The Safe Pharmacy service is led by the Irish Pharmacy Union in partnership with An Garda Síochána, the HSE and Safe Ireland. This service provides information, contact details, safe, private space and means to access additional support from An Garda Síochána and specialist domestic violence services within communities.

Domestic abuse is the physical, sexual, financial, emotional or psychological abuse of one person against another who is a family member or is or has been an intimate partner, regardless of gender or sexuality.

Domestic abuse crosses class, gender, race and religious belief.[1]

[1] https://www.garda.ie/en/crime/domestic-abuse/what-is-coercive-control-.html

Coercive control is a persistent pattern of controlling, coercive and threatening behaviour including all or some forms of domestic abuse (emotional, physical, financial, sexual including threats) by a boyfriend/girlfriend, partner, husband/wife or ex-partner.[2]

[2] https://www.garda.ie/en/crime/domestic-abuse/what-is-coercive-control-.html

A 2005 survey by the National Crime Council and the ESRI found that 15% of women and 6% of men have experienced severe abuse by a current or former partner in their lifetime.[3]

The European Union Agency for Fundamental Rights (2014) Violence Against Women: An EU-wide survey [4] found that:

• 31% of women experienced some form psychological violence in their relationships that is every three women in Ireland.
• 14% of Women in Ireland have experienced physical violence by a partner since the age of 15

[3] National Crime Council and ESRI (2005).

[4] European Union Agency for Fundamental Rights (2014) Violence Against Women: An EU-wide survey. 

• An Garda Síochána responded to in excess of 48,400 domestic abuse incidents in 2021, 10% increase on 2020. 
• An Garda Síochána preferred in excess of 4,250 criminal charges for breaches of domestic violence act orders in 2021, a 6% increase on 2020. 
• An Garda Síochána preferred in excess of 8,600 Criminal charges for crimes involving an element of domestic abuse in 2021, up 13% on 2020 [5]

Safe Ireland members collected data pertaining to women and children they were supporting from March to December 2020 and produced two reports called Tracking the Shadow Pandemic both of which can be found on the Safe Ireland website[6] [7]

• From March to December 2020 over 5,895 women and over 1,085 children contacted a domestic violence service for the first time
• On average over 2,000 women and 500 children received support from a domestic violence service 
• 57,277 helpline calls were answered – approximately 190 calls every day.
• 2,159 requests for refuge could not be met as there was no available space – approximately 8 requests per day

[5] https://www.garda.ie/en/crime-prevention/crimecall-on-rte/crimecall-episodes/2022/31-january-2022/domestic-sexual-gender-based-violence.html

[6] https://www.safeireland.ie/policy-publications/#dflip-df_8398/1/

[7] https://www.safeireland.ie/policy-publications/#dflip-df_8221/1/

There are many reasons why those subjected to domestic abuse disclose. Some of these reasons include:

They may be fearful of the abuser. In many cases their abuser made threats prior to them disclosing.[8] They may be fearful of  the consequences of disclosing abuse e.g. their children taken away.[9]  They may fear being judged/ negatively evaluated by either the Health Care Professional (HCP) or their environment, i.e., their family, friends, neighbours, acquaintances[10] or not being believed[11].  They may fear that confidentiality would be broken[12] by the health service personnel and a  lack of privacy at the healthcare service.[13]

Victims perceptions of whether the HCP could handle their disclosure[14] also acts as a barrier, specifically perceiving the HCP to have low capability to help them  Personal barriers such as a low self-esteem, feelings of shame, embarrassment, guilt and powerlessness[15] also prevent victims from disclosing.

Sometimes victims do not  disclose because they were at the time unaware that they were experiencing abuse[16], think that the abuse was normal[17] and something that you just tolerate in a relationship.

Other reasons victims are reluctant to disclose is being in denial[18], not being ready to leave their abuser[19] being financially dependent[20], lacking social support[21] and trying to avoid reliving the trauma[22] by not speaking about the abuse

Victims perception that a health care setting was not the appropriate[23] place to discuss abuse, as they perceived that it was not a health issue that you discuss with a HCP. Victims are also not always aware of their rights[24] in terms of what choices or support they could gain by telling the HCP about abuse.

Those experiencing domestic abuse and coercive control may have difficulty making contact safely with the support they need while they are at home. Their movements and access to phones may be monitored and limited.

[10] Damra et al., 2015

[11] Salmon et al., 2015

[12] Wallin et al., 2003

[13] Damra et al., 2015

[14] Damra et al., 2015

[15] Salmon et al., 2015; Spangaro et al., 2011; Spangaro, Koziol-McLain, et al., 2016; Wallin et al., 2018

[16] Narula et al.,2012; Zink et al., 2004

[17] Hegarty & Taft, 2001; Othman et al., 2014; Reisenhofer & Seibold, 2013; Zink et al., 2004

[18] Gerbert et al., 1999

[19] McCauley et al., 1998; Othman et al., 2014

[20] Othman et al., 2014; Rodriguez et al., 1996

[21] Rose et al., 2011; Yam, 2000

[22] Spangaro, Koziol-McLain, et al., 2016

[23] Narula et al., 2012; Othman et al., 2014

[24] Othman et al., 2014

Pharmacies are located in all parts of Ireland. They are accessible and used by all. They are a trusted core part of our communities with highly trained, compassionate and discreet staff.

