Fig. 1

Five steps for deciding how to respond as a health provider when you suspect someone is a victim of violence, abuse, neglect or exploitation (VANE). This figure is based on the identification, support and referral protocol in the Netherlands; [6,7,8] other countries may have their own protocols that may differ from the one described here. In the Netherlands, the organization with a legal mandate to 1) provide advice on domestic violence or child abuse and 2) arrange referral when needed, is “Veilig Thuis”, meaning “Safe at Home”. Whenever possible, ‘reporting’ should be done with the consent of the patient, but when the health provider is of the opinion there is acute and/or structural unsafety, he/she may be justified or even obligated to break confidentiality and report the situation to this organization against the wishes of the patient