As COVID-19 restrictions continue across the country, the consequences of isolation are becoming more apparent—unfortunately including a rise in domestic violence. Known as the shadow pandemic, programs are struggling to handle this surge in intimate partner violence alongside the coronavirus. Governments, non-profits, and other initiatives can mitigate this surge by incorporating three tactics, including improving access to internet, training healthcare providers, and utilizing social determinants of health.
THE SHADOW PANDEMIC
Statistically, each of us know at least one person who has experienced domestic violence. According to UN Women1, one in three women will experience physical or sexual violence in their lifetime. This aggression can be called many things—domestic violence (DV), intimate partner violence (IPV), domestic abuse, emotional abuse, and domestic conflict, just to name a few—but always involves at least one abuser using manipulative tactics to control his or her victim.
As COVID-19 spread across the United States, many victims of domestic violence were forced into quarantine with their abusers, and many experts correctly predicted2 that DV would rise in conjunction with stay-at-home orders. As abusers are more likely to use violence during periods of stress, coronavirus provided an unfortunate mix of health, economic, and emotional stressors triggering an unprecedented spike in DV cases—some states even recorded nearly a 200% increase3.
This shadow pandemic across the US highlights how interconnected public health issues are with one another, as well as reinforcing inequities stemming from social determinants of health (SDoH). Unfortunately, even though the country is slowly opening back up, experts predict that a return to normalcy may cause abusers to feel a loss of control and could lash out at their victims4. With the holiday season just around the corner, additional stressors may only add to the risk.
THREE THINGS PROGRAMS CAN DO
While the shadow pandemic is undoubtedly troubling, there are still action plans that governments, non-profits, and issue campaigns can take to combat DV and work to improve living conditions for people experiencing this violence. In particular, the New England Journal of Medicine recommends three things5 that programs can do to push back against DV even in the middle of a pandemic: improve access to internet, increase training for healthcare providers, and incorporate SDoH into standards of care.
1) IMPROVE ACCESS TO THE INTERNET
Access to the internet is often correlated with other important variables such as economic stability and access to a support network. Unfortunately, many people who experience DV or IPV simply don’t have that access, and without it they cannot easily find resources, engage in telehealth, or maintain crucial social relationships. Many people suddenly lost their daily friends—coworkers, neighborhood groups, and community activities—and without these connections, they have no one to regularly check on them to ensure their safety.
Providing widespread access is easier than might be expected. Some experts recommend implementing a government subsidy program similar to the Federal Communications Commission Lifeline program6, while others argue for installing free WiFi points in public places like parks or supermarkets7. Ultimately, working to promote equitable access to the internet is the first thing we can do to decrease DV.
2) INCREASE TRAINING FOR HEALTHCARE PROVIDERS
Instructing healthcare providers to screen for DV is another great tactic for programs. As clinicians normalize asking screening questions, they can create a space that is otherwise not available for people experiencing DV to get help. This is a great option during the pandemic, as providers can ask these questions over telehealth visits. Modifications for virtual meetings where an abuser may be present are also available8.
If DV is disclosed during the screening, initiatives need to make sure clinicians know the resources in their community and are up-to-date on safety practices, such as creating safe words to use during visits or saving help numbers under different contact names in their phone. As providers may be the only point of contact for many of these people during quarantine, this option becomes even more crucial to combatting DV.
3) INCORPORATE SDoH INTO STANDARDS OF CARE
It’s no secret that DV does not affect all communities equally—there is a strong relationship with SDoH and its prevalence. As programs consider standards of care, such as what qualifies a person for help, it is crucial to consider those same SDoH. Economic status, societal privilege, and access to resources are all determinants that impact DV on individuals. Understanding these predictors are essential in crafting responses that better address the needs of each patient and communities.
LIGHT IN THE SHADOWS
COVID-19 has shed a light on how important it is to address the DV crisis. As we continue to craft responses that better represent the needs of each community, we can ever more effectively improve the lives of those experiencing violence. Case-management systems, like Eccovia’s ClientTrack, provide the tools organizations need to identify these SDoH, manage those they serve, and craft more effective initiatives.
If you or someone you know is experiencing domestic violence, know that there is help. Please refer to the resources below for where to start:
- National Domestic Violence Hotline: (Call 800-799-7233)
- Crisis Text Line: (Text HOME to 741741)
- National Parent Hotline: (Call 1-855-427-2736)
- Childhelp National Child Abuse Hotline: (visit https://www.childhelp.org/childhelp-hotline/ or call 1-800-422-4453)
- National Domestic Violence Hotline: (visit http://thehotline.org, text LOVEIS to 22522, or call 1-800-799-7233)
- Futures Without Violence: (visit https://www.futureswithoutviolence.org/resources-events/get-help/)