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Barriers to male victims accessing formal support services

While some male victims of non-sexual and non-domestic violence may experience a range of significant and negative consequences as a result of their victimisation, the literature and findings from stakeholder consultations suggest a large proportion of male victims may not be accessing formal support services following an incidence of violence. For many men, this is probably because they do not actually need formal support. Others, however, who may benefit from contact with formal support services, do not do so. The perceived and actual barriers to men engaging with formal support services that were raised by stakeholders and/or suggested in the literature are discussed here. Some of these barriers are quite specific to men, whereas others are more generic yet potentially more potent for men in combination with other, recognised obstacles.

Personal and social barriers to male victims engaging with formal support services

Men set up their own barriers and boundaries (Service provider personal communication September 2012)

In describing the personal and social barriers that may inhibit male victims from seeking formal support, it is important that generalisations about male responses are not liberally applied. Nonetheless (and while stakeholders were hesitant about supporting generalities), there was agreement that social norms about what it means to be a man, privacy concerns and knowledge about the availability of victim support contributed as much as systematic barriers in discouraging contact with formal support.

Social norms and the concept of shame

Men, as observed by one stakeholder, were ‘victims of endemic machismo’ (Service provider personal communication September 2012). The effect was an unwillingness by some men to show any weakness, a default response of putting on a ‘tough front’ and a consequent denial of need for support, either informal or formal. Stakeholders attributed this trend in part to strong social interpretations of masculinity within some cultural groups. However, it should not be assumed that gender constructs only apply to men from backgrounds with acknowledged or overt cultural norms about masculinity, as they were just as valid for men (eg young men) from other social or cultural backgrounds.

Tied to male reticence about seeking support is the concept of shame. Again, the effect that shame can elicit on both male responses to victimisation and their help-seeking behaviour was largely identified as being more acute among Indigenous or CALD (eg Pacific, Middle Eastern, Sudanese) men but certainly not absent among other adult male victims. This shame originated from the experience of victimisation (ie being in circumstances where they were ‘helpless’ and unable to ‘protect themselves’ or others (Service providers personal communication September 2012)), compounded by self, family and/or social disapproval about perceived inability to cope and possible need for assistance. Indeed, shame was almost universally cited among the stakeholders interviewed as a highly influential constraint.

Help-seeking behaviour

The literature on help-seeking behaviour was shown in an earlier section of this report to be limited and the findings inconsistent. What emerged from the consultations, however, was a view that some men were less inclined to look for victim support and were less likely to know where to look.

Men don’t know where to turn to (Service provider personal communication September 2012).

Indeed, it was suggested that men’s denial of need for support required the use of external prompting to encourage contact with victim support services. As one (male) service provider observed:

This macho bullshit…means that men won’t go and find services themselves, they need to be referred (Service provider personal communication September 2012).

Men may deflect attention away from their support needs by focusing the service provider’s efforts towards their family members. As one stakeholder observed ‘[a] bloke feels obliged to put himself in the backseat and focus attention on everyone else’ (Service provider personal communication October 2012). One of a few examples provided by stakeholders was that of an elderly man whose relative had been a victim of a homicide. This man, who saw his position as the ‘protector’ of the family and contended that any support should be provided to the sister of the deceased, in spite of the service provider’s opinion that the man was the one more in need of support (Service provider personal communication September 2012). It was mentioned in the previous section that female relatives sometimes take it on upon themselves to enquire about services for male victims, often because they know their male relative will not make that step.

Interestingly, a few service providers suggested that male victims may be more willing to engage in support services if they came in the guise of structured and purposeful activity, such as Men’s Sheds and other forms of male cooperatives. Some men may be disinclined to seek or respond to support services if it is provided in conventional formats (eg one-to-one counselling) but more willing in situations where support is an outcome rather than the focus of the activity. These cooperatives were likened to ‘group therapy over a cup of tea’ (Service provider personal communication October 2012) and in a sense, represent an alternate way for male victims to respond to and cope with the effects of their victimisation. This feedback is supported by the literature, which suggested that

many men define themselves via their work, often feeling more comfortable in the workplace than in health oriented settings such as community health centres, hospitals, maternal and child health centres and general practices (Malcher 2009: 92).

