Screening for and counseling women exposed to intimate partner violence (IPV) is part of the free preventive services covered within the U.S. Affordable Care Act, but changes in the healthcare delivery system are needed to achieve this across diverse clinical settings and to improve health outcomes. This issue was the focal point of 2013 Intimate Partner Violence Screening and Counseling Research Symposium hosted by the U.S. Department of Health and Human Services, Office on Women’s Health. This symposium brought together researchers, medical practitioners, federal agency staff, and other stakeholders to identify gaps in research on screening and counseling for IPV in primary health care settings.
The meeting identified priorities for future research which include a novel systems approach to implementing IPV screening and counseling, and a special focus on interventions for substance-using women which are presented in two articles that are part of a special section on IPV published in Journal of Women’s Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The articles are available free on the Journal of Women’s Health website.
In the article “Integrating Intimate Partner Violence Assessment and Intervention into Healthcare in the United States: A Systems Approach”, Elizabeth Miller, MD, PhD, University of Pittsburgh Medical Center, Brigid McCaw, MD, MPH, Kaiser Permanente, Betsy Humphreys, MLS, National Library of Medicine, and Connie Mitchell, MD, MPH, California Department of Public Health, describe a systems approach that combines health and advocacy services to support the identification and transition to care for women exposed to IPV. The approach benefits from the use of electronic health records and partnerships with various service and advocacy providers.
The article “Identifying and Intervening with Substance-Using Women Exposed to Intimate Partner Violence: Phenomenology, Comorbidities, and Integrated Approaches within Primary Care and Other Agency Settings” focuses on women suffering from substance-use and substance disorders who are exposed to IPV and HIV. Terri Weaver, PhD, Saint Louis University, Louisa Gilbert, PhD and Nabila El-Bassel, PhD, Columbia University School of Social Work, Heidi Resnick, PhD, Medical University of South Carolina, and Samia Noursi, PhD, National Institute on Drug Abuse, U.S. National Institutes of Health, discuss the mental health and physical illnesses that may often co-occur in these individuals, and the difficulties they present for screening and intervention efforts. They also offer recommendations to fill the gaps identified in the existing research.
What is domestic and intimate partner violence?
Domestic violence is when one person in a relationship purposely hurts another person physically or emotionally. Domestic violence is also called intimate partner violence because it often is caused by a husband, ex-husband, boyfriend, or ex-boyfriend. Women also can be abusers.
People of all races, education levels, and ages experience domestic abuse. In the United States, more than 5 million women are abused by an intimate partner each year.
Domestic violence includes:
- Physical abuse like hitting, shoving, kicking, biting, or throwing things
- Emotional abuse like yelling, controlling what you do, or threatening to cause serious problems for you
- Sexual abuse like forcing you to do something sexual you don’t want to do
Here are some key points about domestic and intimate partner violence:
- If you are in immediate danger, you can call 911. It is possible for the police to arrest an abuser and to escort you and your children to a safe place. Learn more about getting help for domestic abuse.
- Often, abuse starts as emotional abuse and then becomes physical later. It’s important to get help early.
- Sometimes it is hard to know if you are being abused. You can learn more about signs of abuse.
- Your partner may try to make you feel like the abuse is your fault. Remember that you cannot make someone mistreat you. The abuser is responsible for his or her behavior. Abuse can be a way for your partner to try to have control over you.
- Violence can cause serious physical and emotional problems, including depression and post-traumatic stress disorder. It’s important to try to take care of your health. And if you are using drugs or alcohol to cope with abuse, get help.
- There probably will be times when your partner is very kind. Unfortunately, abusers often begin the mistreatment again after these periods of calm. In fact, over time, abuse often gets worse, not better. Even if your partner promises to stop the abuse, make sure to learn about hotlines and other ways to get help for abuse.
- An abusive partner needs to get help from a mental health professional. But even if he or she gets help, the abuse may not stop.
Being hurt by someone close to you is awful. Reach out for support from family, friends, and community organizations.
“We are very pleased to publish this special section in the Journal focusing on intimate partner violence, and we are grateful to our Guest Editors Dr. Noursi and Lisa Begg, DrPH from the National Institutes of Health,” says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women’s Health, Executive Director of the Virginia Commonwealth University Institute for Women’s Health, Richmond, VA, and President of the Academy of Women’s Health.
About the Journal
Journal of Women’s Health, published monthly, is a core multidisciplinary journal dedicated to the diseases and conditions that hold greater risk for or are more prevalent among women, as well as diseases that present differently in women. The Journal covers the latest advances and clinical applications of new diagnostic procedures and therapeutic protocols for the prevention and management of women’s healthcare issues. Complete tables of content and a sample issue may be viewed on the Journal of Women’s Health website. Journal of Women’s Health is the official journal of the Academy of Women’s Health and the Society for Women’s Health Research.
About the Academy
Academy of Women’s Health is an interdisciplinary, international association of physicians, nurses, and other health professionals who work across the broad field of women’s health, providing its members with up-to-date advances and options in clinical care that will enable the best outcomes for their women patients. The Academy’s focus includes the dissemination of translational research and evidence-based practices for disease prevention, diagnosis, and treatment of women across the lifespan. Journal of Women’s Health and the Academy of Women’s Health are co-presenters of Women’s Health 2015: The 23rd Annual Congress which will take place April 16-19, 2015 in Washington, DC.
WHAT ARE THE RISK FACTORS FOR INTIMATE PARTNER VIOLENCE?
Many factors have been linked to a man’s risk of physically assaulting an intimate partner, including: young age low income low academic achievement involvement in aggressive or delinquent behaviour as an adolescent.
A history of violence in the male partner’s family (particularly having seen his own mother beaten or having experienced violence as a child) and growing up in an impoverished family are also important factors related to perpetrating partner violence.
Many studies find excessive alcohol use to be strongly associated with perpetrating partner violence, though there is debate as to whether heavy drinking causes men to be violent or whether it is used to excuse violent behaviour.
Certain personality factors - including insecurity, low self-esteem, depression and aggressive or antisocial personality disorders - are linked to partner violence, as are factors such as discord or conflict in the marital relationship.
Women are particularly vulnerable to abuse by their partners in societies where there are marked inequalities between men and women, rigid gender roles, cultural norms that support a man’s right to inflict violence on his intimate partner, and weak sanctions against such behaviour.
About the Publisher
Mary Ann Liebert, Inc., publishers is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Violence and Gender, LGBT Health, Population Health Management, and Breastfeeding Medicine. Its biotechnology trade magazine, Genetic Engineering & Biotechnology News (GEN), was the first in its field and is today the industry’s most widely read publication worldwide. A complete list of the firm’s 80 journals, books, and newsmagazines is available on the Mary Ann Liebert, Inc., publishers website.
Journal - Journal of Women’s Health