Understanding Barriers to Obtaining Assistance for Victims of Intimate Partner Violence

1. Understanding Barriers to Obtaining Assistance for Victims of Intimate Partner Violence Myra Bery, Dawn Fadden, Starr Ferrari, Heidi Grondahl, Kimberly Miller & Resty Namata December 3, 2008 Research in Nursing

2. Fairview WomanKind Program, Minneapolis, MN612-672-2700 • Research by Short, L.M., Hadley, S.M., & Bates, B. (2002) • Two year study of ability of professional staff to identify female victims of Intimate Partner Violence at five metropolitan area hospitals - Three intervention hospitals Professionals staff were evaluated and provided education to enhance their ability to recognize, relate to, and refer IPV victims - Two comparison hospitals Professional staff did not receive education - Difference in IPV victims identified Intervention Hospitals 1719 : Comparison Hospitals 27

3. Healthcare Provider Education FocusKABB • Knowledge • Recognition of Signs • Understanding of complexity of IPV • Attitudes • Build confidence in ability identify and support IPV victims • Develop sense of responsibility to identify IPV • Beliefs • Challenged acceptance of IPV myths • Behaviors • Improved ability to develop rapport/trust

4. Important Information About IPV Victims • IPV victims often fail to recognize they are experiencing domestic violence or that domestic violence is wrong • “Readiness” is necessary for IPV victims to engage in or access interventions • IPV victims are often motivated to seek assistance due to their concern for the safety and welfare of their children • The lives of IPV victims are very complex • IPV victims identified the need to feel cared for and supported by healthcare providers in order to break the grip of isolation associated with IPV

5. IPV Victims Fear • Law enforcement will become involved without their consent • Losing the children • Losing an intact family/good part of relationship • Retribution by the perpetrator • Requiring disclosure of the IPV • Involvement from healthcare provider will cause the violence to increase • Feeling rejected or devalued by healthcare providers

6. Factors that Cause IPV Victims to Mistrust Providers • Healthcare provider appears uninterested or callous regarding the IPV victim’s situation • Healthcare system require s reporting to law enforcement • Feeling entrapment or disempowerment regarding decision about management of IPV situation • Feeling forced to enter a shelter

7. Most Beneficial Interventions • Provide education about IPV • Capitalize on “readiness” for intervention • Empower IPV victims to make own decisions • Don’t require disclosure to obtain assistance • Provide multiple options for assistance • Provide counseling regarding safety strategies, legal resources, and understanding relationships

8. Lesbian Victims of IPV • Estimated rate of IPV in lesbian relationships is roughly equal to the rate of IPV in heterosexual relationships • Heterosexist language and attitudes negatively affect the lesbian IPV victim’s trust of providers and access to services • Lesbian IPV victims have unique safety needs • Lesbian IPV victims often experience re-victimization from healthcare providers and other IPV victims

9. Additional Issues to Address • Lack of services to rural populations and special populations • Cultures of silence and isolation • Fear and intimidation by perpetrators • Better understanding of the complex nature of IPV victims lives • Enhanced flexibility in IPV victim resources • Language barriers • Culturally sensitive resources • Lack of adequate funding for services • Fear of law enforcement or failure to act

10. APN Leadership Opportunities • Become experts in establishing IPV victim-friendly healthcare environments • Identify and eliminate barriers to resources • Establish valued services and referral sources • Educate colleagues regarding identification of IPV victims • Promote IPV victim autonomy in decision-making • Identify and address the needs of special IPV victim populations