The National Institute for Health and Care Excellence Quality Standard[25] highlights symptoms or conditions which are indicators of possible domestic violence or abuse: 

• Symptoms of depression, anxiety, post-traumatic stress disorder, sleep disorders
• Suicidal tendencies or self-harming
• Alcohol or other substance misuse
• Unexplained chronic gastrointestinal symptoms
• Unexplained gynaecological symptoms, including pelvic pain and sexual dysfunction
• Adverse reproductive outcomes, including multiple unintended pregnancies or terminations
• Delayed pregnancy care, miscarriage, premature labour and stillbirth or concealed pregnancy
• Genitourinary symptoms, including frequent bladder or kidney infections
• Vaginal bleeding or sexually transmitted infections
• Chronic unexplained pain
• Traumatic injury, particularly if repeated and with vague or implausible explanations
• Problems with the central nervous system – headaches, cognitive problems, hearing loss
• Repeated health consultations with no clear diagnosis. The person may describe themselves as ‘accident prone’ ‘silly’
• Intrusive ‘other person’ in consultations, including partner or spouse, parent, grandparent or an adult child (for elder abuse).

[25]  NICE Domestic abuse quality standard (QS116)

• May be afraid of her partner
• Might seem afraid or anxious to please her husband/boyfriend partner.
• Agree with everything he says and does and be afraid to correct him.
• Talk about his temper, jealousy, anger or possessiveness.
• Have bruises or injuries often, with the excuse of “accidents.”
• Miss work, college, parties or family events without explanation.
• Seem controlled and stopped from seeing family and friends.
• Rarely go out in public without her husband/boyfriend/partner.

[26] www.safeireland.ie

The following principles should guide you be when responding to a victim using the Safe Pharmacy Service:

Consider all of the possible barriers mentioned in the earlier part of this guidance and try and counter these barriers as much as possible. Many victims may be worried that they won’t be believed. They may have been told that they won’t be believed.

There are many ways that you can demonstrate that you believe and do not judge them and that help is available through your words, actions and body language. Remember, your role is not ask or enquire about the details of the abuse. This requires specialist domestic violence training and experience.

This is a complex issue. Take your lead from the victim. Try not to react negatively to the information they may share and  avoid criticising the abuser – sometimes victims want the abuse to stop, but not necessarily the relationship.

If a victim presents at the pharmacy, they will be taken to the consultation room and given access to a phone to call An Garda Síochána or a specialist domestic violence service. The pharmacist is not there to advise, counsel or offer solution. They are there to offer a safe place as a first step in their path to recovery. The pharmacy acts as a gateway to domestic violence support services.

1. Offer a private space

If the person is alone, respond by offering to accompany them to the consultation room. If they’re with another adult, ask if they are able to come to the consultation room on their own.

2. Explain confidentiality

Explain how you will treat information disclosed to you or in front of you.

3. Explain what you can offer

Explain that you can help them access immediate support  from An Garda Síochána or their local specialist domestic violence service.

4. Ask what they would like to happen

Confirm whether they would like a Garda response or support from their local support service. Ask if they are comfortable making the call or if they would prefer you to make the call on their behalf. Ask if they would like you to stay with them or leave.

5. Offer the phone to make the call

Call An Garda Síochána on 999 or your local specialist domestic violence service.  If the individual is able to make the call, provide a phone and the relevant number. If they want you to make the call, explain to the call handler that you are calling on behalf of someone using the Safe Pharmacy Service.

6. Repord the incident

7. Debrief with a colleague

To protect your wellbeing, talk to someone you trust about your experience and be kind to yourself. You may also avail of VHI Counselling Service available to all staff.

• I hear what you’re saying. However, I can help you contact a domestic violence service expert
• What I can do is give you the telephone number for a specialist service closest to where you live, where you can get the confidential and professional help and support you need.
• You can use this phone to dial the number or I can dial it for you.
• This room is completely secure and confidential. You can take as long as you need to.
• Is this ok with you?
• You can leave the phone in here after you have finished.

Pharmacies agree to sign up to the Safe Pharmacy service and nominate a champion. The champion can be the Pharmacist, Pharmacy technician or any front of shop member of the team. 

The person(s) nominated in the pharmacy, i.e. The Safe Pharmacy Champion registers their pharmacy here  giving the pharmacy contact details and permission to share these details with An Garda Siochana.  Once this is completed a starter pack will be sent to the pharmacy.

The Safe Pharmacy Champion needs to complete the training course,

“Safe Pharmacy, Understanding Domestic Abuse and Coercive Control “

This course is certified by ATHE (Awards for Training and Higher Education).

Each student must register here they will need to go to the cart and “buy” the course, but there is no charge at the checkout.

On completion of this course each student will receive a Digital Badge from ATHE.  The cost to complete this course is fully sponsored by the IPU. We encourage all our Safe Pharmacy Champions and their colleagues to avail of this training.

The champion must make all staff aware of the service and procedure. Refresh regularly.

There is a series of 2 webinars which champions can access.

• Webinar 1 – Introduction to the Safe Pharmacy Service

• Webinar 2 – Introduction to Coercive Control and Recognising the Signs

Display Safe Pharmacy posters, Stickers and Decal

Develop/refresh referral pathways to local Gardaí and specialist domestic violence service(s).

The helpline numbers and contact details of the Specialist DV services will be provided to each Safe Pharmacy. AGS and DV services will be advised of the contact details of each participating Safe Pharmacy. In case that the Garda needs to be called, please dial 999.

Provide ongoing training and regular supervision for staff who may be asking people about domestic violence and abuse.

Establish clear policies and procedures for staff who have been affected by domestic violence and abuse. Ensure staff have the opportunity to address issues relating to their own personal experiences, as well as those that may arise after contact with customers.