The Intersection of Intimate Partner Violence and Traumatic Brain Injury: Findings From an Emergency Summit Addressing System-Level Changes to Better Support Women Survivors

Abstract

Background: Traumatic brain injury (TBI) occurring during intimate partner violence (IPV) is a largely unrecognized but significant public health crisis. One in 3 women will experience IPV in their lifetime, up to 75% of whom will sustain a TBI as a result. This article reports on the systems-level findings from a national summit to address barriers, needs, and priorities related to healthcare and support services for women survivors of IPV-TBI. Objectives: (1) To identify key needs, facilitators, and barriers to care for women survivors of IPV presenting with TBI; and (2) to cocreate ideas for resources and principles for identification, clinical care, and support for healthcare practitioners who treat women exposed to IPV and TBI. Methods: Using a community-based participatory research approach, we engaged 30 stakeholders-drawn from a national IPV-TBI Knowledge-to-Practice (K2P) Network including diverse

“I Don’t Think It’s on Anyone’s Radar”: The Workforce and System Barriers to Healthcare for Indigenous Women Following a Traumatic Brain Injury Acquired through Violence in Remote Australia

“…The remote healthcare services are further challenged by the well-documented, longstanding issues associated with healthcare provision in remote areas in Australia and elsewhere including workforce turnover [ 40 , 41 , 42 , 43 ], combined with few neuropsychologist services. None of the service providers involved with the project had completed TBI education, and this is likely to be a shared experience across service sectors who work closely with women who experience violence as has been identified in other settler colonial countries such as Canada [ 27 , 44 ]. Lastly, few community-based service providers routinely pre-screen for potential TBI [ 18 , 45 ].…”

“…It is assumed that there are similar distributions for neuropsychologists, considering the relatively low numbers practising nationally (around 5% of all psychologists) [ 26 ]. TBI studies conducted with service providers in other similar settler nations described “massive chasms” within systems that prevent First Nations women from timely TBI pre-screening and diagnosis [ 27 ]. Lack of adequate community infrastructure, low levels of access to primary healthcare, community health centres and hospitals, and the costs associated with neuropsychologist assessments were some of the major barriers for First Nations women accessing healthcare and specialist care [ 27 ].…”

“…TBI studies conducted with service providers in other similar settler nations described “massive chasms” within systems that prevent First Nations women from timely TBI pre-screening and diagnosis [ 27 ]. Lack of adequate community infrastructure, low levels of access to primary healthcare, community health centres and hospitals, and the costs associated with neuropsychologist assessments were some of the major barriers for First Nations women accessing healthcare and specialist care [ 27 ]. Resource barriers can be coupled with racist and prejudiced assumptions made by staff about First Nations peoples who access medical healthcare for a TBI, which can in turn create further barriers to access and use of service systems [ 15 , 27 ].…”

Exploring the intersection of brain injury and mental health in survivors of intimate partner violence: A scoping review

“…For example, in April 2020, the Government of Canada acknowledged IPV as a critical problem, exacerbated by COVID-19, and invested $207.5 million to support organizations addressing homelessness and women experiencing gender-based violence (79). Given the system-wide barriers and challenges identified with respect to the IPV-BI intersection overall (80), more research in this area could help target future investments to the areas with the greatest impact.…”

Brain Injury and Intimate Partner Violence

“…Two studies addressed the impact on service users and providers of IPV during the COVID-19 pandemic-one study from the perspective of survivors, executive directors/managers, frontline workers, and employer/union representatives, 17 and the other from an emergency summit that involved a diverse set of stakeholders from a national IPV-TBI Knowledge to Practice Network. 18 These studies report increased rates and severity of IPV, increased risks and complex challenges to mental health for service providers, as well as impact on employment for survivors. Key priorities identified include flexibility and adaptability of services through the use of technology; increased outreach; trauma-informed, anti-racist, equitable systems of care; the need for cross-pollination of knowledge between disciplines; and integrated and coordinated care at the system level.…”