Domestic Abuse & NHS Reform: Are Survivors Still Falling Through the Gaps?

December 18, 2025Roger Hughes

The UK government promises trauma-informed care and millions in funding — but is real support reaching those who need it most? Explore what’s missing, why EMDR works, and what survivors are still up against in 2025.

Trauma Isn’t Just About Violence — It’s About What Happens After

Recent headlines highlight the UK government's new “Steps to Safety” initiative — a policy backed by £50 million and a goal to make trauma-informed support available nationwide by 2029. But while this looks good on paper, many working directly with survivors — including myself — know there’s still a gap between policy and lived experience. Most survivors aren’t just healing from violent events. They’re healing from the aftermath: the delays, the disbelief, the overwhelming sense that the system isn’t built to contain trauma. True trauma-informed care doesn’t begin with paperwork — it begins with understanding the human nervous system. That means recognising the signs of shutdown, hypervigilance, emotional spirals, and flashback-driven reactions. Without that grounding, any support offered risks becoming surface-level, even harmful.

The NHS Plan: Good Intentions, Uneven Delivery

The government promises faster referrals, better-trained staff, and equal access across regions to eliminate the postcode lottery. But in practice, service quality remains inconsistent. Some areas are well resourced with specialist teams, while others are still referring survivors to underfunded third-sector charities. This isn’t just inconvenient — it’s a critical safety issue. A trauma-informed label only matters if the clinicians involved are equipped to understand what trauma actually looks and sounds like. At present, trauma training is not standardised across NHS services. That means some GPs and clinicians still miss key signs of emotional trauma, coercive control, or complex PTSD.

What Gets Missed: Psychological and Invisible Abuse

As a trauma therapist, I see what’s often missed by traditional services: emotional abuse, coercive dynamics, chronic gaslighting, and silent forms of harm. These are not always visible — but they are just as destructive. Many of my clients struggle not with a violent memory, but with a long-term erosion of self-worth, autonomy, and safety. The scars of control, criticism, and neglect often run deeper than bruises. Trauma-informed support needs to account for these forms of abuse, or it risks retraumatising the very people it's meant to help.

The Gender Gap Still Holds

The current strategy rightly focuses on violence against women and girls, but male survivors continue to fall through the cracks. Over 700,000 men in England and Wales reported domestic abuse last year. Yet very few specialist services exist for them, and societal stigma keeps many silent. Support groups, refuge spaces, and frontline services are still predominantly female-oriented — leaving male survivors feeling unseen or unwelcome. Trauma doesn’t discriminate by gender. Neither should support.

Christmas, Crisis and System Strain

The blog also highlights how trauma surges seasonally. December, in particular, sees spikes in domestic abuse due to holiday stress, financial pressure, and increased alcohol use. Many survivors are triggered during this period, yet services are often closed or under-resourced. Support systems must account for this annual pressure point — trauma doesn’t pause because it’s Christmas. It intensifies. And when services aren’t equipped, survivors are left to weather a storm alone.

Why “Trauma-Informed” Must Mean More Than a Buzzword

Trauma-informed care is becoming a trendy phrase, but too often it’s used without substance. A service isn’t trauma-informed just because the term appears in its brochure. For it to mean something, it must shape staff training, clinical supervision, policies, and how clients are treated from their first contact through to discharge. Being trauma-informed means understanding how trauma shows up — not just what it’s called. Without embodied, educated practice, the label is hollow.

The Role of EMDR and Online Access

My own practice offers EMDR therapy online — a modality backed by decades of research and widely recognised for its success with PTSD, complex trauma, and emotional dysregulation. EMDR doesn’t require clients to retell every detail of their trauma. It allows for reprocessing without being overwhelmed. For many survivors — especially those struggling to speak about what happened — this is a lifeline. Online therapy offers not just convenience, but a real sense of safety. Clients can engage in stabilisation and healing from their own environment, with full confidentiality and control.

Final Word: The System Is Moving — But Survivors Deserve More

The NHS plan is a welcome step, but it doesn’t go far enough. Real trauma-informed care requires more than money. It demands deep training, structural honesty, and consistent support that recognises the nervous system’s reality — not just the psychological story. Until that happens, survivors will continue to feel like they’re navigating a system that doesn’t fully see or understand them. Healing is possible. But it requires a system that doesn’t just promise to help — it needs to be built to do so.

👉 Read the full article: https://rogerhughes.org/2025/12/18/trauma-truth-and-the-nhs-domestic-abuse-support-is-changing-but-is-it-really-enough/

References:
Domestic violence statistics and gender breakdown – Office for National Statistics. (2023).
https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/domesticabuseprevalenceandtrendsenglandandwales/yearendingmarch2023
Mankind Initiative – Support and statistics for male domestic abuse victims.
https://www.mankind.org.uk
Refuge – National network of refuges for women and children.
https://refuge.org.uk
SafeLives – Insights on coercive control and abuse dynamics.
https://safelives.org.uk
UK Government “Steps to Safety” announcement – GOV.UK (Dec 2025).
https://www.gov.uk/government/news/abuse-victims-to-get-specialist-nhs-support
Why domestic violence increases at Christmas – DVACT.
https://www.dvact.org/post/why-does-domestic-violence-increase-over-christmas
Confronting the surge in abuse over holidays – DRN Law.
https://www.drnlaw.co.uk/confronting-the-surge-in-domestic-abuse-over-christmas
World Health Organization – Gendered patterns in domestic abuse.
https://www.who.int/news-room/fact-sheets/detail/violence-against-women