The tree of prevention : understanding the relationship between the primary, secondary, and tertiary prevention of violence against women

This chapter introduces the “Tree of Prevention” as a conceptual model of the relationship between the primary, secondary, and tertiary types of prevention of men’s violence against women or, as is the term used predominantly throughout this wider collection, DFV. Traditionally, responses to DFV have focused on the tertiary end of the prevention spectrum; that is, supporting victims/survivors and, as the previous chapter explored, holding perpetrators to account. A smaller range of programs and initiatives are in place to address the needs of individuals and groups who are at increased risk of perpetrating or experiencing violence, which are forms of secondary prevention. Finally, the primary prevention of DFV, which aims to prevent violence before it occurs, has become a national priority in recent years. Australian agencies such as VicHealth (2007) and Our Watch (2015, 2018) have been at the forefront of the development of primary prevention frameworks in the area of DFV. These frameworks identify high-level risk factors that can be reduced over time through changes to public policy, social attitudes and practices that promote gender equality and women’s security. While primary prevention activities are understood as conceptually distinct from secondary and tertiary interventions, in practice, the delivery of primary prevention activities occurs frequently in institutional and community contexts and service systems in which secondary and tertiary interventions are also taking place. Despite this, the relationship between primary, secondary and tertiary prevention activities has, to date, been under-examined. To explore this relationship, the Tree of Prevention model presents primary, secondary and tertiary prevention as an interdependent system that is strengthened through investment across all levels of prevention. It encompasses the promotion of conducive social environments, policy settings, and service responses; effective prevention programs; early intervention for at-risk groups; stepped responses to victims/survivors and perpetrators according to their level of need and risk; and community mobilisation and development. Using the tree model, workers, agencies and policymakers can assess the relative “health” of the prevention system in their area or state, identifying areas of weakness and building on areas of strength. The tree model also expands on available points of engagement and activity for men and boys in their contribution to prevention. This chapter, and the Tree of Prevention model overall, is intended to operate in dialogue with Chapter 1 in this collection, which explored conceptualisations of accountability as they operate in the PI system. These chapters challenge conventional delineations between prevention at one end and intervention or, specifically, perpetrator accountability, at the other. Instead, these chapters and the other studies within this collection highlight the interdependent nature of fundamental preconditions to the prevention of DFV and the effectiveness of any interventions or responses which a system might deliver. The earlier chapter works backwards from PI systems “activity” to the preconditions in which this activity must be situated for accountability objectives to be met. This chapter works forwards from these preconditions for prevention which must be present in and on the ground, through the structural roots and then into the trunk for any interventions or responses at the tertiary end to be effective to any meaningful extent