Professional
Referral Pathways
Immediate, standard, and specialist referral pathways — MARAC, DASH RIC, professional duties, and all statutory guidance links for multi-agency working.
Professional responsibility: If you have reasonable cause to believe a child or vulnerable adult is at risk of significant harm, you have a statutory duty to act. You do not need proof — reasonable concern is sufficient. Inaction is not a neutral choice.
Immediate safety concerns
999
If there is immediate danger to a victim or child, call 999. Do not wait to consult — act immediately.
MARAC referral
Refer to your local Multi-Agency Risk Assessment Conference (MARAC) for high-risk cases. MARAC coordinates a multi-agency response to the highest-risk victims.
Emergency safeguarding
Contact local authority children’s or adult services for emergency safeguarding. Out-of-hours emergency duty teams are available 24/7 in every local authority.
Standard referrals
When there is no immediate emergency
- Local DA services — IDVAs, refuges, outreach workers. Your local MARAC coordinator can advise on referral pathways
- GP referral — mental health, counselling, NHS Talking Therapies
- Housing assessment — local authority housing options team. DA is a priority need
- Benefits advisor — Citizens Advice, specialist DA services
- IDVA — Independent Domestic Violence Adviser. Access via police, MARACs, or local DA services
Asking about domestic abuse in practice
Routine enquiry — asking all patients or service users about domestic abuse as standard practice — is recommended in healthcare settings. Evidence shows that direct, sensitive enquiry increases disclosure and does not cause harm.
- Ask in private — never with a partner or family member present
- Use open, non-judgmental language
- Explain confidentiality and its limits at the outset
- Document carefully in records — use the person’s own words
- Refer to your organisation’s DA policy for the referral pathway
Specialist referrals
Specialist services
- Southall Black Sisters — immigration and BAME support
- Ashiana Network — BAME women
- NRPF (No Recourse to Public Funds) specialist DA services — ask local MARAC
Honour-based abuse & forced marriage
- Karma Nirvana — 0800 5999 247
- Forced Marriage Unit — 020 7008 0151
- Multi-agency statutory guidance
Elder abuse & disability
- Hourglass — 0808 808 8141 (elder abuse)
- Staying Safe East — disabled victims
- Adult safeguarding team — local authority
- Section 42 Care Act 2014 inquiry — for adult safeguarding concerns
LGBT+ survivors
- Galop — 0800 999 5428
- LGBT Foundation
- Specialist LGBT+ refuges — ask Galop for referral
Children & young people
- NSPCC — 0808 800 5000 (professional line available)
- MARAC — for children in high-risk households
- Cafcass — for children involved in family court proceedings
- See Children & Young People page for full framework
Military & veteran support
- SSAFA — armed forces charity
- Veterans Gateway
- NAAVoices Founder’s Journal — personal writing from a veteran survivor
Key professional duties
General duties
- Routine enquiry about domestic abuse in appropriate settings (healthcare especially)
- Safeguarding reporting — children and vulnerable adults
- Risk assessment — using DASH RIC or equivalent tool
- Safety planning with the victim
- Documentation — injuries, disclosures, concerns, in the person’s own words
- Information sharing — appropriate multi-agency working (Caldicott principles apply)
- Signposting to specialist services
Healthcare-specific duties
- NICE guidance recommends routine enquiry about DA in maternity, mental health, and sexual health settings
- Thorough documentation of injuries — clinically and photographically where possible
- Referral to IDVA or specialist DA service
- Safeguarding referral when children are in the household
- MARAC referral for high-risk cases
- DASH RIC risk assessment tool — available via SafeLives
Pregnancy & DA — what professionals must do
Pregnancy is a known risk factor for domestic homicide. DA increases in frequency and severity during pregnancy and the postnatal period. It must not be missed in maternity settings.
