Let’s Talk About Strangulation


In June 2022, strangulation and suffocation became stand-alone offences. This is a huge step forward in recognising the seriousness of strangulation and the potential harm to victims/survivors.

There has, to this point, been a focus on how criminal justice agencies respond to the new legislation. We know that, for many different reasons, not all victims/survivors will choose to report to the police. Instead, those who have been subjected to strangulation, for instance in the context of an abusive relationship, may choose to disclose this to specialist domestic abuse or sexual violence services, or perhaps primary or emergency health care settings.

Conversely, some who experience strangulation (sometimes referred to as ‘choking’) – for instance in the context of consensual sex – will not see themselves as victims of this behaviour, but as willing participants. We, at the Institute for Addressing Strangulation (IFAS), have become increasingly aware of the normalisation of sexual choking/strangulation, particularly, but not exclusively, amongst young people. Experiences will most likely not be disclosed in the same way as the abusive behaviours outlined above, if they are disclosed at all.

Whilst the presentation of strangulation may differ, the mechanism that restricts blood flow to the brain, tends to be the same. At IFAS, we are clear that regardless of context, the risks associated with strangulation are the same and could include brain injury and death. We are also conscious that these risks may not be widely known or understood by those who experience strangulation. It is important that people understand the risks, even if they are participating in strangulation/choking willingly, so that they can make an informed decision to participate or not.

Given these differences in the presentation of strangulation, those who experience this behaviour may share this information within a variety of settings including, acute, primary, and specialist healthcare services, social care, education, criminal justice, and specialist services (e.g., domestic abuse and sexual violence). Additionally presentation may not be via only one route.

IFAS believes that a ‘whole system approach’ is required to understand the public health challenges to address the normalisation of strangulation and reduce the immediate, medium, and long term physical and psychological impacts of strangulation.

This is not a new recommendation. The Victim and Prisoners Bill places a statutory duty on Police and Crime Commissioners (PCCs), Integrated Care Boards (ICBs) and local authorities to work together when commissioning support services for victims of domestic abuse, sexual abuse and other serious violence. This recognises the need for a shared understanding of what support is available or required to improve strategic coordination across local areas.

IFAS was established to raise awareness of the risks of strangulation to frontline professionals and the general population. We are aware that those who experience strangulation may present to any one or a number of agencies. Those who experience strangulation may identify as a victim or survivor, some will not. IFAS is calling for a whole system approach to better understand and address the public health issues related to strangulation, regardless of context.

We need you to collect strangulation data to better inform us of the prevalence in domestic abuse and sexual violence relationships and non abusive relationships. We will support you to address the specific needs of your service and create resources for those all circumstances, with a focus on both effective responses and preventative measures.


By CEO, Bernie Ryan

Published 27 June 2024


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