Help-Seeking Behaivors

Article Journal of Interpersonal
Violence
Volume 25 Number 5
Help-Seeking Behaviors
May 2010 929-951
© 2010 The Author(s)
10.1177/0886260509336963
and Reasons for Help http://jiv.sagepub.com
Seeking Reported by a
Representative Sample of
Women Victims of Intimate
Partner Violence in New Zealand
Janet L. Fanslow
Elizabeth M. Robinson
University of Auckland
Efforts to understand and support the process of help seeking by victims of

intimate partner violence are of considerable urgency if we are to design sys-
tems and responses that are capable of actively and appropriately meeting the
needs of victims. Using data from the New Zealand Violence Against Women
Study, which drew from a representative general population sample of women
aged 18 to 64 years, the authors report on the help-seeking behaviors of the
women who had ever in their lifetime experienced physical and/or sexual vio-
lence by an intimate partner (n = 956). More than 75% of respondents reported
that they had told someone about the violence, indicating that it is not neces-
sarily a “secret and private” problem. However, more than 40% of women
indicated that no one had helped them. Informal sources of support (family and
friends) were most frequently told about the violence but not all provided help-
ful responses. Fewer women told formal sources of help such as police, health
care providers, and not all provided helpful responses. Women’s reasons for
seeking help and for leaving violent relationships were similar and included
“could not endure more,” being badly injured, fear or threat of death, and con-
cern for children. Women’s reasons for staying in or returning to violent rela-
tionships included perception of the violence as “normal/not serious,” her
emotional investment in the relationship, or staying for the sake of the children.
The findings suggest that broader community outreach is required to ensure
that family and friends are able to provide appropriate support for women in
abusive relationships who are seeking help. Continued improvement in institu-
tional responses is also required.
Keywords: violence against women; domestic violence; help seeking; New

Zealand; service use
929
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930 Journal of Interpersonal Violence
G lobally the problem of violence against women is no longer in doubt,

with the World Report on Violence indicating that between 10% and
69% of women internationally have experienced physical violence by an
intimate partner (Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002). The
health implications of intimate partner violence (IPV) are also increasingly
recognized, with a Lancet review documenting a number of chronic and
acute health problems, mental health issues, and reproductive and gyneco-
logical problems associated with experience of violence (Campbell, 2002).
Given the widespread and far-reaching consequences of the problem,
efforts to understand and support the process of help seeking by victims of
intimate partner violence are of considerable urgency.
Historically, responses to victims have been developed on the basis of
identified need and active advocacy work rather than being driven by data.
For example, the advocacy and mobilization of women led to the develop-
ment of the shelter movement in the 1970s in the United States. Initiatives
in other sectors of society, such as strategies developed through the crimi-
nal justice sector (e.g., pro-arrest policies, legislation, and development of
protection or restraining orders), and health (e.g., policies for the identifica-
tion, risk assessment, and referral of victims) have been driven by advocacy
and policy work ignited by recognition that “status quo” responses were
failing to meet the needs of victims (Heise & Chapman, 1992).
Questions remain, however, in terms of whether the responses that have
been developed are the most appropriate ways to deliver help to victims of
intimate partner violence according to victims’ personal perceptions of who
they would like to receive help from and the types and nature of help that
they would like to receive. Much of the previous literature investigating
women’s help-seeking behaviors related to IPV has been drawn from
highly selected samples and has focused on specific aspects of help-seeking
behaviors and, in particular, on women’s decisions to leave violent relation-
ships. Insights from this literature suggest that women’s efforts to seek help
are influenced by the woman’s personal appraisal of the violence and of her
Authors’ Note: We would like to acknowledge the women who participated in this study. The
following are also acknowledged: Project manager: Cherie Lovell; Project Assistants:
Margaret (Meg), Tenny, and Clare Murphy; Data Manager: Vivien Lovell; Auckland and
Waikato Interview Teams; data entry staff. We thank the Advisory Group who provided impor-
tant support for the study. Funding for this project was provided by the Health Research
Council of New Zealand (02/207). This study replicates the World Health Organization
(WHO) Multi-Country Study on Women’s Health and Domestic Violence (WHO/EIP/
GPE/99.3). Please address correspondence concerning this article to Janet L. Fanslow, Senior
Lecturer, Social and Community Health, School of Population Health, University of Auckland,
Private Bag 92019, Auckland, New Zealand 1142; e-mail: [email protected].
Fanslow, Robinson / Help-Seeking Behaviors and Reasons 931
relationship, the skills and strategies she employs, the course or phase of
the violent relationship, and the responses she receives from others. This
literature is summarized below.
Woman’s Appraisal
Rusbult and Martz (1995) suggested that a woman’s commitment to
abusive relationships was mediated by her internal assessments of the rela-
tionship such as satisfaction level (the degree to which an individual favor-
ably evaluates a relationship), the quality of alternatives (e.g., a specific
alternative relationship or the option of noninvolvement), and investment
size (e.g., the number and magnitude of resources tied up with the relation-
ship, either directly [time, self-disclosure, emotional energy] or indirectly
[children, mutual friends, shared material possessions]). They highlighted
how increased commitment was linked with increased costs associated with
ending a relationship. Fugate, Landis, Riordan, Naureckas, and Engel
(2005) also reported how women’s personal perceptions could form sig-
nificant barriers to seeking help. In particular, women’s perception that the
violence is “not serious,” was identified as an important inhibitor for
women asking for help.
Characteristics of the Relationship

The type of violence experienced, its severity and frequency, or the pres-
ence of child abuse can also influence women’s decisions to leave (Gelles,
1976, cited in Strube, 1988). Waldrop and Resick’s (2004) review sug-
gested that women may use more avoidant strategies when they are still in
abusive relationships and trying to cope with ongoing violence but that they
may take more active steps to leave the relationship as the abuse becomes
more severe and more frequent. Others have described how women’s help-
seeking strategies may vary depending on where a woman is at in the
course of an abusive relationship, for example, Landenburger’s stages of
binding, enduring, disengaging, and recovering (Arriaga & Capezza, 2005;
Landenburger, 1989).
Response From Others

