Background
The Israeli health system is playing a major role in national efforts to detect and treat victims of domestic violence and sexual assault. A wide range of health care institutions are involved, including hospitals, health funds, mental health clinics and district health offices. To promote detection and treatment, permanent committees have been operating in the health services since 2003, dealing with domestic violence, sexual assault, and neglect of minors and the helpless (hereinafter: ‘violence committees’ or ‘committees’). In 2021, The Department for the Treatment of Domestic Violence and Sexual Assault in the National Service for Social Work in the Ministry of Health, asked the Myers-JDC-Brookdale Institute to examine the work of the committees, and to map their composition, characteristics, and activities. This report presents the third part of a comprehensive study designed to help the Ministry of Health regulate and upgrade the work of the committees.
Goals
To learn about the committees’ modes of operation, composition, characteristics and activities as well as difficulties and challenges in their work.
Method
In November 2023, about a month after the outbreak of the Iron Swords War, an online questionnaire was distributed to committee coordinators in 153 committees, for which contact information was received from the Ministry of Health. 90 completed questionnaires were received (59% response rate). Collection ended in January 2024.
Findings
- Social work and nursing are the most prevalent areas of expertise in the committees: each committee has a social worker or nurse, most committees have more than one social worker or nurse, and all but two committees have a doctor.
- Most of the committees are engaged in the activities required of them: 84% of the committees are engaged in providing advice to, and responding to inquiries from, the staff in the organization regarding cases that arouse suspicion of domestic violence or sexual abuse, 82% of the committees are engaged in distributing information on the subject to the staff in the organization (such as mandatory reports, instructions for handling cases that arouse suspicion, etc.), 77% of the committees are engaged in analyzing cases of detection and treatment of victims of domestic violence and drawing lessons from them, and 70% of them are engaged in planning and delivering training to the organization’s staff.
- In 78% of the committees there are mandatory training sessions, especially for new staff members. The training sessions deal with procedures, information about domestic violence and sexual assault, and the provision of knowledge and skills to the staff.
- Most of the committees have some connection with the organization’s senior management: 49% stated that the committee’s work is part of the organization’s annual work plan, and 36% reported that representatives of senior management are members of the committee.
- In 26% of the organizations, there were no inspection processes (external or internal) in the year and a half preceding the survey.
- In view of the increase in domestic violence and sexual assault in times of emergency, along with the increase in the workload and the reduction in the availability of the staff, the committee has a unique, significant and particularly challenging role to play in increasing awareness and vigilance on the issue, as an essential part of improving the detection and treatment of victims.
Recommendations
- The procedures and standards for the committee’s activity should be updated and specified, taking into account the unique characteristics of each organization.
- The Ministry’s inspection of the committees must be deepened and formalized, including establishing clear indicators for training and providing feedback and monitoring the correction of the deficiencies found, especially in view of the findings that the inspection has a positive effect on the committees’ effect in the organization, its activities and conduct.
- The training system should be expanded and upgraded, and work should be done to spread knowledge, tools and skills to detect and treat the victims of domestic violence, using a variety of tools and methods.
- A unified and shared computerized platform should be developed for the entire health system and other relevant stakeholders that will enable the concentration and distribution of knowledge, tools and skills.
- The documentation process in the health care organizations should be improved, including documentation of identified cases, inquiries received from staff members, data on training sessions and follow-up documentation of the care provided.
- Cooperation among professionals within and outside the health system should be increased.
- The work done in order to detect and treat victims of domestic violence and sexual abuse, as well as the committees other activities should be amplified in diverse ways, which include, among other things, the allocation of positions and the extension of funded time for the members of the committee, and the extent to which senior management is regularly briefed about the scope of domestic violence and sexual assault in their institutions, and about the activities of the committee to address those problems.