Get reimbursed for COVID-19 testing and treatment of uninsured individuals.     Learn more »

Domestic Violence Out of the Shadows

February 2, 2017

Dr. Brigid McCaw, medical director of Kaiser Permanente’s Family Violence Prevention Program in Northern California and a member of the Institute of Medicine, spoke at HRSA on Jan. 24.
Dr. Brigid McCaw, Medical Director of Kaiser Permanente’s Family Violence Prevention Program in Northern California and a member of the Institute of Medicine.

One in three women and one in four men have experienced violence at the hands of an "intimate partner," according to the Centers For Disease Control and Prevention – and more than half of all reported rapes are committed by someone who knows the victim.

Uncovered in a 2010 national survey, the CDC statistics alone are harrowing. Not only do many assaults go undetected, they are often unrecognized by family, friends and health care providers, underscoring the need for more systematic screening in primary care and hospital settings.

The effects on physical and mental health can last a lifetime, the CDC reported (PDF - 748 KB).

Dr. Brigid McCaw of Kaiser Permanente said at a January summit convened by HRSA's Office of Women's Health (OWH) that family and relationship violence affects uncounted millions of people in the U.S., personally or professionally.

In 2015, Kaiser identified 18,000 clients — men and women — at 46 of its clinics who had experienced "Intimate Partner Violence." By 2016, that number had climbed to 25,000.

"For us," she said, "the goal was to make sure that inquiry and intervention were part of everyday work, just like we pay attention to asthma, hypertension, diabetes, vaccination and so forth … Let patients know they can talk about their experiences, and that something good will happen as a result."

Added Dr. Laura Cheever, Associate Administrator of the HIV/AIDS Bureau: "Providers knowing how best to ask the questions of a patient is important. But the system needs to support the broader intervention of linking the patient to … needed services."

High-level concern: Attending the summit (from left) were Dr. Laura Cheever (HAB); Sabrina Matoff-Stepp (OWH); RADM Deborah Parham Hopson (OA); and Dr. Michael Lu (MCHB). The conference was the second in a series of six, bringing together senior staff from 13 bureaus and offices.
High-level concern: Attending the summit (from left) were Dr. Laura Cheever (HAB); Sabrina Matoff-Stepp (OWH); RADM Deborah Parham Hopson (OA); and Dr. Michael Lu (MCHB). The conference was the second in a series of six, bringing together senior staff from 13 bureaus and offices.

 

The problem "disproportionately affects many of the populations our programs serve, and we are uniquely positioned to address it through the work we are already doing and the trust we have established in local communities," said OWH Director Sabrina Matoff-Stepp.  

With 18,000 physicians nationwide who "touch about 10 million lives," said Dr. McCaw, Kaiser seeks to get prevention and intervention messages out "in non-traditional places," while making certain that patients have private time with providers who can quickly refer them to social service organizations.
 

PartnerViolenceTrptychTwo1-29-17.jpgPlan in the works: From left, Dr. Margarita Figueroa-Gonzalez (ORO); Jill Center (OPAE); and CDR Joel Nelson (BHW) provided agency-wide input at the standing-room-only summit. The HRSA Strategy to Address Intimate Partner Violence, when completed, will describe new and current approaches to prevent, identify and intervene in such cases.
Plan in the works: From left, Dr. Margarita Figueroa-Gonzalez (ORO); Jill Center (OPAE); and CDR Joel Nelson (BHW) provided agency-wide input at the standing-room-only summit. The HRSA Strategy to Address Intimate Partner Violence, when completed, will describe new and current approaches to prevent, identify and intervene in such cases.

 

The agency also is working on a pilot project with the Administration for Children and Families to integrate services at 10 health centers. A toolkit for primary care providers and HRSA program staff is expected to be released in mid-February.

Learn more about intimate partner violence from the Journal of the American Medical Association.

Need help? Contact the National Domestic Violence Hotline:1-800-799-7233.

Last Reviewed: February 2017

Date Last Reviewed:  July 2017