This observation sheds some light on why men may be more comfortable undertaking structured activities that are underpinned by therapeutic principles and aims, rather than engaging with services that are easily identifiable as having a health or support focus.

Past experience and trust

Past experience and trust was nominated by stakeholders as a possible contributory factor in low reporting rates to police for male victims of non-sexual and non-domestic violence, and were suggested again when explaining disconnection from formal support. The consequence of past experience with Australian victim support services, unfortunately, was not raised and hence cannot be expanded upon here.

Stakeholder discussion of the effect of previous experience and trust generally referred to what individuals had been exposed to outside of Australia, which translated into fear or suspicion of local authority, such as law enforcement and potentially government-sponsored support services. This was potentially more potent among refugees and persons from countries characterised by civil unrest or where law enforcement operated less ethically. In some cases, one stakeholder explained, the professionals or service providers who had worked with refugees in their country of birth or while in transit had been involved in that person’s mistreatment (Service provider personal communication September 2012). The mistreatment, and its impact on other traumas experienced, sometimes meant male refugee clients withdrew or did not engage with the support services being offered to them in Australia.

More locally based trust issues, particularly with the police and other government services, were suggested as potentially affecting Indigenous male victims’ willingness to engage with victim support. If the support offered was perceived as being in some way connected to the police, however tenuous the link, then men were potentially less likely to engage with the service. Yet stakeholders also highlighted the importance of this first contact between the victim and police, suggesting that it was critical for the establishment of trust in the broader criminal justice system and in turn, victim engagement with formal support services. In situations where male victims felt the police did not take the matter seriously or assumed they were in some way responsible for their victimisation, trust may be irrevocably broken and formal engagement lost.

Small community and cultural effects

The small community effect is not exclusive to men but may interact with other more recognisably male-specific barriers to influence choice about engaging with support services. ‘Small communities’ is used here to refer to small population groups resident in regional and remote areas of New South Wales (eg ‘small country towns’) and/or members of specific community groups (typically but not exclusively Indigenous and CALD communities).

The protection of privacy and confidentiality is a significant factor in whether victims of violent crime (be they men or women) choose to report the incident to police and if they choose to consult with support services, either independently or where referred. Fears about a breach of privacy may be considerable when victims are experiencing shame, there is the risk of reprisal or social condemnation for reporting the matter and/or there is the risk of misunderstanding from the family or peer group about using victim support services. Stakeholders who worked in regional settings or who had contact with male victims from regional and remote parts of New South Wales noted that the limited number of services available outside of Sydney almost certainly added to concerns among some male victims that the nature of their victimisation or their use of formal support, even from General Practitioners, could become more widely known. In other words, ‘your business inevitably became everyone else’s business’.

Fear of exposure was similarly recognised for men from communities in which the acceptance of support per se and support from outside the immediate family or peer group was an ‘unfamiliar way of doing things’ (Service provider personal communication September 2012). Such social/cultural pressures have already been discussed in shaping men’s responses to victimisation. In this context, men may be worried about the judgement they will receive from the family and possibly the community if they acknowledge their victim status (Service provider personal communication September 2012).

Often contiguous with fear or distrust of police described above is community censure. These social effects are not unique to men but cultural constructs around solidarity could enact stronger pressures to comply with what the community expects.

It was observed that members of some communities are fearful of reporting because community mores, be they broadly held or stipulated by a smaller group of influential elements, make it ‘highly dangerous’ for them to interact with the police. These scenarios generally refer to the risk of reprisal from the offender(s) or their associates and family members if contact with the police is made. Community censure also encompasses disapproval of making a complaint (in this case, reporting a matter to the police) against another member of the community. It was acknowledged, for example, that among Indigenous communities ‘you don’t go to the police and “dog” another Indigenous person’ (Service provider personal communication September 2012). This maxim was felt so strongly in the community this stakeholder worked with that the majority of male victim witnesses they encountered only rarely were providing evidence against an Indigenous defendant. In other words, there was an apparent and significant reticence to report a violent offence committed by another Indigenous person, particularly if they were from among the victim’s immediate community.

