Family Violence and Human Trafficking

Chapter 7: Family Violence and Human Trafficking

Types of Violence

  • Intimate Partner Violence (IPV)

  • Child Abuse and Neglect

  • Elder Abuse

  • Human Trafficking

Intimate Partner Violence (IPV)**

Forms of IPV:

  • Physical violence: This includes hitting, slapping, or any form of physical harm intended to control or intimidate the partner.

  • Sexual violence: Coercive sexual acts without consent, which can include rape or other forms of forced sexual activity.

  • Stalking: Persistent harassing or threatening of the partner, often leading to fear for one’s safety.

  • Psychological aggression: Emotional abuse intended to undermine a person's self-worth through constant criticism, control, and manipulation.

  • Teen dating violence: Similar forms of IPV exhibited in teen relationships, which can have long-lasting effects on mental health and relationship dynamics.

Consequences of IPV:

  • Often begins during adolescent years, which can lead to lasting emotional and psychological trauma.

  • Victims may develop anxiety, depression, engage in unhealthy behaviors, or experience suicidal thoughts as they cope with their situation.

Victim's Response to Violence

  • Victims may exhibit different responses to violence, often influenced by individual circumstances and psychological factors:

    • EXPLOSION: Some victims may resort to explosive actions like defending themselves or contacting authorities.

    • Withdrawal: Many respond by isolating themselves from family and friends, seeking to avoid confrontation or judgment.

Batterer's Response:

  • Batterers may attempt to calm the situation, often oscillating between remorse and aggression. Their behaviors can vary significantly:

    • They might be silent or very vocal, and their moods can shift from sullen to excessively angry.

Victim's Feelings:

  • Victims may feel a blend of hope for change and anxiety, akin to walking on "eggshells" around their partner, afraid of triggering further violence.

Forms of Abuse

Types of Abuse:

  • Neglect: Failing to provide necessary care or attention, particularly in the case of children or the elderly.

  • Physical abuse: Any non-accidental physical harm inflicted on another person.

  • Sexual abuse: Any non-consensual sexual activity.

  • Emotional abuse: Inflicting psychological harm through intimidation, threats, and verbal abuse.

  • Financial abuse: Controlling a partner's access to financial resources, aiming to make them financially dependent.

Human Trafficking

Definition:

  • Driving or coercing an individual into any form of labor, servitude, or commercial sexual exploitation against their will.

Victims Can Work In:

  • Legal or illegal industries: Includes agriculture, child and elder care, the drug trade, hospitality, and factory labor, often characterized by exploitative conditions.

Health Risks:

  • Victims face significant risks to both mental and physical health, including:

    • Chronic mental health issues like depression and PTSD.

    • Risk of chronic pain conditions due to abusive labor situations.

Health Effects of Violence

  • Abuse victims are at higher risk for numerous chronic health concerns, including:

    • Gynecologic and reproductive health problems: Such as STIs due to sexual violence.

    • Mental health issues: Persistent depression, anxiety, PTSD, and increased risk of substance abuse.

    • Increased risk of suicide: Due to overwhelming emotional trauma.

Assessing for Intimate Partner Violence (IPV)

Routine Screening:

  • Universal screening mandates asking every patient specific questions regarding IPV during health care encounters. Advocacy for this practice is supported by most nursing professional organizations.

Abuse Assessment Screen (AAS):

  • Key tool introduced by NRCVA in 1988 for effectively screening IPV.

    • Key Questions Include:

      • Are you ever afraid of your partner?

      • Does your partner attempt to control you?

      • Have you ever been physically or sexually harmed by your partner?

    • If yes is answered to any of the above, it is crucial to follow up for more details.

Red Flags for Potential Abuse

  • Signs that may indicate abuse include:

    • Injuries that are healing at different stages without a plausible explanation.

    • Frequent failure to keep medical appointments.

    • Symptoms of traumatic stress, such as insomnia and severe anxiety or depression.

    • A noticeable dependency on the partner for daily decision-making.

    • Substance abuse issues as a coping mechanism.

Documentation of Abuse

Essential Elements in Documenting Abuse:

  • Detailed, non-biased progress notes: Ensure that accounts are factual and objective.

  • Use of injury maps: Assist in providing a clear visual of injuries sustained.

  • Photographic records if necessary: Documenting visible injuries or conditions.

  • Collecting a detailed abuse history: Include past incidents, severity, and frequency.

  • Using direct quotes from victims when appropriate: It can be invaluable in accurately capturing their experiences.

Mandatory Reporting Laws

General Requirements:

  • Mandated reporters must report suspected cases of abuse involving children, the elderly, or vulnerable populations.

  • Specific to Florida for IPV:There’s a right to privacy and self-determination; thus, consent is needed for reporting IPV unless it's life-threatening situations or gunshot wounds stipulating mandatory reporting.

Assessing for Risk of Homicide

  • Women are often killed by intimate partners (husbands, boyfriends).

  • Approximately 75% of these women had reported experiences of past abuse.

  • Studies indicate that up to 42% of women murdered had healthcare interactions before their deaths, underscoring missed opportunities for intervention.