Domestic violence often leaves outward signs of abuse: bruises, black eyes, or broken bones. But, there’s often an invisible toll as well: traumatic brain injuries.
More than 80% of survivors of domestic violence sustain injuries to their head, face or neck, according to surveys by the Ohio Domestic Violence Network and the Ohio State University Department of Public Health. 83% reported being choked or strangled. Almost half of survivors said it happened too many times to count.
A new grant will allow the Ohio Domestic Violence Network to work with more than 200 providers to increase awareness on how these injuries could impact survivors’ brain health. The statewide organization will provide virtual trainings and conferences and establish best practices for shelters, crime victim services and healthcare providers.
“It is kind of something that has been really hidden in plain sight since the very beginning of doing domestic violence work,” said Rachel Ramirez, director of ODVN’s health and disability programs and founder of The Center on Partner-Inflicted Brain Injury.
Increasing awareness
Despite the prevalence of these injuries among domestic violence survivors, Ramirez said concussions have rarely been talked about among service providers. The conversation around traumatic brain injuries has largely been siloed to sports and the military.
Ramirez said that’s partially because domestic violence is a private experience.
“It doesn't happen in front of other people. It's not like a football game … When we think about sports, you take a timeout, you assess for a concussion,” she said. “That’s not possible in our spaces.”
Brain injuries can have a long-term impact on survivors’ health. It may cause challenges with time management, anger management, problem-solving and impulse control. It can cause headaches and impact sleep.
Ramirez said many survivors report not feeling like themselves but not understanding why.
“I have survivors reach out to me who tell me ‘I'm having a harder time reading, like I just can't think. It’s taking me so much longer at work. I lose my keys all the time because I can remember where I put them,’” Ramirez said. “The signs and symptoms and impacts of brain injury can be very widespread.”
A new treatment model
The $10,000 grant from the Ohio Department of Mental Health and Addiction Services will train more providers to spot those symptoms in survivors and create treatment plans with brain injuries in mind, Ramirez said.
For example, if a survivor is struggling with time management, service providers will know to ask about their history with head injuries and work to accommodate the effects of a possible concussion.
“If someone is living with us in a shelter and they know that they have a two o'clock appointment, can we make a plan with them to go do that? If we have people who are very sensitive to noises, to sounds, to lights, can we change our lighting? Can we provide people with sunglasses?”
The hope is that providers can intervene earlier and connect more survivors to medical treatment.
That’s especially important, Ramirez said, since concussions can act as a barrier to escaping abuse. It can be more difficult to apply for a protection order or find new housing, if your brain feels cloudy or you’re suffering from debilitating headaches.
“Helping survivors have a better understanding of what [brain injuries] are and understand, ‘No, you're not crazy. You're not stupid. You're not making these things up, it's just that you've been hurt,’” she said. “Let's come up with ways and strategies that'll work for you to be able to live your life in the way you want to.”