Transient lifestyle

A small number of stakeholders highlighted the effect of transient lifestyles on retention rates with support services among men. Young Indigenous men, for example, often travel back and forth between different parts of the state, making it difficult for them to stay connected with formal support services. In such situations, services may have to eventually disengage with the client. For men leading transient lifestyles who wish to access or maintain some form of formal support, flexible options of service provision may be difficult to find. One service provider recounted their experience trying to organise counselling for one male victim who was moving around the state. The client wanted to access counselling over the phone, but did not want to call a service such as Lifeline. The service provider attempted to locate a counsellor who would be willing to provide their services over the phone but was unsuccessful.

Structural/systematic barriers to engaging male victims in formal support services

Structural and systematic barriers encompass broader issues of availability, accessibility and appropriateness which are common themes when discussing service provision.

Non-identification

It was suggested that generally speaking, men have not been seen as a priority for victim support services. This has led, according to a number of stakeholders, to unevenness in the focus of service provision and a prevailing belief among some court partners and service providers that male victims are more capable of coping with their victimisation than women. Consequently, male victims of violence who potentially would have benefitted from being referred to a formal support service may not be. This oversight prompted one service provider to produce a pamphlet specifically for male victims after an assessment that there was little information available to this group of victims (Service provider personal communication September 2012).

In particular, a number of service providers observed that the kinds of support and assistance they could offer victims attending court were in part influenced by the gender of the victim. As one court-based service provider argued:

If you’re a female victim of violence I can put you in a safe room, offer you a cup of tea and a biscuit and three support workers will be there. You don’t even have to be a victim of actual violence as long as you have an AVO [Apprehended Violence Order] you are protected from seeing the offender and their family. If you’re a male victim I’ve got nothing for you. I can give you a newspaper and that’s about it…There’s a huge difference between the services that are there for women and men (Service provider personal communication September 2012).

The main example provided by stakeholders in relation to this issue concerned the use of ‘safe rooms’. Safe rooms are areas situated within court facilities that have been allocated to victims and witnesses of crime so they do not have to sit in the court or the general waiting area. A number of stakeholders noted that being asked to sit in court or the general waiting area could be stressful for victims, particularly if they were afraid or nervous about seeing the perpetrator and their family. Although the availability of safe rooms differs between courts, it appears that most safe rooms are for the exclusive use of women. Consequently, male victims have little option but to sit in the court or the waiting area.

That being said, a number of stakeholders argued that court partners, service providers and the police are adept at identifying high-needs male victims when they came into contact with them. Victims often identified as requiring assistance were characterised as showing signs of emotional distress and agitation, needing constant reassurance and not appearing to have informal support such as family and friends. Service providers noted that court partners had demonstrated a willingness to refer these high-needs victims to formal support services. This suggests, however, that male victims who do not exhibit these behaviours may not be identified by court partners and service providers and therefore referred. In these circumstances, it may be difficult for the court partner or service provider to recognise need for additional support, unless interaction with the victim after the initial contact is for some reason continued and/or evidence of need for support is demonstrated through some other means.

Service provider priority areas

As noted in previous sections of this report, some of the victim support services that are currently available in New South Wales focus their resources on a small number of priority crime types and victim groups. This means that in practice, male victims who do not fall into these priority areas may not be referred to specific formal support programs. For example, one program operating in New South Wales focuses on male and female victims of sexual and domestic violence, and children victim/witnesses. Thus, this service usually had few male victims of non-sexual and non-domestic violence on its client lists.

Resource issues and a high demand for services are common factors in the establishment of provider priority areas and violent crimes that are collectively seen as particularly serious will justifiably be the focus of support attention. However, it does mean that in practice male victims of non-sexual and non-domestic violence are often not prioritised by these services and may have fewer options to receive formal support and assistance.

Limitations of support services currently available

While there are a range of services that male victims of non-sexual and non-domestic violence may engage with, there are a number of limitations associated with these programs that may act as specific barriers to this group of victims. First, as presented in Table 4, not all NSW services are available across the state, with most operating in metropolitan Sydney and larger regional centres. Male victims attending court or residing in areas not covered by these services have fewer options for engaging with services. Stakeholders said this was a particular issue in regional and remote areas. Men living in these areas often had only one of two options—their General Practitioner or telephone-based referral and support. Similarly, many court support services are only located in one level of court, typically the local courts. While there are notable exceptions to this rule (eg Mission Australia Court Support Service and the DPP WAS), some male victims attending district or higher courts may not have access to similar levels of support.