For help seeking in general, it is clear that the responses of others are
important in influencing how individuals handle difficulties (Pescosolido,
1992). Abused women who receive supportive responses from those they
first tell about the violence are likely to have increased confidence and be
more likely to seek support and help in future (Waldrop & Resick, 2004).
Women’s perceptions about other’s responses are also important. Fugate
and colleagues (2005) identified that a woman’s fear that those from whom
help is being sought will require the woman to end her relationship is an
important barrier to help seeking along with the fear that she will be
required to accept the helper’s definition of both the situation and the
“appropriate” response. Lempert (1997) argued that if the latter situation
occurs, it places the victim in the same power relationship to the helper as
they were to the abuser.
With these interlocking complexities to unravel, it is perhaps not surpris-
ing that empirically supported models of help seeking remain elusive. In
addition, our knowledge of women’s help-seeking behaviors is limited by
the fact that most of the available research has been conducted with women
in shelters, which may not reflect help seeking by women in the wider
population (Strube, 1988).
The few studies of help seeking drawn from a nationally representative
sample in the United States tell us that victims of IPV may employ multiple
help-seeking strategies, involving friends and family, as well as help from
police, social services, and psychiatrists (Kaukinen, 2004). Findings from
Canada also highlight the importance of family and friends in the help-
seeking strategies of IPV victims, even when and if they utilize the criminal
justice system (Kaukinen, 2002). These studies provide us with further
information but they also leave gaps in our knowledge about factors that
lead women to seek help and social support, what types of solutions victims
are looking for, and what keeps others suffering in isolation.
The purposes of the present study are to report on the help-seeking
behaviors of the women who had ever in their lifetime experienced physical
and/or sexual violence by an intimate partner. Specifically to
1. summarize information about to whom women spoke about the violence and
who they found to be helpful;
2. document factors that (a) influenced women who stayed within violent rela-
tionships, (b) factors that influenced women who left; and
3. explore barriers and enablers to leaving the relationship.
Method
Sampling Strategy, Participants, and Response Rate

The survey was conducted by the School of Population Health at the
University of Auckland as part of the New Zealand Violence Against Women
Study (a replication of the World Health Organization [WHO] Multi-Country

study; Garcia-Moreno, Jansen, Ellsberg, Heise, & Watts, 2005). A random
sample of women aged 18 to 64 years was obtained from Auckland, the larg-
est city (population 1.2 million), containing 26.8% of the total New Zealand
population of women aged 15 to 64, and north Waikato, a rural region, con-
taining 2.8% of the total population of women aged 15 to 64. Potential par-
ticipants were contacted by door-knocking at randomly selected households,
following a population-based cluster sampling scheme. The starting point for
each cluster consisted of a randomly selected street and dwelling number.
From the starting point, interviewers in Auckland approached every fourth
house, and interviewers in the Waikato approached every second house until
10 households per cluster had been reached. Nonresidential (e.g., commer-
cial, retail, or industrial buildings) and short-term residential properties (e.g.,
hotels, motels, boarding houses) were excluded.
In households with more than one eligible respondent, one woman was
randomly selected for safety and confidentiality reasons. If the woman
selected was available, consent was sought and an interview arranged, oth-
erwise contact details were obtained. A minimum of three return visits were
made to each household at different times on different days to maximize the
chance of obtaining an interview. Some interviewers made up to nine repeat
visits. Comparison of the demographic characteristics (age, ethnicity, mari-
tal status) of the sample with the general population in the two regions, and
for the nation as a whole, indicated that the sample was quite comparable
to the broader population (for details, see Fanslow & Robinson, 2004). No
financial incentives were offered to participants.
Data Management
All questionnaires were checked for completeness and participants were
recontacted if necessary to obtain missing data. All data were double
entered in Epi-Info, checked and cleaned. Questions with open-ended
“other” responses were reviewed to ascertain if existing coding categories
applied or new categories emerged.
Questionnaire
The questionnaire was developed by the Core Technical Team of the
WHO Multi-Country Study on Women’s Health and Domestic Violence
Against Women following extensive consultation and pretesting in multiple
countries (Garcia-Moreno et al., 2005). As described in an initial paper from
the Multi-Country study, measurement of violence built on the tradition of
the Conflict Tactics Scale by asking respondents about their experience of

specific acts of physical and sexual violence by a current or former intimate
male partner. However, the WHO instrument framed questions in terms of
how partners treat each other rather than so-called conflict negotiation
(Garcia-Moreno et al., 2006). The specific acts for both physical and sexual
violence are listed below.
Definitions
“Intimate partners” included male current or ex-partners that the women
were married to or had lived with or current regular male sexual partners.
Physical violence was having been slapped or had something thrown at
them which could hurt them or having been pushed, shoved, or had their
hair pulled (grouped as “moderate violence” for later analyses); and having
been hit with a fist or something else, had been kicked, dragged, or beaten
up, had been choked or burnt on purpose, or been threatened with, or had
used against them a gun, knife, or other weapon (“severe violence” in later
analyses). Sexual violence was having experienced one or more of the fol-
lowing acts: being physically forced to have sexual intercourse when the
woman did not want to; having sexual intercourse because she was afraid
of what her partner might do; or being forced to do something sexual that
she found degrading or humiliating.
Information about the type of help women sought was obtained as
follows:
1. Open-ended questions about whom women told about the man’s behavior,
and who women felt tried to help.
2. Prompted questions about agencies women went to for help, and whether
women were satisfied with the help provided by these agencies.
3. Open-ended questions about reasons that prompted or inhibited help
seeking.
4. An open-ended question about who else they would have liked help from.
5. Questions on if a woman left the relationship (how many times), where she
went when she first left, how long she stayed away.
6. Her reasons for leaving the relationship, returning to the relationship, or
reasons for staying away from the relationship.
Response Rate and Sample Size

