INTIMATE PARTNER VIOLENCE LCDR LEILA WILLIAMS Intimate Partner

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INTIMATE PARTNER VIOLENCE LCDR LEILA WILLIAMS

INTIMATE PARTNER VIOLENCE LCDR LEILA WILLIAMS

Intimate Partner Violence IPV n Domestic Violence n Defined as a pattern or behavior

Intimate Partner Violence IPV n Domestic Violence n Defined as a pattern or behavior resulting physical, emotional/psychological abuse, economic control, and/or interference with personal liberty directed toward a person n

IPV Victim Current or former spouse n Person with whom the abuser shares or

IPV Victim Current or former spouse n Person with whom the abuser shares or has shared a child in common. n Current or former intimate partner with whom the abuser shares or has shared a common domicile n

Halpern, Hayes, et al. Trauma 2006 n n J. It is estimated that between

Halpern, Hayes, et al. Trauma 2006 n n J. It is estimated that between one to two million women experience IPV annually 2 important features of this estimate --The rate is high but it is also unclear how high it is. --The wide range for this estimate says a great deal about the secrecy of IPV and difficulty determining who has been subjected to IPV

Macmillan, Jamieson, et al. Approaches to screening for IPV in health care settings N=2,

Macmillan, Jamieson, et al. Approaches to screening for IPV in health care settings N=2, 602. Randomized trial n Patients are often reluctant to disclose IPV to their physicians n Self-completed screening, versus faceto-face screening, for IPV appears to be preferred by women n

Bureau of Justice Statistics IPV made up 20% of all nonfatal violent crime experience

Bureau of Justice Statistics IPV made up 20% of all nonfatal violent crime experience by women in 2001 n 1, 247 women and 440 men were killed by an intimate partner in 2001 n

Previous Reporting Policy Minimal confidentiality n Chaplain’s Privilege – All others must report assault

Previous Reporting Policy Minimal confidentiality n Chaplain’s Privilege – All others must report assault n Medical treatment initiated investigation n Victim had no control over the release or management of their personal information n

DOD RESTRICTED REPORTING POLICY n An option for IPV Victims to receive medical treatment

DOD RESTRICTED REPORTING POLICY n An option for IPV Victims to receive medical treatment and Victim Advocacy services without requiring notification to law enforcement or the victim’s or alleged offender’s commander when they report such abuse to one of the following individuals: Health Care Provider or Victim Advocate /Supervisor

Health Care Providers (HCP) n Health care professionals who are credentialed to provide health

Health Care Providers (HCP) n Health care professionals who are credentialed to provide health care services (Including Clinical Social Workers)

Victim Advocate (VA) n A person who has been designated to respond, offer advocacy

Victim Advocate (VA) n A person who has been designated to respond, offer advocacy and support and provide the victim information and clarification on restricted and unrestricted reporting options

Purpose of Victim’s Reporting Options Ensure victims receive medical, counseling and advocacy services n

Purpose of Victim’s Reporting Options Ensure victims receive medical, counseling and advocacy services n Build victim’s trust in system to increase reporting n Remove barriers n

Barriers n n Perceived lack of privacy/confidentiality Embarrassment/stigma Fear of reprisal from offender Lack

Barriers n n Perceived lack of privacy/confidentiality Embarrassment/stigma Fear of reprisal from offender Lack of confidence in chain of command n n Fear of repercussions regarding collateral misconduct Concern about how report will affect their career, unit, and the mission

Limitations of Restricted Reporting Alleged offender remains at large n Victim cannot receive a

Limitations of Restricted Reporting Alleged offender remains at large n Victim cannot receive a Military Protective Order (MPO)/No Contact Order n Victim may continue to have contact with alleged offender. n Victim unable to discuss the assault with other service members n

Exceptions to Confidentiality and Limitations on Use n n n The victim consents in

Exceptions to Confidentiality and Limitations on Use n n n The victim consents in writing Serious threat to health/safety of victim or others Child Abuse involvement Fitness for duty/Disability retirement To supervise direct victim services adequately When ordered by a court or required by law

n The victim should acknowledge in writing his/her election and understanding of the benefits

n The victim should acknowledge in writing his/her election and understanding of the benefits and limitations of the reporting options

n Abuse and violence are at the heart of a plethora of emotional and

n Abuse and violence are at the heart of a plethora of emotional and physical problems. We must be accepting and willing to listen to our patients, we must be ready with the resources when our patients are ready to ask for help…