It is well known that experiencing domestic violence (DV) can cause significant psychological trauma. However, it is less well recognised that the assaults that occur in DV (e.g. blows to the head, non-fatal strangulation) can cause physiological trauma in the form of brain injury, with serious short and long-term effects on psychological, cognitive, and physical functioning. These injuries can seriously impact the victim-survivor’s quality of life and functional outcomes, and lead to poorer interactions with healthcare, justice, and other systems, both during acute/emergency responses and in the long-term. For example, when a victim-survivor is concussed, they may have difficulty recalling events, or appear agitated when talking to police. This can lead to perceptions of unreliability, reducing the likelihood of charges and/or subsequent convictions being made. It is therefore important that both the psychological and physiological trauma caused by brain injury in DV are recognised when victim-survivors interact with systems and service providers. To explore this issue, in 2025 I travelled to the USA and Canada on a Churchill Fellowship, visiting healthcare providers, women’s shelters, courts, prisons, research centres, and talking to victim-survivors, to observe how service providers are responding to brain injury in the context of DV. This talk draws on my learnings from that research trip, to highlight that for victim-survivors of DV, separating mental and physical trauma is often impossible, and a holistic trauma informed approach that recognises both psychological and physiological trauma is needed. I will outline a number of practical and cost-effective ways in which health, justice and other systems can provide a comprehensive trauma-informed approach when working with victim-survivors, which have the potential to improve victim survivors experience of these systems, and also lead to more effective collection of evidence and information. Real world examples of good practice will be also be presented.