In total, 6,174 addresses were selected. Of these, 57 did not have a dwell-
ing (ineligible precontact). A total of 784 (12.8%) households refused,
indefinitely postponed, did not speak English or Mandarin/Cantonese, or
were unable to be contacted. Of the remaining 5,333 houses, 1,563 did not
have eligible women (ineligible postcontact). From the 3,770 households
with eligible women, 2,855 women aged 18 to 64 years were interviewed. In
Auckland, 1,411 interviews (98%) were conducted in English, and 29 (2%)
were conducted in Mandarin or Cantonese.1 All interviews in the Waikato
were conducted in English. An 88.3% household response rate, and a 75.8%
eligible woman response rate was obtained, yielding an overall response rate
of 66.9%. The median length of the interview was 40 min.
Of the 2,855 women who completed the full questionnaire, 2,744 were
ever partnered and 111 had never had a partner. In this article, we report on
the help-seeking behaviors of those who had ever in their lifetime experi-
enced physical and/or sexual violence by an intimate partner (n = 956).
Thirty-three percent of participants in Auckland (an urban area) and 39% in
Waikato (a rural area) reported that they had experienced at least one act of
physical and/or sexual violence by an intimate partner in their lifetime. IPV
within the previous 12 months was reported by approximately 5% of respon-
dents in both locations. Of those who had experienced moderate or severe
physical violence, 42.4% (n = 362), had also experienced sexual violence.
Data Coding
For some analyses, agencies or individuals that women sought help from
were grouped as “formal” (i.e., police, women’s refuges, mental health ser-
vices, doctors or other health care providers, or other professional or nongov-
ernmental organization [NGO] groups) or “informal” (i.e., family members
or friends). When responding to questions related to the woman’s “reasons,”
multiple responses were possible. However, when responding to the question
about where she first went when she left her partner, only one response was
possible.
Analyses
In addition to descriptive statistics, logistic regression was used to inves-
tigate if the recentness (past 12 months or prior to the past 12 months) of
intimate partner violence, the ethnicity, the age of the woman, or the sever-
ity of violence were associated with whether or not the woman sought help
from a particular person or place. Socioeconomic factors—education,
household income, car, telephone, and home ownership, deprivation index,
overcrowding, and marital status were also included in the models.
Interactions between ethnicity and the recentness of the violence were also
investigated. All analyses allowed for the clustering by meshblock and
included the weighting of the data to allow for different numbers of eligible
women in a house. With the exception of findings related to leaving or stay-
ing in the relationship, no significant differences were found in responses
by location (Auckland, North Waikato) and results were aggregated.
Safety and Ethics Considerations

All interviews were conducted in private (no children above the age of
2 years), and all participants, regardless of whether they disclosed abuse or
not, were provided with a list of support agencies. Ethical and safety rec-
ommendations for research on IPV developed by the WHO were followed
as part of the conduct of the present study (World Health Organization,
2001). Ethics approval was granted by the Human Subjects Ethics
Committee of the University of Auckland (Ref. No. 2002/199).
Results
Who Did Women Tell About the Violence?

Women were asked if they had ever told anyone about their partner’s
behavior. Responses were based on unprompted recall. The majority of
women (76.7%) had told at least one person about their partner’s violence.
Of those who told, 58.3% (n = 416) had told family or friends only, 36.1%
(n = 258) had told both family or friends and formal services; and 5.6% (n =
40) had told formal services without talking to family or friends (Figure 1).
Figure 2 shows in greater detail to whom women spoke about the vio-
lence. Women who had experienced violence most frequently had told
family members, for example, parents (37.4%), or a brother or sister (29%).
Others (7.1%) had told various family members including aunts and uncles,
cousins, and so on. Women also told individuals in professional groups
about the violence. Counselors and other mental health professionals were
disclosed to by 16.4% of abused women. Almost equal proportions had
spoken to the police (12.8%) and to doctors or other health workers
(12.7%). Less than 5% of women discussed the violence with other groups
such as women’s organizations (2.0%), and the women’s refuges (2.3%),
priests and religious leaders (3.0%). Almost one quarter (23.3%) indicated
that they had not told anyone about their partners’ violence.
Logistic regression analyses indicated that there were no differences in per-
centage of women who told about the violence according to their ethnicity or
Figure 1
Number of Women Who Spoke About the Violence to
Formal or Informal Sources of Help
Formal only
N = 40
Formal and informal

N = 258
Informal only
N = 416
Not told anyone

N = 242
the recentness of the violence. Women who experienced severe physical

violence were significantly more likely to have told someone about the
violence (85.5%) when compared with women who experienced exclu-
sively sexual violence (61.1%; OR: 3.7; 95% CI: 2.2-6.7), or when com-
pared with women who experienced moderate physical violence (65.4%;
OR: 3.1, 95% CI: 2.0-4.7).
Who Tried to Help?

For each person that the woman told about the violence, Figure 2 also
shows the percentage of women who reported that the person they told had
tried to help them. In the majority of cases, women reported that they had
received a “helpful” response from between one half and two thirds of
those they had spoken with about the violence. Only the women’s refuge
Figure 2
Who Women Had Told About Their Experience of
IPV and Who Women Reported to Be Helpful,
Represented as a Percentage (n = 956)
Note: IPV = intimate partner violence.
was reported to be helpful by all women who reported having contact with
the agency. Of the women who talked about the violence with her partner’s
family or her children, less then half reported that these individuals tried to
help them. Overall, 40% of women who had experienced IPV reported that
no one tried to help them.
Logistic regression analyses indicated that neither the ethnicity of the
women (p = .52), or the recentness of the violence (p = .41) was associated
with the reported helpfulness of formal services. Similarly, ethnicity (p =
.31) and recentness (p = .88) were not associated with the perceived help-
fulness of informal sources of support.
Agencies Help Sought From and

