Identifying Barriers to Domestic Violence Screening, Detection, & Disclosure

Domestic Violence is serious social issue that thrives in silence (Steiner, Ted Talk). It is defined by the Women’s Aid UK, as “Physical, psychological, sexual or financial violence that takes place within an intimate or family-type relationship and that forms a pattern of coercive and controlling behavior, which may include a range of abusive behaviors, not all of which are in themselves inherently ‘violent’ (Laing, & Humphrey p. 4). Statistics show that women are often the victims of DV while men are often the perpetrators, however DV can be enacted by any sex or gender and across various age groups, predominately early to late adulthood. While there are various resources available to assist victims (some more than others, depending on the area of course), numerous victims refrain from reporting or seeking help against DV perpetrators. Here are a variety of barriers that may prevent victims from seeking help.



  1. Provider Barriers: Health Care Providers- doctors, nurses, physician assistants and emergency medical technicians express multiple reasons for not routinely assessing for IPV among their patients.
  • Privacy and Confidentiality- Many providers are worried that screening can potentially offend or anger patients. In addition, providers are afraid of violating confidentiality policies due to mandatory reporting laws (Murphy & Ouimet p. 311)
  • Lack of education/training on the subject matter: Providers feel as if they don’t possess sufficient knowledge and skills to implement the screening and referral process; neither do they feel comfortable interacting with victims of IPV (Murphy & Ouimet p. 311)


  1. Systemic Barriers
  • The institutions that victims turn to for help, such as emergency rooms, clinics, and primary care settings, are often constrained. This can be due to time constraints, lack of case detection procedures and screening protocols, and lack of support for screening implementation (Murphy & Ouimet p. 311)
  • Cost of medical care (Class Lecture 2/11/16)
  • Lack of health care provider knowledge & understanding (Class Lecture 2/11/16)
  • Distrust against the legal systems (Class Lecture 2/11/16)


  1. Victim Barriers
  • Confidentiality – fear that confessing about abuse may lead to further violence
  • Shame & Embarrassment (Class Lecture 2/11/16)
  • Gender Considerations- Stigma associated with men reporting (Class Lecture 2/11/16)
  • Sexual Orientation Considerations- “Double Closeted, Conspiracy of Silence” (Class Lecture 2/11/16)
  • Fear of separating family- need to keep the family together, disruption of the children’s lives,  CPS involvement, (Class Lecture 2/11/16)

Research:

An article assessing one section “the help-seeking choices of abused women”, of the Chicago Women’s Health Risk Study, provided a glimpse into abused women’s reasons for not seeking particular interventions. The CWHRS screened all women for abuse who entered one Chicago-area hospital and four community-based health centers in 1997. Face-to-face interviews were completed with a sample of 491 women who were screened as abused and a comparison group of 208 women who were screened as not abused in the previous year (Fugate, Landis, Riordan, Naureckas, & Engel p. 292)

Four types of helping identified by the CWHRS: Talking to someone, using an agency or counselor, seeking medical care, and calling the police.

Findings (Fugate, Landis, Riordan, Naureckas, & Engel p. 295):

  • Contacting an agency or counselor was the least often used intervention; 82% of the abused women did not contact an agency or counselor.
  • The next least used intervention was medical care; 74% (364) of the women did not seek medical care following an incident in the year prior to the day of the initial interview.
  • 62% (302 and 5 for whom someone else called the police when she did not) did not call the police.
  • Finally, only 29% (140) of the women did not talk to someone else, such as family and friends about the incident.


  1. Cross Cultural Barriers
  • Lack of cultural sensitivity and inclusivity on behalf of providers (Murphy & Ouimet p. 311)
  • Legal concerns, in regards to reporting of immigration status (Class lecture 2/11/16)
  • Language barriers (Class lecture 2/11/16)
  • Different perceptions and attitudes of abuse among different cultural groups (Murphy & Ouimet p. 311)
  • Invalidation by peers & family (Class lecture 2/11/16)

 



References

Fugate, M., Landis,L.,  Riordan, K.,  Naureckas, S.,  & Engel, B. (2005). Barriers to Domestic    Violence Help Seeking: Implications for Intervention. Violence Against Women, 11(3), Sage  Publications.

Laing, L., & Humphreys, C. (2014). Introduction: Key Concepts in Social Work and Domestic Violence. In Social Work & Domestic Violence: Developing critical & reflective practice (pp. 1-16). Los Angeles, CA: Sage Publicatons.

Murphy, S., & Ouimet, L. (2008). Intimate Partner Violence: A Call for Social Work Action. Health & Social Work, 33(4), 309-314. Retrieved December 2, 2015.

Steiner, L. (2012). Ted Talk: Why Domestic Violence Victims Don’t Leave. Retrieved from       https://youtu.be/V1yW5IsnSjo

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