- Always see the woman alone — never conduct DA enquiry with a partner present. If the partner refuses to leave, document this as a safeguarding concern in its own right
- Conduct routine enquiry at antenatal booking, 28 weeks, and key postnatal contacts — use validated tools (HITS, WAST, or local trust protocol)
- Unexplained injuries, late booking, missed appointments, or a controlling partner at every appointment are all red flags requiring action
- An unborn child can be subject to a pre-birth child protection plan where there is significant risk of harm — refer to children’s services
- Pregnancy is a standalone MARAC risk factor — do not wait for a threshold of incidents before referring
- Refer to a specialist perinatal IDVA where available in your area — ask your local MARAC coordinator
- Postnatal depression and anxiety may be a trauma response to abuse — explore this before prescribing or referring to IAPT alone
Statutory guidance & key legal resources
Domestic abuse legislation
Children & safeguarding
Statutory reviews & multi-agency structures
Multi-Agency Safeguarding Hub (MASH)
MASH brings together police, social care, health, education, and other agencies to share information and make coordinated safeguarding decisions. For DA cases involving children or vulnerable adults:
- Referrals to MASH are made when there are concerns about a child or vulnerable adult
- MASH can initiate rapid information sharing across agencies
- Contact your local authority to find MASH referral details for your area
- MASH is separate from MARAC — MARAC focuses on adult victims at high risk of serious harm
Domestic Homicide Reviews (DHRs)
When someone aged 16 or over dies as a result of violence, abuse, or neglect by a partner, former partner, or family member, a Domestic Homicide Review must be commissioned by the local Community Safety Partnership.
- Mandatory under Section 9 of the Domestic Violence Crime and Victims Act 2004
- Purpose: to identify lessons that could prevent future deaths — not to apportion blame
- Reviews examine what agencies knew, when, and whether different actions could have changed the outcome
- Published DHR reports are available via the Home Office and local authority websites
- Professionals should be aware of DHR findings from their area — they often contain directly applicable learning
Child Safeguarding Practice Reviews
When a child dies or is seriously harmed and abuse or neglect is suspected, a Child Safeguarding Practice Review (CSPR) must be conducted by the local Safeguarding Children Partnership.
- Previously called Serious Case Reviews (SCRs) — reformed under Working Together 2018
- Local CSPRs address cases below the national threshold
- National reviews are conducted by the Child Safeguarding Practice Review Panel
- DA is frequently a significant feature in child death reviews — professionals should read local and national findings
Safeguarding Adults Reviews (SARs)
Where an adult with care and support needs has died or been seriously harmed as a result of abuse or neglect, a Safeguarding Adults Review should be conducted by the local Safeguarding Adults Board.
- Governed by Section 44 of the Care Act 2014
- Reviews must be considered when there are reasonable concerns that the SAB could have done more to protect the person
- DA involving vulnerable adults — including those with mental health conditions, learning disabilities, or physical health needs — may trigger a SAR
- Published SARs are available via local authority Safeguarding Adults Board websites
DARVO — A guide for safeguarding professionals
Deny, Attack, Reverse Victim and Offender — recognising this tactic in safeguarding contexts
DARVO is a manipulation tactic used by perpetrators of abuse — particularly in safeguarding, family court, and professional contexts — to undermine victim credibility and deflect accountability. Understanding it is critical for any professional working in domestic abuse, safeguarding, or child protection.
D — Deny
The perpetrator denies that the abusive behaviour occurred, or minimises its significance. This may include flat denial, selective memory, or reframing events entirely.
A — Attack
The perpetrator attacks the credibility, character, or mental health of the person making the allegation — often to professionals, courts, or the community.
R — Reverse Victim & Offender
The perpetrator positions themselves as the real victim and the actual victim as the aggressor or perpetrator. This can be convincing to professionals who are not trained to recognise it.
Why DARVO matters in safeguarding
- Can lead professionals to doubt genuine victims and minimise real risk
- Perpetrators may present as calm, credible, and cooperative — while victims appear distressed or inconsistent
- Particularly dangerous in MARAC, child protection, and family court contexts
- Often co-occurs with parental alienation allegations used to undermine the protective parent
- Professionals must be trained to recognise the pattern, not just the presentation
Professional response to DARVO
- Focus on behaviour patterns and evidence — not just who presents most convincingly
- Understand that victim behaviour (distress, inconsistency, minimisation) may be a trauma response, not unreliability
- Use structured risk assessment tools (DASH RIC) rather than subjective credibility judgements
- Consult specialist DA professionals when DARVO is suspected
- Document DARVO indicators in case notes and MARAC referrals
From the Founder
From the Founder
Personal writing from Amy Royle — survival, recovery, neurodiversity, parenting through trauma, advocacy, and the journey that built NAAVoices.
All resources by NAAVoices.com — ⚖ DA & Neurodiversity — Understanding the Risks, Barriers & Support ⚠ Police Misconduct & Victim BlamingYour Pain, Your Voice, Your Life Matters — NAAVoices