Hope! M e n t a l a n d P h y s i c a l H e a l t h P a n e l 3 - PowerPoint PPT Presentation

Hope!

M e n t a l a n d P h y s i c a l H e a l t h P a n e l 3 O c t o b e r 2 0 1 4

Revathi K. Vikram, M. D., Moderator Overview of Mental and Physical Health Manifestations Mala Tandon, PhD. Mindfulness Treatment and Advanced CBT Razia Kosi, LCSW-C Trauma Informed Care

Although domestic violence occurs across all ethnic groups, cultural differences impact on access to services and effective intervention. Service providers therefore need to be aware that women of South Asian origin may have specific issues that need to be considered. “It is easier to see the physical side of abuse - bruises, cuts, strangulation marks. It’s important not just to identify physical pain but to ask about psychological wounds. It’s harder to see the threats that a husband makes to kill a woman, or to send her back to India.’” Counsellor

Domestic Violence Lifetime Consequences Mental and Psychological • Acute • Chronic

Acute Consequences Deaths - homicide or suicide ~1,300 per year Injuries ~2 million per year More likely to occur in pregnancy

Medical Consequences • Unintended pregnancies, induced abortions, gynecological problems, and sexually transmitted infections, including HIV. • Increases the likelihood of miscarriage, stillbirth, pre-term delivery and low birth weight babies.

Increased risk for chronic illnesses

Long Term Consequences • Adverse Health Conditions Limited mobility and poor overall  health including headaches, back pain, abdominal pain, fibromyalgia, GI disorders • Sexually Transmitted Diseases including HIV/Aids

Long Term Medical Consequences Violence  chronic stress  susceptibility to developing chronic diseases CDC study released in 2012 • 80% increased risk for stroke • 70% increased risk for heart disease • 60% increased risk for asthma

Long Term Medical Consequences cont … • Increased risk taking behaviors such as alcohol and drug abuse • Increased risk of Post Traumatic Stress Syndrome

Impact of Cultural Reasons for not Seeking Help • Fear of going outside community for help • Fear of the child being taken away by perpetrator or authorities Problem : Delay in getting help equals further exposure to the abuser and protection of the abuser Solution : Free Help Line of professionals who work with Asian families

Solution for Medical and Social Services Professionals • Unaccompanied Women Routine inquiry means asking all women, whether or not they show signs of being at risk, if they are experiencing DV. • Accompanied Women (more likely ) Attempts should be made to see her alone. • A good time to ask might be when taking a history • Provide all women with info on DV support services. *If nobody asks, the women will not report*

Psychological Consequences • Anxiety, depression, sleep difficulties, eating disorders, emotional distress and suicidal attempts • Alcohol and substance abuse • Acute stress and PTSD

Indicators in the Behavior of the Victim • Covering the body to hide marks (long sleeves , trousers or scarves) • Attending late or frequently missing appointments • Frequent visits with vague complaints or symptoms • Seeming anxious, fearful or passive ( particularly in presence of others) • Giving inconsistent explanations for injuries or is evasive • Frequent use of pain medication or tranquillizers • Suicide attempts • Repeated episodes of depression, anxiety or self harm • Alcohol or drug misuse • Not wanting letters or contact at home

Effects of Domestic Violence on Children How many children witness the abuse of their mothers? • Seeing, hearing, observing, being aware and even intervening. What are the feelings of these children? • Fear and anxiety, feeling of isolation and vulnerability • Feeling physically and emotionally abandoned.

What behaviors do children witnessing DV exhibit? • Leads to increased behavioral problems, crime, and learning disabilities • Sleep disturbance • Depression • Keeping secrets, anger at both parents • Guilt, embarrassment • Helplessness • Physical responses – injury, abuse to themselves and eating disorders • Poor school performance and attendance • Developmental delays in speech, motor or cognitive skill • Increased aggression with peers or mother

What are the Long-Term Effects? • Emotional and psychological trauma • Using violence to resolve problems, bullying. • Replicating witnessed behaviors in adult instances • Higher risk for substance abuse, post traumatic distress disorder and juvenile delinquency • Witnessing domestic violence is the single best predictor of juvenile delinquency and adult criminality. • Number One reason children run away

What are the Consequences for the Abuser? DOMESTIC VIOLENCE IS A CRIME Impulsive behavior leads to problems: Legal • Prison time for murder • Criminal record for assault and battery, failure to pay child support, violation of orders for protection Economic • Potential loss of job and income, having to pay child support

What are the Consequences for the Abuser? Cont … Personal • Loss of wife and children • Embarrassment • Ostracized from family and friends • Health deterioration • Emotional distress – loneliness, depression, anxiety, rage • Increased substance abuse • Risk of suicide Domestic Violence is a Crime

Certainly the problem is big and the numbers and facts indicate only the tip of the iceberg. • The physical and psychological damage to individuals, families and children is so extensive that it even reaches back home. • The economic costs to society in health care, lost time at work and decreased productivity is enormous. • Reported at $6 Billion per year.

Prevention • Education • Healthy respectful relationships • Conflict negotiation • Life skills training • Collaboration • Talk about the problem with children, colleagues, family and friends

Strategies that Work • VAWA Act Involves the Department of Justice. The Act has increased the growth in responsiveness in DV • Family Violence Prevention Act Increased shelters and protection of victims It believes in providing support without judgment • Building public health and community capacity including data gathering for evidence base for a strategy for prevention

Future Directions • Change the social norm • Bystander Intervention • Own the Problem • Cultural shift is needed to end Domestic Violence

Violence is a human rights issue whether in a war or against individuals Violence breaks the spirit of the individual whether victim or perpetrator

THANK THANK YOU OU Hope!