Close-up of psychiatrist hands together holding palm of her patient

It is October and in Vermont this means beautiful fall colors; red, gold and green. However, there are also other colors that are just as important in October, pink and purple. Pink is for breast cancer awareness and purple is for domestic violence (DV) awareness. Both are public health issues that affect our mothers, sisters, daughters and our sons.

While breast cancer and DV are both equally important health issues, I would like to take a moment to discuss some specific issues around domestic violence. Interpersonal violence (IPV) is an important health issue that is often relegated to the background, the private secret no one wants to talk about. We are not going to sign up for 5k’s and have football players wear purple socks to raise awareness about IPV. We can however use this month and the color purple to raise awareness about the importance of screening, education, community discussions and funding, so that one day we can end domestic violence.

What is Interpersonal Violence?

Also known as Domestic Violence, IVP is generally describes abuse within the context of an intimate relationship where one partner asserts power and control over the other. It can include physical, sexual, psychological abuse, as well as economic coercion. IPV affects over 10,000 Vermont women and men and many more children who witness the violence in their homes. For many Vermonter’s it means that the person that they should trust the most is harming them. It is important to understand that anyone can be affected by DV, regardless of who you are or where you come from.

This is a preventable problem that affects millions of Americans and thousands of Vermonters. Chances are you know someone who has experienced IPV. That is why it is important to understand the issue and how we as health care providers, friends, family and coworkers can help.

Are You Safe at Home?

This is the screening question that I have used many, many times when talking to patients in the emergency department (ED). In the seconds that is takes for me to ask this question I am trying to assess if this patient is safe. I ask every patient this screening question yet, in sixteen years in the ED only a few have ever disclosed that they are unsafe.

So why are patients in the ED not disclosing that they are unsafe at home?

There are many barriers that may be preventing victims of IPV from disclosing abuse in the ED. They may fear for their own safety or the safety or their children. They may be unsure that the nurse may be able to or want to help. It is often because they feel shame or embarrassment. It could also be the way nurses are asking, is the patient alone, are we making eye contact and using nonjudgmental tone?

The Facts: domestic violence is a serious problem in the United States and Vermont.

  • According to the Vermont Network against Domestic and Sexual Violence in 2015 over 5,000 victims of DV where served by 14 organizations, providing 35,000 nights in shelters, legal support and financial assistance. There were over 16,000 hot line calls.
  • More than 1 in 3 women and over 1 in 4 men nationwide have experienced rape, physical violence and or stalking by an intimate partner in their lifetime. 1 in 15 children witness IPV
  • In Vermont 18% of women and 9% of men reported that an intimate partner physically abused them, 19% of Vermont women and 6% of men reported that an intimated partner has threatened them or made them feel unsafe, 15% of Vermont adults say an intimate partner has tried to control their daily activities.
  • Between 1994-2014 the Domestic Fatality Review Commission reported that
  • 50% of all Vermont homicides were Domestic Violence related; 57% of these homicides were committed with guns.

These statistics are grim. The numbers show that IPV is a very real problem nationwide as well as in Vermont. We know that victims of domestic violence use the ED with injuries from abuse and symptoms that include abdominal pain and headaches.

How We Screen

To make it easier for patients to answer truthfully, we try to change our language to break it down  and make make it more real. For example, instead of asking if a patient feel safe at home, I say “since violence is so prevalent in our society, I ask everyone if they have every been hit, punched, slapped pushed or screamed at by their partner”.

Many patients come to the ED with family or friends we try to ensure we are asking screening questions when patients are alone to make them feel safer. If you screen patients, you need to educate yourself about the resources available in Vermont. Visit DV help.

How to Talk to Someone You Know About Domestic Violence

If you suspect a friend, family member or coworker is in an abusive relationship talking about it can be difficult. The most important thing you can do is to let them know that they have your support. It is important to remember that you can’t make someone leave an abusive relationship. It is hard to see someone you know get hurt. Ultimately, the person being hurt needs to be the one who decides to do something about it. What you can do is to listen, believe them, emphasis that it is not their fault and provide resources.

What We as a Community Can Do

  • Talk about DV. We should expand our conversations to include the domestic violence epidemic. Include male victims who often get left out of the conversation.
  • Stop victim blaming instead of asking “why don’t they just leave” ask “why do they abuse.”
  • Prevention- Violence is a learned behavior.
  • Educate ourselves on recognizing the signs of abusive behavior and how to support survivors.
  • Donate to local shelters and advocacy groups around Vermont.
  • Advocate for improved laws protecting victims.
  • Wear purple – it goes really well with pink.

For Help

Raenetta Liberty, has been a nurse for 24 years and an Emergency department nurse for 16 years. She recently became the UVM Medical Center and Vermont State Coordinator for the Forensic program. We provide sexual assault exams and domestic violence screening to all Vermonters. We are always looking for new members so If you are interested in becoming a SANE email me at Raenetta.Liberty@uvmhealth.org.

Our program is always looking for financial donations: to provide new clothing for sexual assault victims and to provide education for the SANE’s.

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