The type of assault that carries a huge risk factor for homicide

Women were overwhelmingly the victims of non-fatal strangulation, making up 90 per cent of those who presented to the territory's clinical forensic service. More than 40 per cent of victims believed they would die during the assault.

Children were also present in 28 per cent of cases where a woman had been strangled and the perpetrator was either a partner or ex-partner in more than 80 per cent of the cases.

The findings have been presented in new research which examined non-sexual assaults that had been referred to Clinical Forensics ACT.

The research looked at all cases referred by police between 2018 and 2022.

Of the 315 cases, 170 were victims of non-fatal strangulation. The majority of the strangulation victims, 153, were women. Sixteen were men and one person had "another preferred term".

Men were the perpetrator in 161 of the cases and most, 104, were in a relationship with their victim. Thirty-five were an ex-partner and 17 were a family member.

Repeated assaults by the same perpetrator were common and happened in 109 of the cases.

"Repeated instances of NFS increase the likelihood of life-threatening and fatal [non-fatal strangulation]," the research paper said.

The research was conducted with Canberra Health Services, the Australian National University and ACT Policing.

Canberra Health Services clinical forensic medical services director Vanita Parekh was a lead researcher. She pointed to other research which showed it was a major risk factor for subsequent homicide.

Research from the United States showed a person who had experienced non-fatal strangulation by a partner was 750 per cent more likely to be killed by that person.

Dr Parekh said other research had shown more than 50 per cent of women who had died in a domestic violence situation had experienced non-fatal strangulation prior to their death.

"We need to get on top of this because it is a risk factor for homicide," she said.

"Perpetrators of strangulation are known to be involved in other crimes as well."

Dr Parekh was alarmed at the number of children who had seen their mothers being strangled.

"That has major ramifications for these kids because if you experience violence as a child you're much more likely to become an adult victim of domestic violence or actually become a perpetrator," she said.

The research said the number of children who had witnessed the act showed a coordinated approach from police, health and education authorities was needed for early intervention.

Unlike other assaults, alcohol was not a main risk factor in non-fatal strangulation.

A majority of the women who presented at Clinical Forensics ACT did so after-hours. Dr Parekh said this reaffirmed the need for 24-hour services.

"We do offer a 24-hour services and it's really important that's funded appropriately with experienced clinicians, doctors and nurses," she said.

A majority of victims had presented to police in the immediate hours after the non-fatal strangulation assault had occurred. Dr Parekh said this could be due to the fact a high proportion believed they would die during the assault.

There was a risk when people presented later of not having enough forensic evidence to collect to show non-fatal strangulation had occurred.

"If you're too early you might not have any injuries. If you come in too late the injuries might have disappeared. And from other research we're doing a lot of those injuries are pretty quick to heal," Dr Parekh said.

Dr Parekh said in about 40 to 50 per cent of non-fatal strangulations there were no visible physical injuries and this is what made it so insidious.

"If you leave no marks ... it's part of the control mechanisms," she said.