Domestic violence is a serious problem in our society. Each year, over 10 million American women are physically abused each by their intimate partners. This equates to nearly 20 people per minute.
According to the National Coalition Against Domestic Violence(NCADV), one-fourth of American women have experienced it. “severe intimate partner physical violence, intimate partner contact sexual violence, and/or intimate partner stalking”—which have lasting effects from fearfulness to physical injuries to PTSD to the need for victim services.
And one in three women (plus one in four men) have experienced some form of violence—slapping, shoving, or pushing—at the hands of an intimate partner.
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In the past, domestic abuse cases were handled by law enforcement, while nurses and doctors tend to mental and physical wounds. In recent years, healthcare providers have taken the initiative to intervene in domestic violence cases.
How Doctors are stepping up
Domestic violence is often viewed as a criminal problem. This is why law enforcement traditionally takes charge of domestic abuse cases. However, victims may find it difficult to navigate emotionally distressing situations by themselves if this approach is used.
It’s not that doctors haven’t noticed abuse or tried to help in the past. But there’s never been a systemic, health-focused response to domestic violence overseen by trained healthcare professionals and social service partners.
However, Dr. Anita Ravi could make this a reality.
Her unusual New York City clinic is called PurpLE Family HealthIt takes a holistic approach when treating women who have suffered from intimate partner violence, sexual assault and human trafficking. It’s part of a growing network of medical centers and clinics that has realized the crucial role they can play in treating—and ultimately reducing—domestic violence.
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Beyond questionnaires in the emergency room with no follow-up, Ravi advocates for screenings and conversations in a range of medical settings—including primary care and pre- and post-natal care, because childbirth is a high-risk time for abuse.
Homicide is the leading cause death in pregnancy or the first 12 months after birthin the United States, according to a study published by Tulane University’s Maeve Wallace and her colleagues in the journalGynecology & Obstetrics. “Homicide during pregnancy or within 42 days of the end of pregnancy exceeded all the leading causes of maternal mortality by more than twofold,”They wrote in it.
Doctors and other healthcare professionals are beginning to work together instead of waiting for domestic violence victims in the ER to arrive. Even policymakers are starting to consider abuse as an important health factor.
The ultimate goal is to develop a health-based approach for domestic violence cases, which can then be passed on to social service partners. Instead of law enforcement taking the lead, the healthcare and social service workers will handle the cases while recognizing that women’s health can be affected by larger social and economic factors.
“Exposure to violence, including intimate partner violence, has a direct impact on mental and physical health outcomes, and is directly tied to injury, psychological distress, and death in all age groups,”Chiquita Brooks, Center for Medicare and Medicaid Services Administrator told PoliticoSeptember
Domestic abuse is a disease.
At Ravi’s clinic, she treats her patients’ immediate medical needs, but she also connects them to a network of services and resources that can help them get out of their relationship or at least reduce harm.
All of the care at Ravi’s clinic is free, paid for by her PurpLE Health Foundation—a non-profit that she also started.
Ravi doesn’t see domestic abuse as a collection broken bones and bruises. “as an infection,”Recognizing the dangers that can spread to other people and to the next generation. Children who witness domestic violence, or have been the victims, are at high risk of perpetuating this cycle as adults.
Ravi has created protocols and tools to help healthcare professionals understand that their job is more than just transferring abused women to the police. She has trained over 5,000 people so far.