Making Life Worth Living

A Thought Experiment

Let’s imagine that in the mid-noughties, cancer doctors discovered a rare and aggressive form of cancer that was not being recognised or identified by doctors. The received funding for a pilot scheme, which was introduced in four London boroughs. This scheme came with a brand new screening tool, special training for medical professionals, multi-agency meetings for those identified as at risk of this rare and aggressive form of cancer, and even a specially employed worker who would support those identified as at risk. On evaluating this pilot, it was discovered that deaths from this rare and aggressive form of cancer had been reduced by fifty percent.

This incredible success led to a national roll out of the scheme. Funding became available to hospitals, GP surgeries, and community groups based on them prioritising this rare and aggressive form of cancer. The multi-agency meetings for those identified to be at risk from this cancer were rolled out across the country. The specially employed workers for this rare and aggressive cancer became the “gold standard” for all cancer care. Everyone was delighted that, finally, this rare and aggressive cancer was being targeted. It seemed like a great leap forward for cancer care.

Twenty years later and things no longer seem so hopeful. All other forms of cancer are no longer considered a priority in cancer care. In fact, women with a breast lump or men noticing blood when they go to the toilet are forced to complete the screening tool for the rare and aggressive cancer before they are able to book an appointment. Often, if they aren’t considered high enough risk for that rare and aggressive cancer, they’re turned away. Charities, including Maggie’s, Marie Curie, Cancer Research UK and Macmillan Cancer Support are all now dependent on funding that prioritises that rare and aggressive form of cancer. And so they no longer offer support or care to those who aren’t screened as being high risk. Campaigns and funding to help people stop smoking and drinking too much have stopped, laws to ban cigarette advertising never took hold, and all other preventative measures for cancer have been halted, except where some charities desperately try to find funds to do work that isn’t focussed on the rare and aggressive cancer.

All the research suggests that the initial pilot results from those four London Boroughs has not been replicated when the scheme was taken nationwide. In fact, the number of people dying of the rare and aggressive cancer has remained the same, even as treatments have improved. Alongside that, deaths from other forms of cancer are increasing and the knowledge that once informed well-rounded cancer is lost. Few people question whether the whole system needs to change.

Not just a thought experiment

If we revisit our thought experiment, replacing “rare and aggressive cancer”, with “fatal domestic abuse perpetration” the above story is exactly where we find ourselves in 2025. The DASH (or DARA) risk assessment is used on all women, whether they consent or not, to assign resources and help. Independent Domestic Violence Advocates (IDVAs) are seen as the gold standard for domestic abuse work, and are only available to support women who have been assessed to have a high risk partner or ex. Multi Agency Risk Assessment Conferences (MARACs) are held about women with a partner or ex who is deemed high risk, often without their consent. When a woman is killed by their partner or ex, many thousands of pounds are spent on a Domestic Abuse Related Death Review; so far there is no formal or required way for the learning from these reviews to be implemented at local, regional or national level. Where women are not assessed to have a high risk partner or ex, they will often be turned away from services, or put on a long waiting list for support. While these measures are all well-intended to prevent men’s fatal violence towards women, since they were introduced we have not seen a reduction in the number of men killing women. In fact, it may be that more men are trying to kill women, as otherwise we could expect that improvements in trauma surgery alone would have led to more women surviving the injuries men have sought to fatally inflict upon them.

Escalating suicide risk

Today’s report (information HERE) from the National Police Chief’s Council has acknowledged that more women died by suicide after domestic abuse than are killed by their abusive partner, for the second year in a row. Some of this will be a result of better literacy amongst police and other services about the prevalence of abusive behaviour, with more questions being asked about whether a woman’s suicide is linked to her partner’s abuse. However, what we must also acknowledge is the ways that support domestic abuse services have gradually been forced to narrow their focus to women who are most likely to be killed. Twenty-five percent of women will be abused by a partner in their lifetime (8.6 million of the 34.49 million women in the UK), while around 100 women a year will be killed by their partner. To insist that all domestic abuse provision focusses almost solely on preventing murder is leading to serious failings for all women (including those at risk of being murdered).

When women seek help, they are often only able to access support if their partner or ex is deemed high enough risk. Many domestic abuse workers tell me during Own My Life training that they feel they never really make a difference in a woman’s life, given that their work is solely focussed on doing DASH risk assessments, MARACs and they are not able to build meaningful relationships with women and their children. It is a sad reality that most domestic abuse services are unable to focus (or even ask!) what women need or want, due to their funding and the wider policies being solely risk focussed. Why should a woman’s access to support be predicated on the dangerousness of her partner?

Abusive men may drive their partners to suicide by the torturous ways that these men control, humiliate, demand and physically harm their partner and children. However, women do seek help and support. And if they are turned away from services because he is not deemed “high risk” enough, or if the only support she is offered is completing a DASH risk assessment, having her case referred to MARAC and receiving a service that is solely focussed on his risk and not her needs, this is certainly going to impact her sense that life is worth living.

Making life worth living

If we are serious about offering life-saving support to women, we must build policies, strategies and services that have a greater goal than simply preventing men from killing women. Particularly given that we’re not actually stopping men from killing women. We need places and spaces for women to go where they can be loved and cared for.

A few weeks ago I visited Trevi in Plymouth. Their women’s centre is open every day, and is a place to make scones, do sewing workshops, drink copious amounts of tea, and snuggle on a sofa. This should be the norm for every community; a place where women can come and be loved and supported, whether or not they are currently struggling. We need to advocate for open doors and open hearts, that no longer demand women complete risk assessments before we can offer them care.

Jo Costello has posted on Twitter HERE, it is also troubling that the only messages that women hear from the domestic abuse sector are about funding cuts, risk of murder, football matches leading to abuse, and generally a whole lot of misery and awfulness. At Own My Life we are committed to creating joyous spaces of sisterhood. This is not about denying the reality of abuse, but is about recognising that abusers will always seek to steal our joy, and so in living joyfully and hopefully, we powerfully resist all he stands for.

Women regularly tell us that Own My Life has been “life-saving” for them. Not because it is reducing an abuser’s risk, but because everything we do is designed to enable women to know that life is worth living. This is how Own My Life became part of number 15 in Tim Woodhouse’s 66 ways to reduce domestic abuse related suicides (available HERE).

Evan Stark made it clear that women have “an unqualified right to resist” abusive men, and yet our risk assessment models infer that women should appease abusers, not do thinks that might provoke him. Yet it is as we resist an abusive partner that we remember we are alive. When we cook him dog food pie, clean the toilet with his toothbrush, or otherwise remind ourselves that we do not belong to him, we hold onto ourselves. And that is a crucial part of suicide prevention, as too is a functioning welfare system (including receiving benefits for more than two children), safe housing, enough food, and domestic abuse services who seek to know and meet our needs.

We urgently need change, not only to save women’s lives, but to ensure that more women’s lives are characterised by joy, hope and sisterhood. We should all want to be part of that world!