Think back to the last time you visited a doctor. Among the many routine questions you were asked at intake, do you remember being asked if you feel safe at home?
Most hospitals and healthcare organizations in Dallas/Fort Worth have policies in place that dictate screening all patients for domestic violence.[*] However, in practice, many healthcare professionals are not trained in trauma-informed methods for screening, and the few questions related to intimate partner violence (IPV) may be easily overlooked in the midst of an extensive intake process. This means that screening for IPV often looks like:
- Asking leading questions, such as, “You feel safe at home, right?”
- Asking about safety while your partner is in the room with you
- Not making eye contact with the patient while screening for IPV
- Skipping IPV screening questions entirely because circumstances do not appear to be to be IPV-related
At Genesis, we work with countless dedicated healthcare providers who recognize the significant impact of domestic violence on their patients’ health and wellness and want to help. Unfortunately, in many healthcare organizations (HCOs), insufficient staff training leads to very few “positive” screens for domestic violence and countless missed opportunities for intervention.
Medical visits are often the only opportunity a victim has to disclose their abuse and seek help, and effective screening can save lives.
The Dallas County Intimate Partner Violence Fatality Review Team’s 2009-2013 Case Review Report found that of the 76 individuals killed by their intimate partner within those five years, only 30% sought police or legal interventions prior to their death, and only one victim sought domestic violence services while in the relationship with the perpetrator. However, almost every person who was killed as a result of IPV had visited a healthcare professional at least once during their relationship with the perpetrator. We also know that victims of IPV are 92% more likely than non-victims to utilize the healthcare system,[†] and when victims do disclose abuse to their healthcare provider, they are much more likely to seek further intervention.[‡]
To this end, in 2017, a consortium of concerned healthcare professionals came together to form the Dallas-Fort Worth Intimate Partner Violence Coalition (DFW IPV Coalition), which collects data and offers trainings in order to increase the effectiveness of healthcare professionals’ responses to IPV in the metroplex. It is crucial that we involve healthcare organizations as an integral partner in our fight to reduce IPV homicides.
Best Practices for Domestic Violence Screening in Healthcare Organizations:
- Screen ALL patients, regardless of age or gender
- Screen at EVERY point of contact, regardless of current circumstances (clinics, Emergency Departments, admissions, day surgery, etc.)
- Train staff on trauma-informed methods for supporting patients who are victims of abuse
- Know the resources in your community, and refer often
Reach out to a DFW IPV Coalition member today to learn more about how your hospital, primary care physician, or other HCO can increase the effectiveness of domestic violence screenings and save lives.
Written by Brooke Meyer, director of programs, Conference on Crimes Against Women
*The Joint Commission on Accreditation of Healthcare Organizations (JCHAO) has created a standard related to IPV assessments with patients and documentation to identify and refer possible victims of abuse or neglect (The Joint Commission Standard PC.01.02.09, 2014). The standard requires that hospitals must implement policies and procedures for identifying and assessing possible victims of abuse and neglect.
[†] Wisner, CL, Gilmer, TP, Saltzman, LE, Zink, TM (1999) Intimate partner violence against women: Do victims cost health plans more? Journal of Family Practice, 48: 439-443.
[‡] McCLoskey, LA, Lichter E, Williams, C, Gerber M, Wittenberg E, Ganz M. (2006). Assessing Intimate Partner Violence in Health Care Settings Leads to Women’s Receipt of Interventions and Improved Health. Public Health Reporter, 121(4):435-444.