improvement (in the scope, the quality and the efficiency) of the attention to the victims of gendered violence. Any of the professionals of the social services agencies or departments contacted by the victim have access this file, either when the victim reveals the situation of gendered violence, or when the professional detects it. Its content is based on the distinction between information that should circulate between the diverse services (circulating module), and other (much more specific) information, which should be monitored by (and from) each one of them (not circulating module). The tool only returns the circulating module, allowing to design adapted itineraries specifically for the situation of each victim. The integrated social file operates, this way, at the same time, as a derivation document between professionals and as a network model between different departments (immigration, minors, education, etc.), facilitating them to exchange information, to reach agreements and to take decisions. SS. SS. NOT CIRCULATING INFOMATIVE MODULE U.A.F. NOT CIRCULATING INFORMATIVE MODULE U.A.M. NOT CIRCULATING INFORMATIVE MODULE U.M.A.D. NOT CIRCULATING INFORMATIVE MODULE C.I.M. NOT CIRCULATING INFORMATIVE MODULE SS. SS., C.I.M., U.M.A.D., U.A.F., U.A.M. CIRCULATING INFORMATIVE MODULE Fig. 2. Integrated Social File: information circulating outline between different social services Nowadays, the integrated social file is in the process of being implemented in the basic primary social services of the municipality of Santiago de Compostela (NW Spain), but not within health care settings. Health system social workers use the telephone pathway to comunicate to each other, with the victim’s knowledge and consent. A written report is elaborated at court request or in case of referral. Another possibility involves the use of the electronic clinical history, which includes a section for the social worker’s comments. However, this option suffers from underusage, both quantitatively and qualitatively. CONCLUSIONS: C1. The integrated social file, developed and used by out-of-the-health- system social services provides significant advantages (Tab. 1). Its disadvantages are limited and surmountable (Tab. 2). Taking into account the characteristics of gender violence cases (high demand of health care, usually in different centers), we consider that it would be convenient and necessary to implement it within the health system. ADVANTAGES ✓OPTIMIZATION OF THE RESOURCES ✓TO AVOID THE VICTIMS TO RELIVE HER HISTORY, NOT HAVING TO TELL THE AGRESSION IN THE EACH DIFFERENT AGENCY (SECONDARY VICTIMIZATION) ✓COVERAGE OF ALL HER NEEDS ✓LINKING THE ASSISTANCE AND EXIT PROGRAMS OF THE SYSTEM ✓UNIFICATION OF THE INTERVENTION CRITERIA. ✓OVERALL ASSISTANCE TO WOMEN WITH ASSOCIATED VULNERABILITIES ✓EARLY DETECTION OF GENDERED VIOLENCE CASES DURING THE PROCESSING OF SOCIAL BENEFITS. POSSIBLE DISADVANTAGES ✓NEED TO WORK WITH HOMOGENEOUS CRITERIA OF COLLECTION AND DATA PROCESSING ✓CONDITIONING OF THE ATTITUDE OF THE DIVERSE SOCIAL OPERATORS WHO HAVE ACCESS TO THE SOCIAL FILE (LABELLING OF THE VICTIM, SNAP EVALUATION OF THE CASES) C2. Profile of the victims more affected by the lack of coordination between the diverse programs of attention (included those of socio-laboral insertion programs or exit programs of the system): victims who present other problems which can influence in the emergence of situation of the violence or to be, in turn, a consequence of that violence environment: any addiction, women who suffer mental illnesses, immigrants women, women with children and /or dependent persons to her care. HEALTH SYSTEM SOCIAL WORK