Family Violence: Considerations Amid the Pandemic

Photo By: Cpl. R. Logan Kyle
By Carrie McDonnell, LICSW, LCSW-C
January 25, 2021

Reports of family violence have increased worldwide since quarantine measures began in the wake of the COVID-19 pandemic. This should come as no surprise to clinicians as we know that factors like economic insecurity, social isolation, reduced options for support, exposure to exploitative relationships, and disaster-related instability are associated with this type of violence.

Unfortunately, family violence was a global problem even before the pandemic and service members have not been shielded from the issue. In 2019, the Family Advocacy Program (FAP) reported 15,473 formal complaints of spouse or intimate partner abuse in which one of the parties was an active duty service member. Regarding child abuse and neglect, the FAP reported 5,600 incidents of substantiated allegations among military families.

The known and hypothesized immediate and long-term consequences associated with family violence are significant and include:

On an even more somber note, research has also shown that exposure to family violence may lead to an increased risk for suicidal behavior. In a Veterans Health Administration study, female veterans who screened positive for psychological, physical, or sexual types of intimate partner violence were two times more likely to have reported suicidal ideation and/or self-directed violence compared to those who screened negative. Research has also shown a correlation between interpersonal violence and risk of suicide, regardless of whether an individual is the victim/survivor or the perpetrator.

While the pandemic has necessitated changes in the delivery of health care services, what should remain constant is clinicians’ attention to signs of family violence. Once family violence has been identified or suspected, what are your responsibilities as a clinician?

Reporting:

As indicated within Department of Defense Instruction (DoDI) 6490.08, there are nine circumstances for which disclosure of protected health information (PHI) is required. Consistent with DoDI 6400.06, disclosures concerning child abuse or domestic violence is one of them.

There are different ways to report family violence, however, and given that service members and their dependents may be hesitant to discuss family violence due to fears of career- and service-related consequences, it is important that clinicians be aware of the available options. Reports can be made in one of two ways: restricted or unrestricted. For a restricted report, military law enforcement and command will not be notified. To review the difference between restricted and unrestricted reports, visit the Military OneSource website

For those worried about the potential consequences of reporting, speaking with a military chaplain may be an attractive option because communications with chaplains are protected and confidential.

Resources for Patients:

As the world grapples with the pandemic and our changing social landscape, family violence must remain an area of focus in terms of both prevention and support. Providing victims/survivors with options regarding reporting and resources for support may make the difference between them speaking up or staying silent.

Ms. McDonnell is a contracted social work subject matter expert for clinical care at the Psychological Health Center of Excellence. She is a licensed clinical social worker with extensive experience in both direct service and administrative oversight of programs specializing in crisis intervention.


The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Psychological Health Center of Excellence or Department of Defense.


Comments

  • Hello,
    As I read this, I couldn't help but to simplify the concept. In short, layman's terms, stress causes some poor choices.
    This is neither new, nor ground breaking.
    Rather than restating the previously restated, restatement of simple stressor as a causative catalyst theory, perhaps a study that demonstrates that the health care continuum is or has established systems that are effective at delivering the care that people actually need?
    As an example: two years ago I attended a lecture on non-narcotic pain control strategies that the VA had established in response to the outcry of the public sector related to over medicating Veterans who have chronic pain issues. Veterans saw immediate restrictive measures implemented that decreased or altogether ceased their established pain control plan as a way to motivate the, "drug seekers," to seek out alternative therapy. In many cases the therapies were not available.
    As dominoes go, people already under considerable pressure, were set up to fall.
    How about a study on simple process improvement as a method for reducing stressors and thereby eliminating stress related maladaptive behavior?
    Respectfully,

  • Based on my clinical research families who create enriched and functional psychosocial environments (PSE) confer more constructive coping mechanisms during these very distressful times.

    Families who display dysfunctional and toxic PSE confer far greater risks.

    I appreciate your thoughtful resources for these families.
    Rich

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