Background/History
Background--
There have been several pieces of legislation that have
greatly influenced the necessity of on-going, multi-disciplinary
training and the availability of training resources:
-the Alaska Domestic Violence Prevention and Victim Protection Act of 1996
-the federal Violence Against Women Act of 1994 (VAWA)
-the Alaska HB 375 act of 1998 relating to child abuse and neglect
-the federal laws relating to children--the Child Abuse and Prevention Treatment
Act of 1996 (CAPTA); 25 USC, Chapter 34 and 18 USC, 1169, on mandatory child
abuse reporting for an Indian child's welfare; and the Indian Child Welfare
Act of 1978, 25 USC, 1901.
The Alaska Domestic Violence Prevention and Victim Protection Act of 1996 mandated
that continuing education training be provided and requires DHSS to adopt standards
and procedures on domestic violence for health care facilities.
Continuing education training must be provided to: judicial officers, court
clerks, prosecuting attorneys, paralegals, school teachers, administrative
staff of public and private schools, social workers, peace officers, officers
in the dept. of corrections, administrative officers of institutions, child
care providers, paid employees of domestic violence and sexual assault programs,
practitioners of the healing arts, and paid employees of programs providing
rx/counseling on substance abuse.
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO),
the national hospital accrediting agency, requires that hospitals develop "objective
criteria for identifying and assessing possible victims of abuse and neglect
[and appropriate referrals], and they are [to be] used throughout the organization.
Staff are to be trained in the use of these criteria."
Project History--
Alaska Domestic Violence Training Project--
Since 1993, the Alaska Family Violence Prevention Project
(AFVPP), originally known as the Alaska Domestic Violence
Training Project, has developed and delivered training
to hundreds of health care and other service professionals
and domestic violence advocates in over 200 local and
regional trainings in over 39 Alaskan communities ("Train
the Trainers" Workshops), provided on-request technical
expertise, and maintained a Clearinghouse of available
resource/training materials.
Alaska Rural Domestic Violence and Child Abuse Workshops--
During 1998-99, the Alaska Family Violence Prevention Project (AFVPP) coordinated
Alaska Rural Domestic Violence and Child Abuse Workshops in 15 community/regions
throughout Alaska to help communities work together to end the cycle of family
violence and to understand the relationship between domestic violence and
child abuse. Communities/regions where training was held: Ketchikan, Cordova,
Kotzebue, Dillingham, Anchorage, Mat-Su, St.Mary's/Bethel, Copper Center/Glenallen/Valdez,
Ft. Yukon, Barrow, Unalaska, Sitka, Galena, Nome, and Kenai. Funding to support
travel expenses and conference coordination came through the Alaska Council
on Domestic Violence and Sexual Assault, through June 1999.
Participants included: domestic violence and sexual assault advocates, law
enforcement officers, corrections and child protection workers, social workers,
prosecutors, public defenders, mental health providers, CASA staff, ICWA workers,
tribal representatives, clergy, and other community service professionals.
Evaluations from these trainings stressed the need for on-going support and
training; the need to form local multi-disciplinary task forces to work together
to identify issues, challenges, and strategies to improve our response to victims
of domestic violence and their children; and the need to provide for additional
opportunities for service providers to discuss how they can work together to
ensure safety and the availability of appropriate services for victims of domestic
violence and child abuse.
The "10 State" Project--
The Alaska Family Violence Prevention Project (AFVPP)
coordinated the "10 State" National Health
Initiative on Domestic Violence Project, a national project
sponsored by the national Family Violence Prevention
Fund. Alaska was selected, as 1 of 10 states in the nation,
to participate in this project as a model training and
implementation site. The purpose of this project is to
develop and implement a statewide plan for a comprehensive
health care system response to domestic violence.
-A "10 State" leadership team was formed and selected 15 Alaskan
health care facilities/clinics to receive initial training on April 16-18,
1999 and a follow-up training in April, 2000. The AFVPP, with the Alaska Network
on Domestic Violence and Sexual Assault, planned and coordinated this training
and provided the technical expertise and resources to support site teams. The
15 "10 State" site teams formed multi-disciplinary teams at their
facilities and the AFVPP provides ongoing technical expertise as requested
to support development of protocols, policies, and on-going training plans
at each site. Five additional health care sites received training in April
2000.
Initiative on Abuse During Pregnancy-
-The Alaska Family Violence Prevention Project (AFVPP)
is currently developing resource materials for an educational
initiative on abuse during pregnancy, including: 6 posters,
an information card, and video and radio public service
announcements (psa's). The resources are expected to
be made available for distribution during late Spring
2002.
Injury Prevention-
-The AFVPP provides training to health care and service
providers, including public health professionals and
resources for domestic violence victims and survivors;
develops curriculum for impact of domestic violence on
children, collects data on screening for domestic violence
in the pediatric setting, publishes articles on domestic
violence as a health care issue for women and children,
and operates a Clearinghouse lending library of resources/training
materials for health care and service providers and domestic
violence service providers.
