Outlook: Newsletter of the Society of Behavorial Medicine

Summer 2020

Domestic Violence in the Time of COVID-19: Directions for Future Research

By Em V. Adams PhD, CTRS; Violence and Trauma SIG Co-Chair


Domestic Violence (DV) is a broad term used to describe intimate partner violence, child abuse, elder abuse, and sexual violence.1 DV is associated with a broad range of negative health outcomes, including chronic illness, PTSD, and acute traumatic injury.1 When stay-at-home orders first began rates of DV have increased from 25%-33% globally.2 Rates in the U.S. are still unknown, but some individual cities report seeing an increase, while others report their hotlines and resources are getting less traffic.
 

Risks of DV amid COVID-19

Risk factors for DV include unemployment, substance use disorder, mental illness, and access to guns and ammunition, and social isolation.3 The stay-at-home orders related to COVID-19 have exacerbated these risk factors in several ways:4 Unemployment rates increased in the in the U.S. from 3.4 to a current 14.7 percent;5 Since stay-at-home orders were first implemented alcohol sales have increased by 55%;6 Access to mental illness resources is imited;7 Gun sales are up by 20% and ammunition sales have increased by 400%-500%.8 In addition to these risk factors, people are essentially trapped at home potentially with exploitive relationships, increases the potential for DV to occur.9 The potential for increased prevalence is compounded by increased difficulty accessing services.10
 

Barriers to Accessing Service

Access to services may have been limited in several ways. First, because people were at home, many without an excuse to leave, may not have been able to call for help without risking further violence. Depending on the state, volunteer services such as peer mentoring, and help support hotlines may not have been listed as essential services. Shelters were more difficult to get into because they were trying to reduce crowding and prevent transmission of COVID-19.

 

Directions for Future Research

The first wave of COVID-19 highlighted gaps in services and research. Needed research may include:

  • Developing and testing targeted campaigns to distribute information about discrete ways victims can reach help.
  • How to ensure a continuum of care and minimize treatment disruption for people already receiving treatment for mental illness and substance use disorder.
  • Testing the feasibility of telehealth services and support.
  • Develop specific interventions to promote coping strategies that can be used at home.
  • Ensuring there is a continuum of care for people already receiving treatment.
  • Strategies to provide technology to clients so they can access telehealth services.
  • Trying to determine prevalence rates during COVID-19, and associations between rate increased and differences between city policies and services.
  • How to prevent intrapersonal barriers such as fear of law-enforcement violence if emergency services are called.
  • Evaluating impact of access to ‘non-essential’ volunteer services.

While stay-at-home orders have eased for the time being, it is uncertain if rates of COVID-19 will spike again. Research to help establish protocol for handling DV in times of emergency should be a priority among researchers.

 

References

  1. Center for Disease Control. “Prevent Domestic Violence in Your Community.” (2019) https://www.cdc.gov/injury/features/intimate-partner-violence/index.html Accessed May 28, 2020
  2. Campbell, Andrew M. "An increasing risk of family violence during the Covid-19 pandemic: Strengthening community collaborations to save lives." Forensic Science International: Reports (2020): 100089.
  3. Center for Disease Control and Prevention. “Risk and Protective Factors for Perpetration” (2019). https://www.cdc.gov/violenceprevention/intimatepartnerviolence/riskprotectivefactors.html Accessed May 28, 2020
  4. van Gelder N., Peterman A., Potts A., O'Donnell M., Thompson K., Shah N. & Oertelt‐Prigione S. (2020). COVID‐19: “Reducing the risk of infection might increase the risk of intimate partner violence.” EClinicalMedicine, Retrieved on 19th April, 2020 from doi: 10.1016/j.eclinm.2020.100348.
  5. The United States Bureau of Labor Statistics. “News Release” (2020) https://www.bls.gov/news.release/pdf/empsit.pdf Accessed June 4, 2020
  6. Nielsen. Rebalancing the Effect of COVID-19 on alcohol sales.” (2020) https://www.nielsen.com/us/en/insights/article/2020/rebalancing-the-covid-19-effect-on-alcohol-sales/ Accessed June 1, 2020
  7. Galea, Sandro, Raina M. Merchant, and Nicole Lurie. "The mental health consequences of COVID-19 and physical distancing: The need for prevention and early intervention." JAMA internal medicine (2020).
  8. National Public Radio. “Some Stock Up on Guns and Ammunition” (2020) https://www.npr.org/2020/03/20/817369503/some-stock-up-on-guns-and-ammunition-during-coronavirus-crisis Accessed May 31, 2020.
  9. Bradbury‐Jones, Caroline, and Louise Isham. "The pandemic paradox: the consequences of COVID‐19 on domestic violence." Journal of clinical nursing (2020).
  10. Usher, Kim, et al. "Family violence and COVID‐19: Increased vulnerability and reduced options for support." International journal of mental health nursing (2020).