Satisfaction With Those Agencies
Women were asked “Did you ever go to any of the following for help?”
and a list of agencies was read out to them (prompted recall), along with a
linked question about the woman’s satisfaction with the help given by agen-
cies she had contact with. The list replicates the formal agencies nominated
in the free recall question “who did you tell?” The pattern of responses was
similar, although reported levels of contact with services were higher for the
prompted list (e.g., 25.4% reported having sought help from police, 24.4%
from general practitioners and other health care providers, 13% from mental
health services). Reported levels of satisfaction also varied widely, ranging
from 15.9% satisfaction with the help received from general practitioners and
other health care providers, 21.9% with mental health care providers, and
31.3% satisfaction with police (data not shown).
Reasons Help Not Sought From Formal Services

Women who had not sought help from any formal services (n = 456,
48.7% of the sample) were asked for their reasons. The predominant reason
for not seeking help was that women perceived the violence to be “normal/
or not serious” (63.4%). The next most common reasons were that women
were ashamed or embarrassed (14.0%), and because they “feared the con-
sequences” (6.4%). Ten percent reported that they felt they should deal with
it on their own. All other reasons (e.g., afraid of losing children, believed it
would not help) were reported by less than 5% of the women who had
experienced IPV (data not shown).
Reasons for Seeking Help From Formal Services

Of those who accessed one or more of the formal services (n = 486),
most women reported seeking help because they could not endure more
(48.5%), followed by women who reported that their partner/ex-partner
threatened or tried to kill them (11.3%), they were badly injured by their
partner (15.4%), or were fearful that their partner would kill them (11.4%).
A second cluster of reasons related to concern for children, described as
children suffering (17.2%), or children who had been hit or threatened
(7.9%). Encouragement to leave from friends or family was also reported
(17.7%; Table 1).
Women Who Left

There was a significant difference in proportion of abused women who
left the relationship according to location. Fewer, approximately half (54%)
of abused women in Auckland left, even for one night, compared with the
Waikato, where approximately two thirds (68%) left. Of those who left, a
smaller proportion of women in Auckland indicated that they stayed away
Table 1
Percentage of Women With Lifetime Experience of Physical
and/or Sexual IPV Who Reported Reasons for Asking for
Help With, and for Leaving Violent Relationshipsa
Reasons That Made Reasons for Leaving
You Go for Help the Last Time
(n = 486) Percentage (n = 508) Percentage
(95% CI) (95% CI)
Could not endure more 48.5 (43.6-53.3) 64.2 (59.8-68.6)

Encouraged by friends/family 17.7 (14.0-21.5) 6.7 (4.4-9.0)
Badly injured 15.4 (12.0-18.7) 7.1 (4.2-9.9)
He threatened to kill her 11.3 (8.1-14.5) 10.2 (7.0-13.3)
Afraid he would kill her 11.4 (8.3-14.6) 5.9 (3.8-7.9)
Children suffering 17.2 (13.5-20.9) 8.6 (5.9-11.3)
He threatened or hit children 7.9 (5.2-10.5) 5.0 (3.0-7.0)
She was afraid she would kill him 2.1 (0.8-3.5) 1.2 (0.2-2.2)
She was thrown out of home 2.0 (0.6-3.3) 2.2 (0.7-3.7)
For her mental health/save sanity 8.2 (5.5-10.9) —
To get information/legal help 8.1 (5.5-10.6) —
Encouraged by organization — 1.7 (0.1-3.3)
No particular incident — 5.3 (3.3-7.4)
He was unfaithful — 3.8 (2.1-5.5)
She was pregnant — 1.4 (0.4-2.3)
To have time out/break from relationship — 1.4 (0.3-2.4)
Other 22.4 (18.5-26.2) 8.3 (5.6-10.9)

a
Percentages sum to greater than 100% because individuals could provide multiple
responses.
permanently (37.8%), compared with women in the Waikato (64%; data not
shown).
Reasons women reported for leaving replicated the women’s reasons for
seeking help: they could not endure more (64.2%), their partner/ex-partner
threatened or tried to kill them (10.2%), they were badly injured by their
partner (7.1%), or were fearful that he would kill her (5.9%). A second
cluster of reasons related to concern for children, described as children suf-
fering (8.6%), or the children had been hit or threatened (5.0%). Women
also reported that they left because they were encouraged by friends/family
to leave (6.7%) or by an organization (1.7%). Almost 4% reported that they
left because the partner was unfaithful (Table 1).
Across both locations, approximately half of the women who left stayed
first with her family (53.0%), followed by friends and neighbors (22.8%).
Smaller proportions went to agencies such as women’s refuges (4.9%), or
a hotel or lodgings (6.6%), their partner’s relatives (1.3%), or the street

(2.4%), and 3.5% of women went to other locations (data not shown).
Women who did not return to violent relationships were asked “If you
didn’t return, what were the things that helped you remain separated?” The
most common factor mentioned was family support (54.3%). Financial and
practical matters, such as getting an independent income (21.4%) and get-
ting her own housing (16.7%), were also signaled. Obtaining protection
orders (12.1%) and the assistance of police was also mentioned (8.4%).
10.2% of women reported staying away because of their personal resolve,
expressed as their determination or strength. Women’s refuge support was
signaled by 4.7% of women. “Other” reasons were mentioned by 15.5% of
women (data not shown).
Women Who Stayed

Even though there were regional differences in the proportion of women
who stayed within violent relationships, the women’s reported reasons for
staying were very similar in the two locations and included reasons related
to the woman’s emotional investment in her partner: she loved him (26.1%),
she forgave him (11.8%), she thought he would change (14.5%); reasons
related to the children: couldn’t leave the children (21.3%); reasons related
to the marriage: sanctity of marriage (15.5%), sake of the family (4.5%).
Almost one in three women who stayed in violent relationships reported
that they perceived the violence to be “normal” or not serious. Relatively
small proportions of women reported that their decisions to remain with the
relationship were influenced by financial or other considerations: couldn’t
support children (6.3%), couldn’t support self (6.1%), couldn’t get housing
(1.3%), she felt she had nowhere to go (12.4%). Reasons associated with
social pressures were reported by relatively few: family said to stay (3.2%),
she didn’t want to be single (4.2%; Table 2, column 2).
Why Women Returned

