Screening Can Detect Intimate Partner Violence

An estimated 15 million U.S. youth are exposed to Intimate Partner Violence (IPV) annually; some of them come through the doors of Children's Mercy.

Childhood IPV exposure results in lifelong negative outcomes that affect all areas of life-learning, behavior, physical and mental health and relationships-and last throughout the child's life. Unfortunately, most cases of IPV are not obvious during health care visits. For that reason, the Emergency Departments, Urgent Cares and other CMH patient care areas practice universal IPV assessment using the Bridge screen, which has produced positive outcomes in detecting cases of IPV and connecting children and other family victims with resources to help. 

"Patients and their families depend on our expertise and keen awareness to detect problems and on our dedication to working together to solve them," said Kimberly Randell, MD, MSc, Emergency and Urgent Care. An example of CMH staff members uncovering a case of IPV was documented in a report earlier this year.

In November 2012, a mother was approached in the ED and asked to participate in an IPV study. When the research assistant spoke to the mother, it became evident that things were not right in the patient's home. The information was passed along to the patient's provider; it was later discovered that the mother was in a long-term, extremely abusive relationship. A social worker came to her aid and provided her with counseling and a safety plan, as it was not safe to do more on that particular day. Three months later, the mother returned to the ED with her children. She approached a security officer and asked to speak with a social worker. Social Work connected her with a Bridge Program advocate who linked her with the appropriate resources. (When IPV is identified, Social Work can refer the case to the Bridge Program.) With the assistance of the hospital and the advocate, she was empowered to make a life-changing decision to seek safety and begin the healing process for herself and her children. She and her family were placed at a shelter that night and would no longer have to return to a violent and life-threatening home.

ATTENTION TO DETAIL
"These staff members' attention to detail and thorough performance enabled a mother to make a difficult and brave choice for new and safer lives for herself and her children," Dr. Randell said. "While this story has a promising outlook, many people living in abusive households struggle to be safe. Without the exceptional care and attention of CMH employees, this story could have had a very different ending."

Dr. Randell noted that the mother's answers to initial Bridge screen questions didn't reveal the IPV situation. "That's why it really is important that we provide layers of opportunity for families to disclose IPV and access resources rather than depend only on the Bridge screen," she said. "You never know the value of encouragement and resources you provide. One simple comment or piece of information could have a drastic impact on someone's decision to come forward and seek help. " The Children's Mercy Council on Violence Prevention has established IPV Guidelines and an IPV Tool Kit that provide guidance on topics such as how to screen, screening techniques with a child in the room, and suggested wording for screening questions.

 

 

The American Academy of Pediatrics says, "Exposure in the home to IPV as a child is associated with a multitude of behavioral and mental health consequences." Universal IPV screening can help detect problems and connect children and other family victims with resources to help.

The Children's Mercy Council on Violence Prevention provides resources, guidance and education on IPV screening and assessment.