B REAKING THE S ILENCE : W OMEN IN P ERIL 21 ST A NNUAL N URSING E XCELLENCE IN L EADERSHIP AND E VIDENCE -B ASED P RACTICE P I T HETA C HAPTER, U NIVERSITY OF A RKANSAS E LEANOR M ANN S CHOOL OF N URSING Carolyn Mosley, PhD, RN, CS, FAAN, ANEF April 16, 2012

N ATIONAL D OMESTIC V IOLENCE S TATISTICS A women is beaten every 12 seconds in the US 35% of all emergency room visits are a result of domestic violence Crimes are committed by men against women in 92% of all domestic violence cases Of those who abuse their partner, over 65% also physically and/or sexually abuse the children Each day 4 women die as a result of abuse Each day 3 children die as a result of abuse

A RKANSAS D OMESTIC V IOLENCE S TATISTICS YEARRANK th in Nation th in Nation ( Ranked 1 st in Nation for African American Female Domestic Related Deaths) th in Nation th in Nation th in Nation th in Nation th in Nation th in Nation th in Nation (Violence Policy Center Report, When Men Murder Women, 2010)

S EPTEMBER 15, 2009 A RKANSAS S UMMARY D OMESTIC V IOLENCE C OUNT 606 victims served in one day 71% - individual support/advocacy 63% - emergency shelter 46% - group support/advocacy 43% - transportation 37% - children’s support/advocacy 31% - court accompaniment/advocacy 23% - advocacy related to public benefits/TANF/welfare 20% transitional housing Answered 7 hotline calls every hour

U NMET R EQUESTS FOR S ERVICES 60% - not enough funds for needed programs and services 26% - not enough staff 20% no available beds or funding for hotels 11% - limited funding for translators, bilingual staff, or accessible equipment

R ISK F ACTOR FOR THE P ERPETRATOR Seeing or being a victim of violence as a child Using drugs and/or alcohol, especially drinking heavily Being violent or aggressive in the past Not having a job or other life events that cause stress Low academic achievement Marital conflict or instability Traditional male norms/societal norms supportive of violence Depression Personality disorders Weak community sanctions Note: These are just a few risk factors.

F EMALE V ICTIMS OF V IOLENCE AND P ERCENT I NCREASE BY N ETWORK -’04-’09 Network% Increase CBS119% NBC192% FOX105% ABC39%

E FFECTS OF A BUSE ON C HILDREN Powerless Confused Angry Guilty Afraid Alone

W HY D O THE A BUSED S TAY ? Fear of the batterer’s violence Immobilization by psychological and/physical trauma Connection to perpetrator through children Belief in cultural, family or religious values Continual hope and belief that violence will end or he will change Belief that batter will commit suicide Lack of funds Lack of real alternatives for employment and financial assistance

D OMESTIC V IOLENCE I MPACT O N H EALTH Physical Cuts, scratches, bruises, and welts Internal bleeding, head trauma, broken bones Disfigurement, disability Abdominal/thoracic injuries, Ocular damage Psychological/Emotional Panic attacks Post traumatic stress disorder Eating and sleep disorders Inability to trust others Somatic complaints Depression, anxiety, suicidal behavior Substance abuse

E CONOMIC C OSTS OF D OMESTIC V IOLENCE ED visits458, 096 Outpatient visits306, 051 Overnight in hospital758, 066 Physician visits860,346 Dental visits216,955 Ambulance/paramedic services85,070 Physical therapy visits974,693 Cost$8.3 billion ( Cost of Intimate Partner Violence Against Women in the United States, National Center for Injury Prevention and Control, March 2003 )

U NIVERSITY OF A RKANSAS C LINTON S CHOOL OF P UBLIC S ERVICE Needs Violence prevention education Funds/resources Training for service providers More mental health counselors with expertise on treating victims of violence, and relationship building among service providers. Gaps Not enough service providers/counselors Not enough prevention education

U NIVERSITY OF A RKANSAS C LINTON S CHOOL OF P UBLIC S ERVICE Gaps (cont.) Lack of services for people with mental health issues Lack of violence prevention programs for youth Lack of standardized program for batterer

2011 A RKANSAS D OMESTIC L EGISLATION SB 751/Act 1004—An act to provide for adult abuse and domestic violence reporting. This Act states that a health care provider may report to a law enforcement agency an injury to an adult that they believe may be due to domestic violence. This report may be made if the injured adult agrees to the disclosure or if the health care provider feels the report is necessary to prevent serious harm to the adult. The injured adult must be informed of the report and the health care provider is immune from criminal or civil liability for making or deciding not to make the report.

2011 A RKANSAS D OMESTIC L EGISLATION HB 2001/Act 1049—An act regarding the care of pets under the domestic abuse act. This act list new relief that the court may provide in an order of protection. An order may now include language that directs the care, custody or control of any pet owned, possessed, leased, kept or held by either party residing in the household.

2011 A RKANSAS D OMESTIC L EGISLATION HB 2198/Act 1199– An act to require a law enforcement officer to complete continuing education and training relating to persons with disabilities in a law enforcement context. This act states that as part of certification requirements of the Arkansas Commission on Law Enforcement Standards and Training, all law enforcement officers shall complete a minimum of six hours yearly on training related to persons with disabilities in a law enforcement context.

S O W HAT FOR Y OU ? Research opportunities that address demographic, social, and environmental factors that may account for variations in victimization rates among women of different racial and ethnic backgrounds and the link between victimization experienced as a minor and subsequent victimization. Research that ask what distinguishes men who are able to form healthy, non violent relationships despite childhood adversity from those who become abusive? Development and testing of prevention strategies Career opportunities working with this population of individuals