Saving lives by preventing domestic violence
Intimate partner abuse is a ubiquitous problem that transcends age, “race,” culture, language, socioeconomic status, education, marital and parental statuses, ability, sexual orientation and the like.
Though public and professional attention has been directed at understanding the extent, nature and effects of intimate partner abuse in order to develop and deliver effective services for addressing this problem, the all-toofamiliar accounts of women and children found dead are stark reminders that further attention is required.
In this light, the action plan announced last week by the Quebec government with regard to intimate partner abuse contains essential measures for reducing the possibility that our greatest fears — for women and children at risk of homicide — will be realized. Measures include early screening for men in distress who have been abusive toward their partners, funding to support groups for abusive men, and programs for children and youths regarding the prob- lem. To these we would add an enhanced understanding and detection of depression and alcohol use in the context of intimate partner abuse.
Clinical wisdom and research evidence all point to support for these initiatives. For example, researchers have long documented the heightened distress evidenced by abusive partners when women make efforts to take a stand against or, worse, terminate the relationship with an abuser.
Indeed, separation from an abusive partner can lead to an escalation of violence resulting in a physical assault at best, and in what is now known as intimate spousal homicide at worst. More recent analyses of crime statistics also suggest that perpetrators of intimate partner homicide have often already come to the attention of law enforcement and the criminal justice system for offences committed against others, often a current or past intimate partner.
On the relationship between substance abuse and violence of all kinds, correlation is significant; some estimate it as high as 55 per cent. It is important to understand this strong relationship cannot be drawn upon to conclude that substance use causes intimate partner abuse.
Rather, it appears that substance use disinhibits — that is, makes it easier, to cross the line from such non-physical forms of violence as emotional, psychological or financial abuse to physical forms of abuse in which injury and law-enforcement attention are more likely to ensue.
This nexus of factors compels us to step up to the challenge of improving strategies for detecting and assessing risk of intimate partner violence in general, and degree of danger or lethality in particular. Whereas many professionals today are conscious of intimate partner abuse and skilled at determining whether intimate partner abuse is occurring, sharp training is needed for helping professionals who might interact with abusive men post-separation in order to assess risk.
Key questions need to be asked about historical patterns of abuse with specific focus on frequency, severity, use of weapons, threats to kill, stalking; the abuser’s state of mind and the current situational factors like separation from partner and/or children; and factors that disinhibit, in- cluding substance use.
An assessment of lethality offers a fuller picture of the history of violence and its progression to date. Following through with this kind of intensive assessment protocol may not be easily done.
The orientations announced in the government’s action plan recognize the importance of early detection. Government funding ought to be considered for specialized training in detecting lethality, and for hospitals and other health care facilities to monitor depression, mitigate stigma and track potential abusers since resources are already underfunded and over-stretched.
Mechanisms for consulting and communicating with other helping professionals will also be crucial to the success of those measures.