Beyond Broken Bones

T H E R E A L I M PA C T O F D O M E S T I C V I O L E N C E O N H E A LT H M AY 1 , 2 0 1 3

K R I S T I N C A R M I C H A E L L I S W, M B A A U T H O R : X T H AT E X : M A K I N G A C L E A N B R E A K W H E N T H E R E L AT I O N S H I P I S O V E R DOMESTIC VIOLENCE SPECIALIST C H R I S T U S S T. V I N C E N T R E G I O N A L M E D I C A L C E N T E R

Objectives
1. Explore the links between abuse and a variety of

possible negative health outcomes 2. Realize the benefits of addressing abuse in the medical setting 3. Learn several abuse-response models which can engage your local medical providers in partnership

3 Important Questions To Ask About DV and Health?

1. In what ways do offenders

target survivors health?

2. Why do offenders target survivor health? 3. What does it tell us that offenders place emphasis here?

Nicolas Raymond

Health Impacts of Abuse

What health impacts from domestic violence are we seeing most often from survivors seeking services?

Long Term Consequences of Abuse

Why Do We See These Specific Impacts?

Difference between discrete incident of battering vs. repeated exposure to abuse.

Why Address DV In Medical System?

Top 8 Reasons: Gateway for diverse peoples Survivors trust and have relationships established Short window of increased sensitivity and clarity People are used to being given recommendations Pre-knowledge that medical providers are interested in health and wellbeing People know that doctors have strict confidentiality Only place where offender will not be with survivor If you dont work with this system it can harm survivors

What Happens If The Medical System Is Not Engaged?

How Can Medical Providers Get Involved?

Pillars of CHRISTUS ST. Vincent Model:
Working from the premise that patient health outcomes

are dramatically impacted by abuse All planning and actions based on Results Based Accountability framework Multi-disciplinary approach Implemented hospital-wide and in affiliated clinics Relies on community experts and referrals for on-going service Full partnership in community effort to improve and increase service delivery to survivors

Most At-risk Patients Utilization Of The Emergency Department

Quality Oversight Committee Domestic Violence
GOAL:
Confidential pursuant to NMSA 1978 41-9-1

Domestic Violence-3 Patients January 2009 - December 2012

35
30

Beginning of Interventions

25 20 15 10 5 0 FY09Q3 FY09Q4 FY10Q1 FY10Q4 FY11Q1 FY11Q2 FY11Q3 FY11Q4 FY12Q1 FY12Q2 FY12Q3 FY12Q4 FY13Q1 FY13Q2

New Strategies Identified/Investment

TOP 10: 1. Intensive case management and navigation 2. Asking survivor what their needs are 3. Counseling, psychiatric and spiritual needs addressed 4. Increased length of stay at Sobering Center 5. Recovery programs accessed out of Santa Fe 6. Cell phones, gas cards etc 7. Stakeholder meetings, working with law enforcement 8. Unconditional positive regard 9. Coordination across many departments 10. Addressing the DV, subs. abuse, behavioral health simultaneously

Community Collaboration Possibilities

The Safety Net abuse response program for clinics
Developed by the Santa Fe Medical Action Team 1. Warm Environment For Disclosure 2. Screening 3. Intervention Model 4. Doctor, Document, Data
Participating clinics include: CSV Womens Services Dr. VanEeckhouts OBGYN La Familia Southside La Familia Healthcare for the Homeless *Preliminary results are excellent

Christine Zenino

Final Questions To Consider

1. How are survivors lives changed by health impacts? 2. How can we talk more with survivors about their health? 3. How can our services be more responsive to survivor health? Thank You For All You Do To End Abuse!

For More Information

Excellent National Organization:
Futures Without Violence: http://www.futureswithoutviolence.org/

To Download this PPT go to: Kristincarmichael.com

Kristin Carmichael is the author of the new book: X That Ex: Making a Clean Break When the Relationship is Over Xthatex.com