Health Care Providers
Domestic violence is both a personal and community health issue. Domestic violence affects all ages, encompassing child abuse, domestic violence and elder abuse.
1. As many as 40% of all women who seek care in hospital emergency rooms for violence-related injuries have been injured by a current or former partner.
2. Estimates of the prevalence of domestic violence against pregnant women range from 7% to 20%.
3. Children of mothers who experience prenatal physical domestic violence are at an increased risk of exhibiting aggressive, anxious, depressed or hyperactive behavior.
4. People and children with disabilities are significantly more likely to become victims of violence, abuse, or neglect than people without disabilities.
Cites: (1) T.M. Nappi et al. 2004. Brigham and Women's Hospital, Mary Horrigan Connors Center for Women's Health. Domestic Violence: A Guide to Screening and Intervention. 3. (2) Id. (3) Whitaker, RC, Orzol, SM, Kahn, RS. 2006. Maternal Mental Health, Substance Use, and Domestic Violence in the Year After Delivery and Subsequent Behavior Problems in Children at Age 3 Years. Archive of General Psychiatry. 63: 551-560. (4) http://www.cdc.gov/ncbddd/disabilityandhealth/relatedconditions.html.
PCADV and its member programs encourage health care providers to take steps to address domestic violence - and we are here to help. Call us at 800-932-4632.
- Find brochures or palm cards for the waiting areas.
- Request training for providers on healthcare and domestic violence.
- Locate state and local resources for victims of domestic violence.
- Contact our Health Education Specialist at 800-932-4632 to find a domestic violence medical advocate in your county for information, support and training.
Acute and Long-Term Consequences
Medical emergencies and ongoing abuse can lead to long-term health problems. Some issues include, but are not limited to, physical, emotional, and mental trauma; anxiety, depression and other mental health issues; neglect; special risks associated with pregnancy; child abuse; drug and alcohol addiction; rape, sexual coercion, and non-consensual pregnancies; sexually transmitted infections; traumatic brain injury; withholding, delaying, or misusing needed equipment and medication; and health issues that stem from homelessness or a significantly compromised quality of life.
Be a Pro-Active Provider
Health care providers can play a critical role in preventing and intervening in the dangerous, even fatal, patterns of domestic violence. The Pennsylvania Department of Welfare's 2010 Domestic Violence Task Force acknowledges:
The health care system has a vital role to play in bringing about social and institutional changes to end domestic violence.
A brief screening process for every patient regardless of gender, race, age, sexuality, religion, nationality, profession, or economic status can make a critical difference for adults, teens, and children who live with or are at risk for abuse.
Health care providers are usually the first and sometimes last contact a victim of violence encounters. Talking with patients about domestic violence provides a valuable opportunity for providers to learn about their experiences with abuse. Battered women report that one of the most important aspects of their interactions with a physician was being listened to about the abuse. July 2010 Report of the Pennsylvania Domestic Violence Task Force, Pennsylvania Department of Welfare,
The American College of Obstetricians and Gynecologists (ACOG) recommends that physicians screen ALL patients for intimate partner violence by making the following statement and asking these three simple questions:
"Because violence is so common in many women's lives and because there is help available for women being abused, I now ask every patient about domestic violence:
1. Within the past year -- or since you have been pregnant -- have you been hit, slapped, kicked or otherwise physically hurt by someone?
2. Are you in a relationship with a person who threatens or physically hurts you?
3. Has anyone forced you to have sexual activities that made you feel uncomfortable?"
Use the acronym RADAR, as explained below.
R = Routinely Screen Patients
A = Ask Direct Question - So the patient can answer "yes" or "no"
D = Document Your Findings
A = Assess Patient Safety
R = Review Options and Referrals
Documenting signs of abuse in a patient's medical record provides information for future visits that may cast light on chronic conditions and behavioral health issues.
Providers can refer patients who are abused by their intimate partners or family members to their local domestic violence program, hospital or clinic domestic violence medical advocate, to discuss safety planning and options.
One barrier to screening that practitioners report is a feeling that their intervention will not be effective or the patient will not leave the abuser. Leaving an abuser is a process, one in which a victim assesses safety, financial and legal resources, timing, family and other support before successfully separating. A year after separating finds most victims safer, but retaliatory violence (even homicide) is a documented concern. Education about abusers' behavior, as well as training on recognizing, screening and appropriately referring patients for domestic violence, help to boost staff confidence in their interventions.
PCADV offers a Health Care Provider Training Evaluation Tool Kit for those who would like to assess training needs in the area of domestic violence.
A trauma-informed model for health care services acknowledges the complex and overlapping circumstances in the lives of many patients, and PCADV supports this methodology as the Best Practices approach.
The National Center on Domestic Violence, Trauma and Mental Health has information and technical assistance for working with those who live with intimate partner, family, or dating abuse.
PCADV Works to Assist Providers to Care for Families Affected by Violence
- PCADV is an active supporter of legislation to protect women's and children's healthcare options.
- PCADV serves on the Pennsylvania Department of Welfare Domestic Violence Task Force with other statewide entities to develop a coordinated, integrated response to domestic violence in the Commonwealth.
- PCADV domestic violence medical advocates provide technical assistance and training to healthcare providers helping domestic violence victims and their families. To find a medical advocate near you, call 800-932-4632.
- Report of the Pennsylvania Domestic Violence Task Force
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- Pennsylvania Medical Society Domestic Violence Resources/Tools
- U.S. Department of Health and Human Services: Women and Domestic Violence: Programs and Tools That Improve Care for Victims
- Preventing Domestic Violence: Clinical Guidelines on Routine Screening, National Health Resource Center on Domestic Violence, 1999.
- Family Violence Prevention Fund's National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings
- Downloadable screening tool kit - Palm version
- R3 App - iTunes and Android App to help providers Recognize, Respond, and Refer for domestic violence
- National Domestic Violence Hotline 1-800-799-7233
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If you fear for your immediate safety, call 9-1-1 or your local police.
Contact the domestic violence program in your area for free and confidential help.
Other victim programs are available to help you and your family.
Any attorney helping a domestic violence victim may contact the PCADV legal department at 888-235-3425 for information on law and legal procedures. (This is not a helpline for victims.)
The information provided on this website is intended for informational purposes only. The information provided under this topic is not legal advice, does not create an attorney-client relationship, and is not a substitute for contacting an experienced attorney. Read our full legal disclaimer.
- Documenting Domestic Violence: How Health Care Providers Can Help Victims National Institute of Justice Research Brief, 2001.
- Does screening in the emergency department hurt or help victims of intimate partner violence? Ann Emerg Med. 2008 Apr;51(4):433-42, 442.e1-7. Epub 2008 Mar 7.
- Experts, Health Care Providers Challenge Federal Task Force Conclusion, Warn That Less Screening & Intervention Will Endanger Victims Of Abuse Futures Without Violence
- Domestic Violence: Medical Records Can Sound An Early Warning National Domestic Violence Hotline
- Screening for Abuse May Be Key to Ending It - New York Times, 5/20/2008
- Futures Without Violence
- Family Violence Prevention and Health Practice e-Journal
- The Centers for Disease Control and Prevention, National Center for Injury Prevention and Control - IPV
- Nursing Network on Violence Against Women International
- An Intervention Model for Dental Professionals
- Traumatic Brain Injury and Domestic Violence: What Do Professionals Need To Know?
- Traumatic Brain Injury As a Result of Domestic Violence: Information, Screening and Model Practices PCADV, 2011.
- Health Care Response Act See Healthcare on our Public Policy Laws & Regulations page
- Comply with the Joint Commission Standard PC.01.02.09 on Victims of Abuse,