OREANDA-NEWS. Using an innovative approach, Kaiser Permanente Northern California has dramatically increased the recognition of patients experiencing intimate partner or domestic violence.

On June 21, the prestigious medical journal JAMA (Journal of the American Medical Association) published an analysis about the Family Violence Prevention Program by Kelly C. Young-Wolff, PhD, MPH, research scientist with the Division of Research, and Brigid McCaw, MD, MPH, MS, medical director, and Krista Kotz, PhD, MPH, program director, of the Family Violence Prevention Program. The co-authors recently discussed with Janet Byron, of Kaiser Permanente’s Division of Research, how lessons learned at Kaiser Permanente can be used to improve identification and intervention for domestic violence in other health care settings.

What are the challenges associated with health care identification?

Kotz: A patient may be experiencing headaches, anxiety, and depression, but wouldn’t know to say these symptoms are linked to intimate partner violence. Many health care systems don’t ask patients about it, or patients may not have the opportunity to talk to their doctor if their partner is in the room.

McCaw: Domestic violence is complex, and processes of disclosure, seeking services, and recovery are not simple and straightforward. Many people consider domestic violence a private matter. They are often frightened and ashamed and don’t realize it is a health issue that they can talk about with their doctor. And many doctors aren’t sure how to ask questions or respond when they learn a patient is experiencing domestic violence.

How does Kaiser Permanente address intimate partner violence?

Kotz: People who are affected by intimate partner violence may seek care in different departments, including emergency, outpatient clinics, and mental health. We have messaging throughout our facilities that lets members know that this is a place where they can go for help.

McCaw: We have made inquiry, recognition, and intervention part of everyday care. When patients disclose domestic violence, clinicians have tools and training so that they are confident about how to respond in a caring, effective manner and offer resources to work toward solutions with the patient. This can include referrals to on-site behavioral health clinicians or connections to community advocacy services that provide safety planning, shelter, and legal services.