Of the women who left their violent partner and later returned, approxi-
mately 20% returned based on reasons associated with their relationship,
including she loved him (20.6%), she forgave him (17.8%), she thought he
would change (23.8%), he asked her to return (17.8%). Similarly, many
report returning for the “sake of the family” (25.2%) because she couldn’t
leave the children (11.9%) or the sanctity of marriage (9.4%). Much smaller
proportions returned to the relationship for financial or pragmatic reasons
such as being unable to support herself (7.3%), being unable to support the
Table 2
Percentage of Women With Lifetime Experience of Physical
and/or Sexual IPV Who Reported Reasons for Staying
in or Returning to Violent Relationshipsa
Reasons for Staying Reasons for Returning
(n = 319) Percentage (n = 253) Percentage
(95% CI) (95% CI)
Violence normal/not serious 33.2 (27.8-38.5) 2.4 (0.6-4.2)

She loved him 26.1 (20.8-31.3) 20.6 (15.2-26.0)
She thought he would change 14.5 (9.7-19.2) 23.8 (18.3-29.3)
She forgave him 11.8 (7.9-15.8) 17.8 (13.0-22.7)
He asked her to return — 17.8 (12.8-22.8)
Sanctity of marriage 15.5 (11.3-19.7) 9.4 (5.5-13.4)
Sake of family 4.5 (2.3-6.7) 25.2 (19.4-31.0)
Couldn’t leave children 21.3 (16.0-26.1) 11.9 (7.6-16.2)
Nowhere to go/couldn’t stay there 12.4 (8.3-16.4) 4.2 (1.5-6.9)
Couldn’t support children 6.3 (3.5-9.2) 2.4 (1.0-4.3)
Couldn’t support self 6.1 (3.2-8.9) 7.3 (4.0-10.6)
Family said to stay/said to return 3.2 (0.7-5.6) 2.4 (0.4-4.5)
Couldn’t get housing 1.3 (0.0-3.0) 4.2 (1.7-6.7)
Didn’t want to be single 4.2 (1.2-7.2) —
He threatened her/the children 0.8 (0.0-0.2) 2.8 (0.5-5.1)
Other 32.1 (26.9-37.8) 19.6 (12.7-26.0)

a
Percentages sum to greater than 100% because individuals could provide multiple
responses.
children (2.4%), couldn’t stay where she was (4.2%), or couldn’t get hous-
ing (4.2%). A small percentage of women reported returning to the violent
relationship because of a partner’s threats to her and/or her children (2.8%).
Only 2.4% of women indicated that they considered the violence to be
normal/not serious at the time they returned (Table 2).
Discussion
The majority of women who experienced intimate partner violence

(approximately three fourths) reported that they had told someone about the
violence. This finding is in sharp contrast with the majority of sites in the
WHO Multi-Country study in which between one half to two thirds of
victims of IPV had not told anyone about the violence (Garcia-Moreno
et al., 2005; Naved, Azim, Bhuiya, & Persson, 2006), often for reasons of
fear of jeopardizing family honor, or potential stigma that might tarnish the
woman’s own reputation. This indicates that, far from being a secret and
private problem that is not discussed outside of the home, in New Zealand,
many women have talked about their experience of violence by an intimate
partner. However, more than 40% of women indicated that no one had tried
to help them. These findings have important implications for how we
develop and organize our helping responses.
Consistent with previous research, family and friends provided signifi-
cant help to a number of women. This is indicated by the high proportion
of women who reported telling parents, siblings, and other family members
about the violence; the fact that the majority of women who left violent
relationships went first to family members, and by the importance of sup-
portive family responses for remaining out of abusive relationships.
Although not canvassed as part of this study, qualitative data from a sample
of New Zealand women who are now living free from abuse provides
insights into the nature of some of the positive support that family can
provide, including unconditional support, acting as a sounding board, pro-
viding practical support (e.g., with moving house or child care) and assist-
ing the woman to have some time to recover or think situations through
(Hand et al., 2002). Roberts and Schenkman-Roberts (2005), in their
qualitative study of 501 battered women in the United States, document
how family support early in the course of a relationship (e.g., before mar-
riage, cohabitation, or the birth of children) played a crucial role in helping
women to extricate themselves before the violence became an entrenched
pattern. Helpful family responses included encouraging women to seek
legal or emotional/counseling support, providing safe housing, or actively
intervening (e.g., by calling the abuser and telling him to desist his threat-
ening behavior, and outlining potential consequences for him).
However, the present survey also indicates that approximately one third
of victimized women who disclosed experiencing violence to family mem-
bers felt that the person they told about the violence had not tried to help.
Again, qualitative data from other sources provides insight into how some
family dynamics and actions can be actively destructive of women’s safety,
such as through failure to recognize that violence is a problem (e.g., those
who see it “as just the way life is”; Hand et al., 2002). Although it is easy
to see that this response would act to further embed women within the cycle
of violence, it is also possible that unhelpful responses can result from a
lack of the necessary knowledge, skills, or access to the resources required
to marshal appropriate assistance.
Some advocacy groups have recognized the need to support family and
friends to offer appropriate responses and have developed information
resources outlining verbal responses that are helpful (e.g., “no one deserves
to be hit”) and unhelpful (e.g., “What did you do that caused him to hit
you?”), providing information on practical strategies for helping women in
emergencies (e.g., helping her develop exit strategies and plans for what to
do if locked in the house; enlisting help from neighbors, calling the police),
maintaining physical safety, considering safety of children, and legal strat-
egies (e.g., informing her about the existence of protection orders, helping
her plan and execute storage of legal documents and bank records;
Preventing Violence, 2009; Roberts & Schenkman-Roberts, 2005). More
widespread distribution of information of this type through the community
might help to ensure that family and friends are enabled to provide appro-
priate and supportive assistance when women communicate with them
about the violence. Possible mechanisms by which this information might
be distributed include through public awareness campaigns; targeted distri-
bution of information within communities where there is a high prevalence
of violence; and through ensuring that such information is available through
support agencies within the community, including services such as Citizen’s
Advice Bureaus and public libraries.
Importance of Engaging Formal

