Interpersonal violence comprises a variety of different types of violence that occur between individuals, including violence perpetrated by strangers and acquaintances, intimate partners and family members. Interpersonal violence is a leading cause of death, particularly among young adults. Inconsistencies in definitions and approaches to the measurement of interpersonal violence mean it is difficult to clearly understand its prevalence and the differences and similarities between its different subcategories and contexts.
1. Introduction
Interpersonal violence is a global human rights and public health issue (
Rosenberg et al. 2006). Interpersonal violence can include physical, sexual and psychological violence and deprivation or neglect (
Kilpatrick 2004). Specialist third-sector services provide support for many (but not all) forms of violence that fall within the broader remit of interpersonal violence, primarily domestic and sexual violence and abuse (DSVA). As such, specialist services are a source of information about certain types of interpersonal violence. The measurement of violence by specialist services is varied, with no real consensus on what the best methodologies are. Indeed, in a recent systematic scoping review of the outcomes utilised in evaluations and reports of support services and interventions for those who have experienced DSVA, 11 distinct categories of outcomes and 426 outcome measures were identified, of which fewer than half had been used in more than one publication (
Carlisle et al. 2023). This illustrates the inconsistencies within the sector in terms of both what and how to measure when it comes to violence.
Exposure to interpersonal violence increases individuals’ lifelong vulnerability to a broad range of emotional, behavioural and physical health problems (
Mercy et al. 2017). Improved measurement of interpersonal violence is important for strengthening the evidence base needed to increase the effectiveness of interventions and build a theory of change that can identify potential points of intervention. The challenges of measuring interpersonal violence include inconsistent definitions of violence and abuse across contexts and sectors, different sectors using different measurement frameworks and data not being consistently disaggregated by variables such as gender, ethnicity and disability, making it difficult to identify how interpersonal violence effects different groups. Were all data collected disaggregated by these and other important demographic characteristics, a more accurate intersectional picture of how interpersonal violence impacts population groups differently could be built.
While most current statistics on interpersonal violence derive from administrative authorities, an additional source of data that could be included, yet is currently underutilised, is that from specialist support services for victim-survivors and perpetrators. Specialist services commonly provide victim-survivor-centred support and safety, through specialist expertise in violence and abuse (
European Institute for Gender Equality 2012). Possible services offered include refuges, outreach, counselling, legal advice, floating support, independent domestic violence advisor (IDVA) and independent sexual violence advisor (ISVA) support, children’s services and helplines (
Council of Europe 2011b;
Hagemann-White 2019;
Floriani and Dudouet 2021;
Macdonald 2021). Specialist support services tend to focus on DSVA and vary by ethos (traditional feminism vs. gender neutral (
Taylor-Dunn and Erol 2021)); the specific population they serve (e.g., women only, men only and mixed gender and/or specific to Black and minoritised or Asian people); type of violence (e.g., domestic violence and abuse only, sexual violence and abuse only, other types of violence against women and girls (VAWG)) and whether they provide support for victim-survivors, perpetrators or whole families.
Specialist third-sector services produce two types of data that are relevant to the measurement of interpersonal violence: routinely collected administrative data and additional data collected for the purpose of undertaking research, such as evaluations. Administrative data are primarily collected by service providers for the purpose of supporting their day-to-day work and meeting the contractual requirements of funders and commissioners (
Smith and Davidge 2022). Administrative data are also often used to monitor and improve service provision (
Kendall 2020) and are increasingly drawn upon for research and evaluation (
Johnson and Stylianou 2022).
This review describes and discusses some of the key challenges facing data collected by specialist services.
2. The Conceptualisation of Violence in Specialist Support Third-Sector Services
Interpersonal violence encompasses a wide range of different violent and abusive behaviours (
Krug et al. 2002). Specialist support services in the UK are often third-sector organisations with a focus on a particular subset or subsets of interpersonal violence in order to provide tailored specialist support. Thus, rather than all collecting data on all types of interpersonal violence, different specialist services will collect data relating to the type/s of violence they provide support for.
One such subset of interpersonal violence that is commonly provided for by specialist support services is domestic violence and abuse (DVA). In the UK, there are several definitions of domestic abuse. The 2021 Domestic Abuse Act defines it as “the act of any of the following: physical or sexual abuse; violent or threatening behaviour; controlling or coercive behaviour; economic abuse; psychological, emotional or other abuse. For the definition to apply, both parties must be aged 16 or over and ‘personally connected’” (
UK Government 2021). The conceptualisations of DVA used by specialist services are largely congruent with this definition; they all consider all such acts to be violence, even those that are not ‘severe’ or not ‘physical’. However, there are slight differences in approaches that have implications for the data that are collected. Other subsets of interpersonal violence that are the focus of different specialist services in the UK include sexual violence and abuse (SVA), so-called ‘honour-based’ violence, including forced marriage and female genital mutilation, and stalking. Some services provide support for victim-survivors of any form of VAWG, and some provide gender-inclusive DSVA services. Some are single focused, providing support for DVA or SVA only, whilst others are dual focussed, providing services for both DVA and SVA.
Such differences have implications for comparing, integrating and linking specialist services data. First, because different services provide support for different types of abuse, there is a possibility of double counting. For instance, service users who have experienced SVA and access a service catered to DVA may also get referred to and receive support from a specialist SVA service. Because specialist services operating within the boundaries of different local authority contracts often record different data in incompatible systems, the same individuals can appear in multiple datasets (
Bowstead 2019). To accurately establish the effectiveness of interventions as part of a multisectoral response, the use of unique identifiers may be required to understand the impact of multiple visits to different services (
Kendall 2020). Second, the parameters of the data must be considered and understood before any conclusions can be made. The nature of specialist services administartive data means it cannot be used to calculate a precise prevalence of (certain types of) interpersonal violence. However, it would still provide useful insights into the context underlying different forms of violence against different subgroups of victim-survivors.
3. Methods Used to Measure Violence
The monitoring and evaluation of specialist support services can be a contentious issue, with concerns regarding compromising victim-survivor safety, requiring inappropriate outcomes, and worry that findings may be used against services (
Sullivan 2011). On the other hand, it enables such services to evidence their effectiveness, which is key to securing and maintaining funding, and provides a mechanism through which specialist services can contribute to the knowledge and evidence base on VAWG (
Imkaan et al. 2016). The methods on offer to researchers, evaluators and service providers to measure violence and the impact of services are wide ranging. Each type of methodology has strengths and limitations and is implemented to varying degrees across the sector. Methodological issues of time-points, qualitative vs. quantitative data, outcomes and outcome measurement tools and self-reported vs, objective outcomes are reviewed.
4. How DSVA Services Measure and Record Violence in Administrative Datasets
At the level of services and interventions, there are both similarities and differences in the way that providers measure the violence experienced by victim-survivors accessing their services, and the impact of the various forms of support provided. Whilst there is significant overlap in administrative data collected between services, there is also variation and modification to standardised measurement tools. Similarities and differences in what data is collected and how it is recorded, who is included in specialist services datasets and how risk is measured are reviewed.
5. Discussion: Implications for DSVA Services’ Data Collection and Its Contribution to the Measurement of Violence
Implications of the challenges surrounding the measurement of interpersonal violence in specialist services data for researchers, service providers, funders and commissioners are outlined.
6. Recommendations
The researchers recommend the development of a core outcomes framework, exploration of methods for linking specialist services data with other sources of administrative data on violence, and sustainable funding for third sector specialist support services.