Healthcare and Domestic Violence in Arkansas. Angela McGraw, CVAP-A The Arkansas Coalition Against Domestic Violence. ACADV Mission Statement. The mission of the Arkansas Coalition Against Domestic Violence is to eliminate domestic violence and promote healthy families. . Training Topics.
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Angela McGraw, CVAP-A
The Arkansas Coalition Against Domestic Violence
The mission of the Arkansas Coalition Against Domestic Violence is to eliminate domestic violence and promote healthy families.
Family Violence is Very Common:
Family Violence is Very Common:
1. 1st attempt to get help is from health care providers.
a. legal or battered women’s services
b. individual or cultural issues
2. Community services assist victims in accessing health care providers.
Cultural contexts of both domestic violence & health care.
Misunderstanding of one or more of these issues decreases our effectiveness with our patients.
Domestic Violence is any abusive, violent, coercive, forceful, or threatening act of word inflicted by one member of a family of household on another.
Arkansas Code Title 9: Family Law: Chapter 15: Domestic Abuse: Subsection 103: Definitions. (9-15-103)"Domestic abuse" means: (A) Physical harm, bodily injury, assault, or the infliction of fear of imminent physical harm, bodily injury, or assault between family or household members; or (B) Any sexual conduct between family or household members, whether minors or adults, which constitutes a crime under the laws of this state;
(3) "Family or household members" means spouses, former spouses, parents and children, persons related by blood within the fourth degree of consanguinity, any children residing in the household, persons who presently or in the past have resided or cohabited together, persons who have or have had a child in common, and persons who are presently or in the past have been in a dating relationship together; and
4)(A) "Dating relationship" means a romantic or intimate social relationship between two (2) individuals which shall be determined by examining the following factors: (i) The length of the relationship; (ii) The type of the relationship; and (iii) The frequency of interaction between the two (2) individuals involved in the relationship. (B) "Dating relationship" shall not include a casual relationship or ordinary fraternization between two (2) individuals in a business or social context.
In the presence of children; means in the physical presence of child or knowing or having reason to know that child is present and may see or hear act.
Offenses against pregnant women.
A health care provider may report to a law enforcement agency an injury to an adult that the health care provider has reason to believe is the result of a battery or other physically abusive conduct, including physical injuries resulting from domestic violence, if the
Act 944 (2003)
An act to enhance the penalty for offenses of domestic violence committed on a pregnant woman.
(A woman is considered pregnant 4 weeks after conception)
Use of economics
Use of children to control an adult victim
Phase 1: Tension Building
keep children silent
HoneymoonEffects of IPV
Phase 2: Crisis/Assault
money and partner
Phase 3: Honeymoon
past with violence
They have effectively exerted control and
power over others through violence
No one has stopped them from being
violent in the pastCauses of IPV
IPV is learned in the family, in communities, & in society.
Alcohol and/or drugs
Stress and/or Anger
Out of control behavior
Behavior of the victim or problems in the relationship
I will ask you a series of questions, which I want you to answer just by a show of hands.
answer these questions:
hand…do not raise your hands…sit on
your hands…and just answer these
questions for yourself:
Perpetrators come from all groups
Minimizing, denying, or lying
Coercive tactics by using the health care provider
50% to 70% increase
in gynecological, central nervous system, and
Campbell et al, 2002
Abused women experience a
“I want to understand how violence affects me mentally and physically…so I can learn to avoid bad situations.”
-woman at crisis center
Wilson et al, 2007
Cancelled and missed appointments, interrupted care and noncompliance with treatment and follow-up may be related to victimization.
Other victims: Those trying to help or innocent bystanders
Role of the Health Care Provider
The national health care costs of IPV are high, with direct medical and mental health care services for victims amounting to nearly $4.1 billion.
Among women admitted to an emergency room for violence-related injuries, 37 percent were abused by an intimate partner.
In a study on the effects of violence, women who experienced any type of violence or abuse were significantly more likely to report being in “fair or poor” health, and were almost twice as likely to be coping with some form of depression.
The Centers for Disease Control and Prevention estimates that the cost of intimate partner rape, physical assault and stalking totaled $5.8 billion each year for direct medical and mental health care services and lost productivity from paid work and household chores.
~4 times more likely
to use an intervention
2.6 times more likely
to exit the abusive relationship
McCloskey et al, 2006
Basile et al, 2007
 Department of Health & Human Services. Preventing Intimate Partner & Sexual Violence. Accessed May 16, 2012.
 Catalano, S.M. Criminal Victimization, 2003 : Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics, 2004, NCJ 205455.
 National Association of Crime Victim Compensation Boards. Compensation to Victims Continues to IncreaseExit Notice. Accessed March 14, 2007.
 U.S. Dept. of Health and Human Services, National Center for Injury Prevention and Control. March, 2003. Costs of Intimate Partner Violence Against Women in the United States. Atlanta, GA: Centers for Disease Control and Prevention.
 U.S. Department of Justice, Bureau of Justice Statistics. (1997). Violence Related Injuries Treated in Hospital Emergency Departments, Special Report.
 Collins, K., Schoen, C., Joseph, S, Duchon, L. Simantov, E. & Yellowitz, M. (1999). Health Concerns Across A Woman's Lifespan: The Commonwealth Fund 1998 Survey of Women's Health.
 Christina Nicolaidis et al., 2004, “Violence, Mental Health, and Physical Symptoms in an Academic Internal Medicine Practice,” Journal of General Internal Medicine 19, 81523. Retrieved October 5, 2009.
 Sandra K. Burge et al., 2005, “Patients’ Advice to Physicians about Intervening in Family Court,” Annals of Family Medicine 3, 3.
 U.S. Department of Labor, Bureau of Labor Statistics. 2010. Occupational Homicides by Selected Characteristics, 1997-2009. Available at: http://www.bls.gov/iif/oshwc/cfoi/work_hom.pdf
Max, W, Rice, DP, Finkelstein, E, Bardwell, R, Leadbetter, S. 2004. The Economic Toll of Intimate Partner Violence Against Women in the United States. Violence and Victims, 19(3) 259-272.
Costs of Intimate Partner Violence Against Women in the United States. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. 2009.