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Health care system responses to children exposed to domestic violence
Insights
Healthcare providers are improving domestic violence identification but often overlook children. Innovative programs show that supporting mothers and children together is key to their well-being and safety.
Area of Science:
- Public Health
- Pediatrics
- Sociology
Background:
- Healthcare systems are increasingly adopting protocols for identifying and responding to domestic violence (DV).
- Despite existing hospital protocols, routine training for healthcare practitioners on DV identification and response remains limited.
- The focus on individual patient care in adult healthcare settings has led to insufficient attention to the well-being of children affected by domestic violence.
Purpose of the Study:
- To highlight the need for integrated healthcare approaches for mothers and children affected by domestic violence.
- To examine innovative programs addressing the intertwined safety of children and mothers experiencing domestic violence.
- To identify opportunities for screening and intervention for domestic violence in pediatric and adolescent healthcare settings.
Main Methods:
- Review of current healthcare protocols and training related to domestic violence.
- Analysis of innovative programs in children's hospitals that support mothers and children together.
- Identification of screening opportunities within pediatric care, teen dating violence contexts, and prenatal visits.
Main Results:
- Most hospitals have domestic violence protocols, but consistent practitioner training is lacking.
- Innovative programs demonstrate that addressing maternal DV can enhance child safety and allow families to remain together.
- Pediatricians often lack training in DV identification and do not perceive responding to DV as part of their role.
- Teen dating violence and prenatal visits represent key opportunities for DV screening.
Conclusions:
- Integrating the healthcare needs of mothers and children exposed to domestic violence requires enhanced training and inter-institutional collaboration.
- Current healthcare practices often neglect the impact of domestic violence on children, necessitating a shift towards family-centered care.
- Improved insurance reimbursement models are crucial to support the comprehensive services required for families affected by domestic violence.
Abstract:
The health care system has only recently adopted protocols and training to enable practitioners to identify and respond to victims of domestic violence. Currently, most hospitals have domestic violence protocols in place, although training in the use of protocols is less routine. However, because the provision of health care focuses on the treatment of the individual, the well-being of the children of adult domestic violence victims has received little attention in adult health care settings. Pediatricians do not routinely receive training in domestic violence identification and do not see responding to battered mothers as within the purview of their practice. Innovative programs in children's hospitals in Boston, Massachusetts, and San Diego, California, recognize that the safety of children is integrally tied to the safety of their mothers. These programs identify abused children whose mothers are the victims of domestic violence and provide advocacy and support that allow mothers and children to remain together in most instances. Little is known about the health impacts of teen dating violence, and opportunities for screening exist in the settings where teens receive health care. Likewise, prenatal visits provide regularized opportunities for domestic violence screening. Integrating the health care needs of mothers and children from violent households will require continued and expanded training, collaboration with community institutions, and improvements in insurance reimbursements to cover the costs of needed services.