One in four U.S. women has experienced violence by a partner at some point in her life. Domestic violence (DV), also referred to as intimate partner violence (IPV) or relationship abuse, can have long-lasting effects on the health and well-being of individuals, families, and communities.

Research shows that survivors of DV across all lines of race, socio-economic status, gender, sexuality, and other factors, experience increased rates of many health issues, including hypertension, depression, asthma, and unplanned pregnancy. So, where do we start to prevent and treat such a pervasive issue?

There are thousands of lifesaving DV organizations, hotlines, advocates, and shelters making efforts to end relationship violence across the country but many survivors suffer in silence because they are not able or are too afraid to access services. Some don’t even know that such services exist. Our question is, how do we support survivor health and safety while also preventing violence? We start with the healthcare system.

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7 meaningful ways healthcare can respond to domestic violence

• Talk to patients about healthy relationships—and not-so-healthy relationships

We know that when health providers talk to patients about abuse, survivors are four times more likely to use an intervention. Clinicians, therefore, have an important opportunity during clinical visits to support their patients who are experiencing abusive relationships and prevent violence. But what can that look like in practice? Many providers already integrate DV screening questions into their visits, but is there a way to go one step further? The answer is yes. They can help make the connection between DV and health.

• Educate all patients about the connection between DV and health

Health centers participating in the Improving Health Outcomes Through Violence Prevention Pilot Project found that when providers offer universal education about the intersections of healthy relationships, those that aren’t, and how they affect health, the conversation was normalized and patients were not required to disclose violence in order to get access to services and information, increasing safety and empowerment for survivors.

• Use tools that make it easier to adopt an evidence-based approach

Developed by Futures Without Violence, safety cards are an easy-to-use patient education tool used to help start this conversation and connect patients with services. Small and discreet, these cards can help patients recognize how their intimate relationship may impact their health and the health of others while providing information for safety planning and referrals. There are different types of safety cards specifically tailored to different health settings and communities.

• Bring a universal education approach to health centers

Setting specific training for all health workers—from the front desk to physicians—promotes team-based care that is a part of success in sustaining a comprehensive response to DV. 

• Collaborate with DV advocates

Healthcare and DV service providers are natural partners due to their shared mission to improve the health, wellness, and safety of communities. Many healthcare providers partner with DV agencies to integrate healthcare and domestic violence response systems. These collaborative partnerships are a crucial step in supporting survivors.

DV agencies help healthcare providers address key social determinants of DV to develop prevention and intervention strategies. These partnerships can also create links to an extensive network of DV services that may not be provided in medical settings, such as emergency shelter or legal services.

Advocates and health providers involved in the Domestic Violence Health Care Partnership (DVCHP) have been working to create additional access points for survivor support and violence prevention, and promote new partners to create a connected system of care for patients.

Center for Community Solutions in San Diego, California has partnered with Planned Parenthood of the Pacific Southwest to offer DV services in clinics across the area. Through this partnership, the two agencies worked to host training for all staff on how to address DV in health settings. Collaborations like these strengthen healthcare’s response to violence and ensure survivor health and safety.

• Help patients get enrolled in health coverage

Open enrollment is November 1st-December 15^th! Having access to affordable, quality healthcare is crucial for survivors and their families. Help make sure that your patients get access to affordable coverage that will support survivor health and safety. Did you know that before the existence of the Affordable Care Act (ACA), some insurance companies used to consider medical treatment related to DV a pre-existing condition that would exclude survivors from getting insurance? Did you know that DV screening and counseling are covered services under the ACA? Support your patients in enrolling by December 15^th by telling them to check out healthcare.gov and cuidadodesalud.gov/es/.

• Take care of yourself first

Lastly, the old saying “you can’t pour from an empty cup” exists for a reason. How can we support other people through traumatic experiences when we have not sought healing for ourselves? We know that health workers are also affected by domestic and sexual violence as well as other forms of trauma—through personal experiences and by talking to patients. A crucial step in addressing violence for your patients is to take care of yourself first by examining your own relationship histories and thinking of ways you can support your own healing.

 

The bottom line

The health and social effects of DV can be long-lasting and severe. Because DV survivors are often present in the healthcare system, health professionals are uniquely positioned to serve an important role in addressing DV. By partnering with DV advocates, educating all patients about the health effects of violence, ensuring healthcare access for survivors, and taking care of yourself, you are on your way to preventing violence and supporting survivors!