Systems/Institutions in Responding
Almost half of the women who experienced IPV reported that they had
accessed at least one formal support system, a higher level of system
engagement than reported by most of the other sites from the WHO Multi-
Country study (Garcia-Moreno et al., 2005; Naved et al., 2006). The major-
ity of the women also reported talking about the violence with family and
friends. The range of services women told about the violence reinforces the
importance of having widespread knowledge of IPV and appropriate iden-
tification, assessment, and referral responses to victims embedded in a
variety of generalist services (e.g., mental health settings) and health care
settings (e.g., public and private hospitals, and general practitioners).
Although only a small percentage of victims of IPV reported accessing
specialized violence prevention services such as refuges, or general crisis
services such as police, even small percentages can result in a high volume
of cases, given the high prevalence rates within the population. As a result,
the importance of supporting these services to respond appropriately to
victims of IPV remains a priority and requires continued sustainable levels
of funding, as well as development of, and training in, appropriate institu-
tional responses.
Quality of Response
Approximately half to three fourths of women who accessed formal
services felt that they had received a helpful response. All helpful responses
are important and these percentages show that there is a strong platform on
which to build improvements. However, helpful responses by frontline staff
are most likely to occur when they are embedded in systems that support
these actions through tangible aspects such as policies and practice proto-
cols, and through changes in organizational culture. Although many sectors
(e.g., justice, through establishing police proarrest policies and protection
orders; and health, through developing policy, protocol, and training related
to early identification, risk assessment, and referral for victims) have made
improvements in their response, maintenance of positive changes over time
can be difficult (Fanslow, Norton, & Robinson, 1999). Sustaining desired
improvements requires systemic change (Stenius & Veysey, 2005) and
working to address factors that may diminish effects over time (e.g., staff
turnover, failure to orient new staff policy or guidelines for response, lack
of support for the implementation of best practice by those senior within the
organization). Examples of systemic level responses include institutional
assessments of hospital responses to partner violence and child abuse
(Campbell et al., 2001; Coben, 2002) and institutional audits of court
responses (Pence & McMahon, 2003). Further attention to identifying how
“systems level” factors can be influenced to support helpful responses to
victims would be a promising line of inquiry, if we are to influence quality
of responses that victims receive.
Women who sought help from refuges reported very high levels of per-
ceived helpfulness; however, only a very small proportion of women who
had experienced violence accessed refuges at all. Some of this low access
may be attributable to historical or geographical lack of coverage by the
services. Internal barriers, such as women’s perception that the violence is
not serious enough to warrant contacting the service, may also inhibit con-
tact. Lack of knowledge of the range of services that refuges provide (e.g.,
specialist knowledge of family violence, advice on protection orders, etc.)
might also limit the extent to which refuges are accessed by many of the
women, many of whom may believe that refuges only provide safe housing.
Consideration may need to be given to raising public awareness of the full
range of services that refuges are able to provide. This could be accom-
plished through linking with allied services and the wider community, such
as educating health care providers, who could then provide concrete infor-
mation to women about available services; or providing information to the
human resources department of large workplaces.
In some cases, there were substantial differences in the proportion of

women who reported “telling about their partner’s behavior” and those who
responded to a prompt list of agencies that the women may have sought help
from. Although part of this difference may be accounted for by the method-
ological difference (free recall vs. prompted recall), it is also possible that the
responses to the prompted recall question capture additional contacts, such as
those initiated by someone other than the woman (e.g., neighbors calling the
police). The fact that the majority of women who experienced IPV did not tell
the police, however, emphasizes the importance of extending our responses
to victims beyond crime-based approaches.
Attitudes to Family Violence/Norms

of Behavior/Acceptability
The majority of women who sought help, and the majority of women
who left violent relationships reported doing so because they “could not
endure more.” Where and when this line is drawn will undoubtedly differ
from person to person (akin to the “individual thresholds of seriousness”
reported by Fugate et al., 2005), but factors that may affect it include real-
istic assessments of the man’s behavior and his likelihood of change, and
recognition of the seriousness of the violence they have experienced. Other
commonly reported reasons for leaving and/or seeking help included
because women experienced serious injury or feared for their lives. This
emphasizes that the violence experienced by many women in the context of
intimate relationships is not trivial.
In contrast, the predominant reason for staying in a violent relationship
was because the violence was perceived as “normal or not serious.” Other
research, however, has indicated, that, even in situations where women were
later killed by an intimate partner, only half had accurately predicted the risks
associated with the situation (Campbell, 2004). Some attempts have been
made to develop tools to help women gauge the seriousness or degree of
danger that their partner may pose (Stuart & Campbell, 1989). Greater com-
munity knowledge of potential risk factors associated with violent and con-
trolling relationships, as well as greater public discussion about the content
and value of “healthy” nonviolent relationships might assist in providing
women with reference points about what is “normal” or “endurable.”
Women’s reasons for staying in or returning to violent relationships are
important areas of exploration because they point to issues that need to be
addressed by any intervention program. This study indicated that substan-
tial proportions of women stayed in, or returned to violent relationships
because of emotional investment in their partner. Towns and Adams (2000),

