Identifying and preventing domestic abuse can be challenging, especially for doctors, mental health providers, and other medical professionals. Healthcare screenings often include questions about relationships, safety, and other abuse indicators, but do these screenings prevent domestic violence?
How Healthcare Providers Screen for Domestic Abuse
If you’ve been to a doctor for a routine appointment in the past few years, you’ve undoubtedly been asked questions about domestic abuse. Along with inquiries about nutrition and exercise habits, providers typically ask whether you feel safe at home, whether a partner has even threatened violence, whether you can make your own decisions, and if your partner has ever laid hands on you out of anger.
Questionnaires should only be the start of the conversation between a patient and their doctor. In a study published in the National Library of Medicine, researchers say healthcare providers shouldn’t rely entirely on the questionnaire. Instead, the study concludes, medical professionals should rely on the evidence: how the patient acts when questioned about abuse, evidence of physical injuries, or other indicators of possible abuse.
Identifying victims of domestic abuse can be difficult. Often, these victims have lived in abusive environments for months or years, slowly adapting to the abusive behaviors. Some recognize the behavior as abuse, but many others don’t even realize they are experiencing physical, mental, or emotional harm from a partner.
Healthcare communities are pushing initiatives designed to help providers recognize signs of abuse, talk about signs of abuse with patients, and inform potential and known victims about resources and assistance. Additionally, the Violence Against Women’s Act was revamped in 2022, providing even more funding and resources to help healthcare professionals better identify and treat victims of domestic abuse.
Are the Screenings Helping?
Are these screenings preventing abuse? Not exactly. A 2014 British study found that domestic abuse screenings helped identify more than twice as many potential victims, but those screenings did little to help those victims get help. That is, while the medical community has focused on recognizing abuse survivors, there isn’t nearly enough emphasis on providing those victims with the resources they need to leave.
Instead of merely asking patients about their relationships and home life, the study suggests medical professionals receive more training about available resources to help the victims. Healthcare providers should know about all local abuse intervention programs, shelters, and other helping agencies to which they could refer known or suspected abuse victims.
How Mandatory Reporters Discourage Honesty
In most states, healthcare providers are “mandatory reporters,” meaning they are legally obligated to report suspected abuse to the police or other authorities. Because of this, abuse victims might hesitate to admit the abuse, fearing retribution or legal action.
Mandatory reporting is an integral part of the legal process. But it also acts as a barrier to care, preventing women from coming forward. If more women felt safe admitting to abuse without facing instant legal action, could providers identify and help more victims? There is ongoing research surrounding this topic.
For some providers, the mandate to report can be frustrating. If a victim is not ready to leave the relationship or doesn’t recognize the abuse as significant or serious, she is unlikely to tell her doctor or mental health professional about the abuse. And if the victim won’t admit to or report the abuse, the provider can only share available resources, encourage her to seek help, and then let her return to the abuse.
Healthcare providers face a delicate balance between identifying potential victims, giving information and resources to those victims, and deciding when the abuse warrants referral to law enforcement.
Talking to Your Doctor About Domestic Abuse
Many victims are too embarrassed or afraid to admit to their abuse, even to a trusted healthcare provider. The mandatory reporting directives in most states keep many survivors from talking about the abuse. Leaving an abusive situation isn’t easy. It’s a complicated and frightening prospect for many victims.
However, if you are in an abusive relationship or suspect someone you know is experiencing abuse, there is hope. Sharing your story with a healthcare provider might feel scary. But most doctors and mental health professionals can connect victims with supportive, understanding agencies and resources.
Abuse is never okay. If you are in an unhealthy relationship, consider sharing your concerns with your medical provider. They can help you safely report the abuse and find help.