Safeguarding People With Multiple Sclerosis From Domestic Violence

• A/Prof Claudia Marck

  claudia.marck@unimelb.edu.au
  

Project Details

This program of work led by A/Prof Claudia Marck addresses a critical and under-recognised public health concern affecting people with MS by establishing the evidence base for identifying and responding to domestic violence in clinical practice. This work is in collaboration with the MS Domestic Violence and Abuse Research Initiative (https://msdva.leeds.ac.uk/ ) in Leeds, UK led by Prof Helen Ford. The project team consists of people with lived experience, MS clinicians, family violence experts, and MS researchers. Our poster presentation at RIMS/ECTRIMS in Barcelona in 2025 won best poster prize.

The research recognises that people with MS face compounded vulnerability to domestic violence due to converging risk factors including the typical age of MS onset coinciding with peak years for intimate partner violence, the physical and cognitive disabilities associated with MS, social isolation, reduced employment, financial dependency, and reliance on informal caregivers. Research suggests that up to 63% of people with MS may experience domestic violence in various forms including financial, psychological, physical, sexual, and coercive abuse, yet domestic violence remains significantly under-detected and underreported in MS clinical care.

A toolkit developed by the Leeds MS DVA research initiative proposes practical, evidence-based strategies for neurology clinicians to routinely assess patients at risk through normalised enquiries conducted in private clinical settings, validate disclosures through nonjudgmental and supportive responses, assess immediate risk of serious harm, respond with appropriate safety planning and referrals to specialist services, and carefully document disclosures according to local safeguarding policies. The research emphasises that neurology clinicians are well positioned to implement these assessment strategies and reduce risk for ongoing violence through establishing coordinated support networks.

As a first step towards this, a study funded by the Melbourne Disability Institute in 2025 identified substantial barriers to Australian MS clinicians’ preparedness to identify and address domestic violence. Barriers included lack of knowledge about what constitutes domestic violence, its prevalence and risk factors, unfamiliarity with disability-inclusive domestic violence services and local protocols, and concerns about vicarious trauma. It was identified that the next steps require developing and piloting a co-designed social needs screening tool tailored for MS care, accompanied by comprehensive implementation resources including referral pathways and algorithms. The research emphasises establishing dedicated care coordination roles such as social workers or link workers to streamline follow-up, creating centralised resource portals to help clinicians and patients access services, and generating local evidence demonstrating the impact of screening on health outcomes and healthcare utilisation. The authors stress that successful implementation depends on stakeholder co-design, alignment with national policy frameworks, and sustained commitment from both clinicians and organisations to build knowledge and establish locally tailored safeguarding protocols.

Publications

1.        Marck CH, Learmonth Y, Hollomotz A, Ford HL. Safeguarding people with multiple sclerosis from domestic violence. JAMA Neurology. 2026 (accepted);

2.        Marck CH, Hawkins M, Ayton D,  Sutherland G, Kavanagh A, Dunlop D, Fallis R, Hunter M, Burke T, Kalincik T, Klaic M, Corbett E, Learmonth Y. Australian clinicians’ preparedness for identifying and managing experiences of violence in patients with multiple sclerosis: A qualitative evaluation. Mult Scler. 2025;31(3_suppl). doi:10.1177/13524585251358344