Of the victim support services operating in New South Wales, there is currently a lack of services that address the needs of men and specific groups of male victims. MensLine is the only male-specific service available, but its focus is on men experiencing familial and relationship issues, rather than victim support per se. Male victims of sexual assault have some options open to them but services for other male victims of violence were described as ‘generally lacking’ in the state (Service provider personal communication September 2012).

Finally, there appears to be a shortage of services for specific groups of men who are perceived as being particularly vulnerable, either because of their victimisation or because they may sit outside mainstream service provision. For example, the lack of targeted services for homosexual men was highlighted by a number of stakeholders, who noted that this may act as a barrier to homosexual male victims engaging with formal support services. Communication barriers for victims who do not have English as their first language, combined with identified problems about the availability and proficiency of translators, was raised too, although as an issue for CALD communities more generally rather than men specifically.

The scarcity of culturally appropriate services for Indigenous victims in New South Wales, particularly in regional areas, was another concern. One of the reasons for this shortage was the emphasis of attention on offenders and ‘getting them back on track’ (Service provider personal communication September 2012). Hence, the bulk of culturally appropriate support services for Indigenous victims in New South Wales are undertaken by a relatively small group of support workers. Where appropriate services were not available, support workers had to refer their clients to mainstream services, which were not necessarily suitable for some of their male clients. For example, one service provider attributed their clients’ reluctance to accept referrals to the reason that ‘black men do not want to talk about how they feel with white women’ (Service provider personal communication September 2012).

The experiences of this service provider and others referred to throughout this report, is supported by a broader body of literature that has found that many health services currently operating in Indigenous communities are not culturally appropriate for their target population. One of the most common explanations for this gap is that Western understandings and conceptions of health issues, particularly mental illness, are at odds with those held by Indigenous communities (see Vicary & Bishop 2005, Vicary & Westerman 2004; Ypinazar et al. 2007 for an overview of these differences). For example, many Indigenous communities believe that feelings of distress, depression and anxiety are caused by a ‘spiritual or law transgression’ (Vicary & Bishop 2005: 11), or spending too much time away from country, rather than a discrete disease or traumatic event (eg experiencing violence). As a result of this gap, many Indigenous persons prefer traditional methods of healing and will only approach Western services when they have exhausted all other options (Vicary & Bishop 2005).

In light of the disparities, commentators have increasingly emphasised the importance of Indigenous services being culturally competent—services that integrate the ‘practitioner’s cultural awareness and knowledge into the clinical context’ (Berry & Crowe 2009: 7). Culturally appropriate practices that have been identified in relation to the Australian Indigenous population include the use of cultural consultants (Indigenous persons who are willing to vouch for non-Indigenous practitioners), non-direct questioning of patients by practitioners, assessing patients within the context of their culture, family and community, and encouraging practitioners to develop a thorough understanding of the family, tribal and skin groups living in the area (Berry & Crowe 2009; Westerman 2004).

Another culturally competent practice that is relevant to the current research concerns the gender of practitioners and service providers. Research indicates that Indigenous persons are raised to relate to and interact with other people of their own gender (Westerman 2004). Indigenous men may not engage with services staffed predominantly by women. However, the suggestion that Indigenous men may prefer to engage with male practitioners was not unique to this group.

As mentioned earlier, all of the support services consulted as part of this project were staffed predominantly by women. Many stakeholders did not perceive the female-dominated support workforce as being a particular barrier for male victims seeking assistance, yet a small number acknowledged that it had caused some issues. Occasionally, male victims specifically asked to speak to a man, a request they sometimes found logistically difficult to accommodate. Further, some service providers said that from time to time they had difficulty interacting with male clients and had wondered whether a male support worker would have been more appropriate. In debating the relative merits of male and female support persons’ responses to male victims of violence, it was suggested that male support workers may be better at normalising victims’ feelings of fear and shame and reinstating their perceived masculinity. Conversely, some stakeholders argued that men may be able to approach women with an expectation of support and emotional comfort. Men may be reluctant to appear vulnerable in front of another man.