Did you know that every minute, approximately 20 people become a victim of domestic violence at the hand of an intimate partner in the United States? One in four women and one in seven men have been the victim of severe physical violence (National Coalition Against Domestic Violence, n.d.)?

Domestic Violence – A Short History

Domestic violence has existed since the dawn of humankind. Elaine J. Alpert M.D., M.P.H. (2002) states, “Although pandemic in scope, domestic violence until recently remained secret and undefined, in part because historically there was no common language to name the problem, describe its scope, garner the evidence, or take concerted action regarding intervention or prevention.”

We now have an acute awareness of domestic violence thanks to the women’s rights movement and the feminist movement of the 1960s. The medical community began to recognize domestic violence in the 1970s. The 1990s brought us closer to diagnosing and treating domestic violence (Alpert, 2002).

As healthcare providers, we must take responsibility to recognize and report domestic violence.

3 Ways to Recognizing Domestic Violence in the Clinical Setting

Domestic violence does not discriminate, and it affects people of all races, genders, ages, sexual orientations, and religions. It frequently surfaces in the form of bruises, cuts, and scrapes. However, domestic violence can also manifest in other ways:

Sexual abuse occurs when the attacker forces another person into unwanted sexual activity.
Physical abuse occurs when the attacker punches, chokes, shoves, or uses weapons to harm another person.
Psychological abuse occurs when the attacker uses verbal abuse or excessive possessiveness. Psychological abuse can also occur when the attacker withholds the victim from their friends and family, withholds money, or destroys personal property (Watson, 2019).

Screening individuals for domestic violence can help identify victims. A variety of indicators assist healthcare professionals in recognizing domestic violence.

1. Screening Individuals Appropriately

All women and girls who present in a clinical setting should undergo screening for domestic violence. In addition, men and boys who present with symptoms of domestic violence should also be screened. The following indicators provide insight into individuals who may benefit from screening.

• History of trauma
• Alcohol abuse
• Repeated ER visits
• Injury inconsistent with the explanation
• Eating disorders
• Injury during pregnancy
• A partner who will not leave the room
• Chronic pain syndromes
• Delay between onset of injury and seeking care
• Experience with suicidal ideations, depression, anxiety, and other psychological conditions (“Guidelines for Clinical Assessment and Intervention on Domestic Violence Guidelines for Clinical Assessment and Intervention,” n.d.)

2. Proper Assessment

Performing an assessment can pose challenges, but these tips can provide guidance:

• Screen with the victim alone, without the presence of friends, family, or partner.
• Describe screening as standard, not related to suspected domestic violence.
• Incorporate screening questions into obtaining a routine medical history.
• Keep resources, such as handouts and posters, in privately accessible areas, such as restrooms and examination rooms (Intimate Partner Violence, 2019).

3. Understanding State Laws

States require mandatory reporting in cases of suspected child abuse. Unfortunately, reporting adult domestic violence can pose more challenges.

Mandatory reporting helps identify and protect victims. However, reporting domestic violence can lead to safety concerns for the victim. In addition, most state laws do not mandate reporting of domestic violence (Intimate Partner Violence, 2019).

Healthcare workers have an obligation to understand the responsibility inherent in their role, as well as state laws. For a review of state laws, click here.

If You are the Victim of Domestic Violence…

Assistance for victims of domestic violence comes from various resources. The National Domestic Violence Hotline provides live chatting, directly from their website. You can also call 1-800-799-SAFE (7233). They also have a text line; text “START” to 88788.