drawing on qualitative data from women who experienced abuse, talked
about how the construction of romantic love, and the roles that we assign
men and women, can serve to further enmesh women in abusive relation-
ships. This was expressed by women through such statements as “if I really
loved him enough, he would be okay.” The substantial proportion of
women from this study who reported that love for the man was their main
reason for staying and/or returning, as well those who reported believing
that the man would change his behavior, suggest that providing women
with realistic tools for assessing the likelihood of their partner’s ability to
change might be of benefit.
Only a small proportion of women reported staying in an abusive rela-
tionship or returning to an abusive relationship because of financial or
practical considerations such as housing. However, when asked about fac-
tors that supported women’s ability to remain out of violent relationships,
factors such as establishing an independent income, or independent housing
were identified more strongly. It is possible these practical factors become
more relevant and salient for women once they have left the relationship.
One of the key strengths of this study is that it is drawn from a general
population sample and can provide information from a cross section of
women who have experienced intimate partner violence, not only those who
have sought help through refuges or other formal help-seeking agencies. As
such it provides information on a broader spectrum of help-seeking behavior
than has been available from previous studies utilizing clinical samples.
However, there are also limitations to the use of cross-sectional data. Data of
this type may be subject to recall bias, with individuals who have left violent
relationships possibly forgetting or reconstructing information about who
they have spoken to. It may also fail to capture or compress information
about the process of help-seeking, which may change over time or over the
course of the relationship (e.g., as individuals seek help first from family,
then from more formal agencies; Strube, 1988). However, despite these
limitations, there is significant value in the overview provided by this infor-
mation, as it suggests new areas for strategic action in informing family and
friends of the need for appropriate responses, which might be tailored to dif-
ferent stages of women’s help-seeking process (e.g., at first disclosure, help
and support following leaving). It also reinforces the need for continuing
improvement in response by those sectors that have also already engaged on
the issues (e.g., police, health).
Beyond these intervention activities, however, we need to recognize that
the population prevalence of intimate partner violence is so high we will
never be able to provide services to all victims, all perpetrators, and all
children who encounter IPV even if we increase the number of women
seeking help. If we truly wish to prevent the problem, we will have to invest
in broader-based efforts to change community and societal level beliefs
about the roles of women and men and about the nature of relationships.
Currently, efforts to create community-based primary prevention initiatives
include developing responses in other sectors, such as in faith-communities
(Levitt & Ware, 2006); the education sector (Foshee et al., 2004); and
within workplaces (Family Violence Prevention Fund, 2009); as well as
through government funding to support coordination of community-based
activities (Ministry of Social Development, 2009). These activities show
promise; but only ongoing tracking of the problem over time will enable us
to determine if, collectively, they are successful at prevention.
Conclusion
In contrast to other parts of the world, it is clear that intimate partner

