Vulnerability, victims and violence.

The burden on accident and emergency (A&E) departments of dealing with the aftermath of violence has increased substantially in the last 10 years. Both the underlying causes and the effects on the injured are multifaceted. It is important that clinicians who treat the injured know which interventions, like early family support and preschool education, are effective in preventing violence. It is also important to target those who will benefit from interventions to prevent, for example, serious psychological sequelae or further alcohol related harm. As with child protection, the organisation of services for adults needs to be built on teamwork with other agencies, particularly so that the injured are assessed for risk of future harm and are given opportunities to report offences to the police if they wish. Up to now, the contribution of A&E doctors to dealing with violence has been largely reactive. This policy paper argues that since many of the underlying causes and circumstances of violence can be modified, a more proactive, interagency approach would be effective in the fight against violence.