Screening can reduce domestic violence: study
The Canadian Press | Posted: March 8, 2011 11:42 PM | Last Updated: March 8, 2011
Screening all women who come to a health-care facility increases the number who admit to being abused by their partner, says a new study that represents a major shift in thinking about the value of universal screening programs for domestic violence.
The research and health-care policy communities have long believed there has been insufficient evidence to support such programs. But a study led by Patricia O'Campo, director of the Centre for Inner City Research at St. Michael's Hospital in Toronto, reached a different conclusion.
O'Campo reviewed all the major studies conducted on the topic between 1990 and 2010 and found that the most effective universal screening programs include:
- The support of their institution and senior administratorsStandardized questions for asking about abuse and clear guidelines, such as talking to patients privately
- Thorough initial and ongoing training for staff
- Immediate access to or referral to support services.
"What is not effective is asking staff to do the screening without providing staff with any support during what is a stressful experience for women who are experiencing violence," she said in a release. "When the right supports are in place for staff, then the screening process can be very effective and more patients can be helped.
"What these supports do is help the staff feel more confident and capable of performing the screening effectively."
O'Campo, whose analysis appears in the journal Social Science and Medicine, said past studies have measured the effectiveness of universal screening programs in terms of whether they result in less abuse. However, she said that's not the best measure of success because there are so many, sometimes tentative, steps involved in the process, many of which are outside the health-care system.
Programs that showed the most improvement in screening rates provided immediate access to support services for such issues as mental health, housing, health care, employment and legal issues, she said. Some programs had on-site case managers; others made immediate referrals to community agencies.
"It is not helpful to ask a patient to disclose that she's experiencing violence and then to have no service or help to offer her," the paper says. "Health-care providers need to have support-service providers on site or to have good connections to services outside the hospital so women get the help they need immediately."
O'Campo wants to see more screening for abuse.
"Intimate partner violence tends to be a hidden problem," she said. "When health-care providers screen properly, women are willing to disclose and get the help they need. Especially in a place like Canada, where almost every woman has a doctor and has health insurance, universal screening is a perfect way to get to everybody."
The World Report on Violence and Health estimates that 22 to 30 per cent of women in North America suffer physical assault at least once in their lifetime.