Immediate and Late Response to Intimate Partner Violence Intervention in the Pediatric Emergency Department: A Case...

Childhood exposure to intimate partner violence (IPV) results in numerous, lifelong, negative health outcomes, underscoring the American Academy of Pediatrics' recommendation for IPV screening and intervention in the pediatric health care setting. We report a case in which a mother denied IPV during routine IPV screening in a pediatric emergency department (ED). However, subsequent discussion with health care providers during the ED visit revealed IPV. The mother declined to meet with an IPV advocate because the abuser was texting repeatedly to ask about the duration of the ED visit. However, the onsite social worker met with the mother to provide supportive counseling and complete safety assessment and planning. The mother returned to the abusive home after ED discharge because 3 of her 4 children were with the abuser at that time. Four months later, the mother returned to the ED with her children to see the IPV advocate. After speaking with the advocate, the mother and children went to safe shelter directly from the ED. This case underscores the importance of providing caregivers with multiple opportunities to disclose IPV, the need for health care providers to remain alert to indications that IPV may be occurring, and the role of the entire health care team in addressing IPV. This case also demonstrates that although IPV interventions may not immediately result in leaving an abusive relationship, the unseen benefits of such education and support can ultimately improve safety.