We all have specific images that come to mind when we hear the term intimate partner violence or the more widely used term domestic violence. Common pictures include women suffering under the control and abuse of their husbands, men who
We all have specific images that come to mind when we hear the term intimate partner violence or the more widely used term domestic violence. Common pictures include women suffering under the control and abuse of their husbands, men who are subjected to verbal and physical abuse by their partners and the emotional trauma suffered by children who witness these acts in the home.
The National Institute of Justice and Centers for Disease Control estimates that between 20 percent and 30 percent of women and 7.5 percent of men will be the victim of IPV at some point in their lives. Up to 10 million violent home-based episodes per year are witnessed by children. These shocking statistics, along with the long-term effect in the community easily add up to IPV being a public health crisis.
We all know IPV occurs on our seemingly beautiful island — most of the time behind closed doors where the violence can go on for years, harming all involved and very often continuing an insidious cycle that the children in the household may unconsciously carry into their own adult relationships. Very often outside family members and friends are either in denial of the abuse, somehow accept it as “normal,” simply do not “see it,” or are intimidated into not intervening. Those who do step up and offer assistance to the victim can get frustrated when things don’t change right away.
This is why a public health movement on the island of Kaua‘i needs to occur. Victims of this abuse present a multitude of health problems. This includes not only direct injuries from the violent acts they have sustained but neck/back pain, chronic ulcers, headaches/migraines, gynecological problems, arthritis/joint problems, pregnancy complications, irritable bowel syndrome and digestion issues. In addition, victims have higher rates of HIV and sexually transmitted diseases than the rest of the population. Psychologically, rates of depression, anxiety, post traumatic stress disorder, homicide, suicide and substance abuse are higher in victims of IPV abuse. Consequences can continue for years following the end of the abuse. These problems can result in ongoing issues that cost our island millions of dollars per year in emergency and on-going medical care as well as the “hidden” costs passed on to our children. Our health care and social service system here on Kaua‘i has the ability to play an important role in helping to stop this violent cycle.
Sooner or later most individuals will seek out medical or social service care in some form, be it a school physical, hospital visit (whether injuries form abuse are present or not), dentist appointments, or counseling sessions. While some health care/social service organizations have taken the initiative to offer tips to their employees and volunteers for identifying IPV and strategies for referring those clients, few have created formal guidelines and protocols to screen and intervene in these situations.
Additionally, facilities that should be prepared to identify and respond to IPV victims include all of those in public health settings, substance abuse centers, schools, rehab/occupational settings, and social service non-profits (after school programs, foster care agencies, parenting programs etc).
Standardized confidential screening of everyone for IPV at all health care/social service facilities on our island could go a long way in addressing IPV issues. Research indicates that routine face-to-face inquiry by skilled service providers can identify victims much more efficiently than a question on a form. Providers also need to be given the tools to assist in assessing the victim’s specific situation including appropriate referrals for intervention and care to take place. Even when a patient does not disclose abuse the first time they are asked, repeated screening allows for future opportunities to disclose and creates a supportive environment where an eventual disclosure will feel “safe.”
There is no question that domestic violence/intimate partner violence is a profound public health issue. We as a small island community have the opportunity to share resources between organizations and offer a continuity of care that may not be available in larger communities. It is up to each of us who works or volunteers for a health related organization to raise these issues and request any help needed to put these important steps in place. One example, is the recent partnership between the YWCA and Malama Pono; Kaua‘i AIDS Project. This collaboration has led to the cross training of staff that will ensure that the potential effects of IPV and HIV/AIDS issues are addressed in both organizations. This teamwork can provide a model for other organizations to adopt.
The YWCA of Kaua‘i for many years has provided essential services to victims of abuse with a 24 hour crisis hotline and family violence shelter. Additional YWCA programs that address violence include on-going sexual assault treatment and alternatives to violence counseling. Prevention programs are also offered in the schools and through a network of community organizations.
The YWCA of Kaua‘i invites you as an individual or as an organization to please take the time during the National YWCA annual Week Without Violence (Oct. 18-24) to ask your health care provider or place of work what they are doing to address domestic violence as a public health issue. The YWCA Annual Candlelight Vigil was Wednesday at St. Michael’s Church. For more information on services or how your organization can help address these issues call the YWCA at 245-5959 or call 245-6362 for crisis services.
• Dr. Kat Scarbo is the prevention education/youth services coordinator for YWCA Kaua‘i.
