Can a Health Clinic-Based Intervention Increase Safety in Abused Women? Results from a Pilot Study

Abstract

The results of this study and others indicate the potential usefulness of screening and intervention in a medical setting.

Relationship of Physical Intimate Partner Violence with Mental Health Diagnoses in the Nationwide Emergency Department Sample

“…45 Despite the JCAHO mandate, less than half of US EDs report having policies and procedures in place for IPV screening, and even fewer EDs regularly ask about mental health problems in women identified as IPV victims. 40,45,78 A bidirectional association 31 has been previously suggested between IPV history and costly mental health problems 45 such as symptoms of depression, 79-81 PTSD, 82,83 suicidality, [84][85][86] and substance abuse. [87][88][89] In a recent study of women enrolled in the Group Health Cooperative, IPV exposure was specifically linked to excessive utilization of mental health services.…”

“…[37][38][39] Among women identified in primary care or emergency departments (EDs), 37%-50% reported lifetime physical violence and 36%-72% lifetime nonphysical violence, with 10%-18% reporting physical violence and 28%-44% reporting nonphysical violence in the past year. [40][41][42][43][44] Women with a history of IPV were shown to utilize healthcare services (including primary care and EDs) for injuries and physical and mental health problems nearly twice as often as women with no history of IPV, 37,45,46 highlighting opportunities for IPV screening by healthcare providers. The Centers for Disease Control and Prevention estimates annual IPV-related costs among women at $5.8 billion (with $4.0 billion in healthcare costs).…”

“…37,48 Routine screening for identification and treatment of IPV by healthcare providers can potentially reduce the burden of IPV and its associated health problems on individuals, families, the healthcare system, and society as a whole. 40 According to the US Preventive Services Task Force (USPSTF), high-quality evidence supporting IPV screening in primary care and EDs as a safe and effective strategy for the prevention of IPV and its associated health outcomes remains inconclusive 40,49 with recently conducted intervention trials yielding inconsistent findings. While the USPSTF and other organizations have recommended screening of reproductive aged women for IPV in various healthcare settings, 31 the Joint Commission on Accreditation of Healthcare Organizations ( JCAHO) requires all EDs to have policies and procedures in place for IPV screening and patients who disclose IPV can be treated or referred to services, which address healthcare needs associated with IPV.…”

Applying the Social Ecological Model to Violence against Women with Disabilities

“…This finding suggests the usefulness of screening for IPV in health care clinics and well as intervening with counseling if screened positive for IPV [37].…”

“…In a study conducted in a health care clinic by Gillum, Sun, and Woods, women who screened positive for IPV that received brochures containing health information and a list of community resources along with a monthly phone call regarding contact information were significantly less likely to engage in safety-promoting behaviors compared to women who received an on-site counseling session and six follow-up counseling sessions over the phone [37]. This finding suggests the usefulness of screening for IPV in health care clinics and well as intervening with counseling if screened positive for IPV [37].…”