violence in New Zealand is not really a private and secret matter. As three
quarters of abused women told someone that they had experienced violence
from a partner, the challenge becomes less about getting people to talk
about the problem and more about establishing and maintaining mecha-
nisms to ensure women receive the help they need, when they need it. The
fact that 40% of abused women reported that no one had tried to help them
suggests that we are currently a long way from achieving this aim. Action
for the future could profitably address innovative responses to educate fam-
ily and friends in supportive responses and ensure that our formal services
have high quality, sustainable, response systems in place. Further efforts to
identify the most helpful responses to women who disclose the experience
of partner violence, and efforts to disseminate this information widely
through the community, may assist women to access appropriate help in a
timely fashion. At the community level, encouraging discussion about the
seriousness and lack of normality of violence within intimate relationships
might support women to seek help earlier and support active responses
from family and friends.
Note
1. This was the largest group who did not speak English.
References
Arriaga, X., & Capezza, N. (2005). Targets of partner violence: The importance of understand-
ing coping trajectories. Journal of Interpersonal Violence, 20(1), 89-99.
Campbell, J. C. (2002). Health consequences of intimate partner violence. The Lancet, 359,
1331-1336.
Campbell, J. C. (2004). Helping women understand their risk in situation of intimate partner
violence. Journal of Interpersonal Violence, 19, 1464-1477.
Campbell, J. C., Coben, J. H., McLoughlin, E., Dearwater, S., Nah, G., Glass, N., et al. (2001).
An evaluation of a system-change training model to improve emergency department
response to battered women. Academic Emergency Medicine, 8(2), 131-138
Coben, J. H. (2002, November). Measuring the quality of hospital-based domestic violence
programs. Academic Emergency Medicine, 9, 1176-1183.
Family Violence Prevention Fund. (2009). The Workplace and Domestic Violence. Retrieved
May 21, 2009, from http://endabuse.org/section/programs/workplace
Fanslow, J. L., Norton, R. N., & Robinson, E. M. (1999, August). One year follow-up of an
emergency department protocol for abused women. Australian and New Zealand Journal
of Public Health, 23, 418-420.
Fanslow, J. L., & Robinson, E. (2004). Violence against women in New Zealand: Prevalence
and health consequences. New Zealand Medical Journal, 117, 1173.
Foshee, V., Bauman, K., Ennett, S., Linder, F., Benefield, T., & Suchindran, C. (2004).
Assessing the long-term effects of the Safe Dates Program and a booster in preventing and
reducing adolescent dating violence victimization and perpetration. American Journal of
Public Health, 94, 619-624.
Fugate, M., Landis, L., Riordan, K., Naureckas, S., & Engel, B. (2005). Barriers to domestic
violence help seeking. Violence Against Women, 11, 290-310.
Garcia-Moreno, C., Jansen, H. A. F. M., Ellsberg, M., Heise, L., & Watts, C. (2005). WHO
Multi-Country Study on Women’s Health and Domestic Violence against Women: Initial
Results on Prevalence, Health Outcomes and Women’s Responses. Geneva: World Health
Organization.
Garcia-Moreno, C., Jansen, H. A. F. M., Ellsberg, M., Heise, L., Watts, C. H., & WHO Multi-
Country Study on Women’s Health and Domestic Violence against Women Study Team.
(2006). Prevalence of intimate partner violence: Findings from the WHO Multi-Country
Study on Women’s Health and Domestic Violence. Lancet, 368, 1260-1269.
Hand, J., Elizabeth, V., Martin, B., Rauwhero, Y. H., Burton, M., Shelby, S., et al. (2002). Free
from abuse: What women say and what can be done, New Zealand: Public Health
Promotion, Auckland District Health Board.
Heise, L., & Chapman, J. R. (1992). Reflections on a movement: The U.S. battle against
women abuse. In M. Schuler (Ed.), Freedom from violence: Women’s strategies from
around the world (pp. 257-294). New York: United Nations Development Fund for
Women (UNIFEM).
Kaukinen, C. (2002). The help-seeking decisions of violent crime victims: An examination of
the direct and conditional effects of gender and the victim offender relationship. Journal
of Interpersonal Violence, 17, 434-456.
Kaukinen, C. (2004). The help-seeking strategies of female violent-crime victims: The
direct and conditional effects of race and the victim–offender relationship. Journal of
Interpersonal Violence, 19, 967-990.
Krug, E., Dahlberg, L. L., Mercy, J. A., Zwi, A., & Lozano, R. (Eds.). (2002). World report on
violence and health. Geneva, Switzerland: World Health Organization. Retrieved May 3,
2009, from http://www.who.int/violence_injury_prevention/violence/world_report/en/
full_en.pdf
Landenburger, K. (1989). A process of entrapment in and recovery from an abusive relation-
ship. Issues in Mental Health Nursing, 10, 209-227.
Lempert. L. B. (1997). The other side of help: Negative effects of the help-seeking processes
of abused women. Qualitative Sociology, 20, 289-309.
Levitt, H. M., & Ware, K. (2006). “Anything with two heads is a monster”: Religious leaders’
perspectives on marital equality and domestic violence. Violence Against Women, 12,
1169-1190.
Ministry of Social Development. (2009). Community action fund to prevent domestic violence.
Retrieved May 3, 2009, from http://www.familyservices.govt.nz/our-work/preventing-
violence/community-action.html
Naved, R. T., Azim, S., Bhuiya, A., & Persson, L. A. (2006). Physical violence by husbands:
Magnitude, disclosure, and help-seeking behavior of women in Bangladesh. Social
Science & Medicine, 62, 2917-2929.
Pence, E., & McMahon, M. (2003). Working from inside and outside institutions: How safety
audits can help courts’ decision making around domestic violence and child maltreatment.
Juvenile and Family Court Journal, 54(4), 133-147.
Pescosolido, B. (1992). Beyond rational choice: The social dynamics of how people seek help.
American Journal of Sociology, 97, 1096-1138.
Preventing Violence in the Home. (2009). Help for a Friend/Family Member. Retrieved May
21, 2009, from http://www.preventingviolence.org.nz/index.php?section=37
Roberts, A. R., & Schenkman-Roberts, B. (2005). Ending intimate abuse: Practical guidance
and survival strategies. New York: Oxford University Press.
Rusbult, C. E., & Martz, J. M. (1995). Remaining in an abusive relationship: An investment
model analysis of nonvoluntary dependence. Personality and Social Psychology Bulletin,
21, 558-571.
Stenius, V. M. K, & Veysey, B. M. (2005). “It’s the little things”: Women, trauma and strate-
gies for healing. Journal of Interpersonal Violence, 20, 1155-1174.
Stuart, E. P., & Campbell, J. C. (1989). Assessment of patterns of dangerousness with battered
women. Issues in Mental Health Nursing, 10, 245-260.
Strube, M. (1988). The decision to leave an abusive relationship: Empirical evidence and
theoretical issues. Psychological Bulletin, 104, 236-250.
Towns, A., & Adams, P. (2000). “If I loved him enough, he would be okay”: Women’s
accounts of male partner violence. Violence Against Women, 6, 558-585.
Waldrop, A. E., & Resick, P. A. (2004). Coping among adult female victims of domestic vio-
lence. Journal of Family Violence, 19, 291-302.
World Health Organization. (2001). Putting women first: Ethical and safety recommendations
for research on domestic violence against women. Geneva, Switzerland: Author. WHO/
FCH/GWH/01.1. Retrieved May 3, 2009, from http://www.who.int/gender/violence/
womenfirtseng.pdf
Janet L. Fanslow, PhD, is a senior lecturer in mental health promotion at the School of
Population Health, University of Auckland, in Auckland, New Zealand. Her research interests
include epidemiological studies of violence against women and health care provider response
to victims of intimate partner violence.
Elizabeth M. Robinson, MSc, is a senior research fellow in the Biostatistics Unit at the School
of Population Health, University of Auckland, in Auckland, New Zealand. Her work is primarily
in the design and analyses of methodologies commonly used in medical research such as sample
surveys, case control studies, and cohort studies as well as in the use of new statistical methods
such as generalized linear mixed models that are appropriate for correlated data.
For reprints and permission queries, please visit SAGE’s Web site at http://www
.sagepub.com/journalsPermissions.nav

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Article Journal of Interpersonal

Efforts to understand and support the process of help seeking by victims of

Keywords: violence against women; domestic violence; help seeking; New

G lobally the problem of violence against women is no longer in doubt,

Characteristics of the Relationship

Response From Others

Sampling Strategy, Participants, and Response Rate

Study (a replication of the World Health Organization [WHO] Multi-Country

the Conflict Tactics Scale by asking respondents about their experience of

Response Rate and Sample Size

Safety and Ethics Considerations

Who Did Women Tell About the Violence?

Formal and informal

Not told anyone

the recentness of the violence. Women who experienced severe physical

Who Tried to Help?

Note: IPV = intimate partner violence.

Agencies Help Sought From and

Reasons Help Not Sought From Formal Services

Reasons for Seeking Help From Formal Services

Women Who Left

Could not endure more 48.5 (43.6-53.3) 64.2 (59.8-68.6)

Note: IPV = intimate partner violence.

a hotel or lodgings (6.6%), their partner’s relatives (1.3%), or the street

Women Who Stayed

Why Women Returned

Violence normal/not serious 33.2 (27.8-38.5) 2.4 (0.6-4.2)

Note: IPV = intimate partner violence.

The majority of women who experienced intimate partner violence

Importance of Engaging Formal

In some cases, there were substantial differences in the proportion of

Attitudes to Family Violence/Norms

because of emotional investment in their partner. Towns and Adams (2000),

In contrast to other parts of the world, it is clear that intimate partner

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