The Need--
Domestic Violence:
Domestic violence is the leading cause of injuries and
homicide for American women.
50% of female homicide victims in America are murdered by their husbands or
boyfriends.
Alaska ranks among the top 5 states in the nation for per capita rates of domestic
violence.
The rate of Alaskan women being killed by a partner is 1.5 times the national
average.
PRAMS data (1991-1994) revealed that 13% of women (1 out of 8) who had recently
given birth had been physically hurt by someone close to them before or during
pregnancy. This number does not include the emotional abuse.
Pregnant teens are at a particularly high risk of abuse during pregnancy--PRAMS
data for 1991-94 indicates that 27% of teens who have just given birth have
experienced domestic violence. Anchorage had a high rate of teen mothers experiencing
domestic violence--32%.
Children--
If the mother is not safe, neither are the children.
Domestic violence is the NUMBER ONE indicator for child abuse.
Domestic violence, substance abuse, and mental health problems are known risk
factors for child abuse. These conditions are chronic and recurrent and require
long-term intervention and support to alleviate.
Child abuse is 15 times more likely to occur in households where adult domestic
violence is also present.
"In the United States alone, at least 5 million children [sources vary--between
3.3 and 10 million] are victims of and/or witnesses to physical abuse, domestic
violence, or community violence..." (Perry, 1995). "The home is the
most violent place in the United States....The intergenerational 'cycle of violence'
is well documented...Living in this vortex of violence creates violent children." (Perry,
1996).
63% of women who experienced abuse reported that their children were also abused
by the abuser (1986).
91% of abused women indicate that their children witnessed their beatings.
Children look, learn, listen, and repeat.
80% of homicides investigated by the Alaska State Troopers were domestic violence
related (1995). Of the 16 domestic violence related homicide victims, 4 were
children (1996).
21% of the 11,692 clients served by domestic violence programs in Alaska were
minor children (in FY96).
The health, behavioral, and social consequences of domestic violence are enormous.
These children have a much higher incidence of: depression, suicidal tendencies,
eating disorders, and developmental delay.
Effects of domestic violence on children include: stomach aches, headaches,
ulcers, insomnia, eating disorders, substance abuse, post-traumatic stress
disorder, criminal behavior and arrests, depression, self-mutilation, and suicide.
There is a strong correlation between homeless youth or teenage pregnancy and
growing up in an abusive household.
Constant stress affects development of the brain. (Perry).
Just as love imprints itself on a child's brain, so does abuse. More than 82%
of Alaska prison inmates were abused physically or sexually as children.
Sexual Assault:
Since 1976, Alaska has ranked in the top five states
in the nation for the highest rate of reported rape per
capita. In 1993, Alaska ranked 1st in the nation: highest
per capita incidence of rape.
Alaska has 6 times the national average of reported child sexual assault.
1 in 4 girls before the age of 12 and 1 in 6 boys before the age of 18 nationally
will be sexually assaulted.
Fairbanks Health Center surveyed 419 clients over a 3-week period and found
that 24% reported physical abuse in the past 6 months while 39% reported some
form of sexual abuse (1995).
In 3 out of 4 reported cases, the victim knew the offender, the most commonly
reported type of sexual abuse is a father who commits incest with his daughter--usually
the eldest daughter.
As many as 4 out of 5 offenders were sexually assaulted as children.
One-third of incest victims' mothers were sexually abused as children.
Alaska's rape rate is 2.2 times the national average overall.
Elder Abuse:
7 out of 8 cases of elder abuse go unreported without the hope of any help.
In 84% of cases of elder abuse, the abuser is a relative--usually a son or
daughter that the elder lives with.
Protocols for Screening and Referral--
Health care providers and emergency personnel are frequently the first and
only service providers to have contact with a victim. In 1994, two-thirds
of Alaska physicians surveyed had not had any training on domestic violence
yet 40% of physicians indicated that 10% or more of their adult female patients
had experienced domestic violence.
In 1998, only 13.3% of Alaska hospitals and 50% of public health centers surveyed
say they routinely screen for domestic violence.
In 1996, only 29% of Alaska women responding to the PRAMS survey indicated
that they had been asked about domestic violence.
In 1997, only 2.07% of all referrals to domestic violence shelters came from
medical services.
Challenges--
More Alaskan-based research is needed on risk factors
and the complex relationship between domestic violence
and child abuse, elder abuse, and domestic violence during
pregnancy, as well as its overall prevalence and incidence.
Unmet requests for training and technical assistance in development of screening
protocols, assessment, and appropriate referral and Clearinghouse education/training
resources.
Continue to collaborate, strengthen, and build trust relationships with domestic
violence advocates, state agencies, and multi-disciplinary task forces in Alaskan
regions/communities.
Fully integrate substance abuse treatment, domestic violence treatment, and
mental health treatment programs; and form long-term relationships with families.
Promote greater interaction and cooperation between agencies, advocates, health
care professionals, and multi-disciplinary task forces.
Respond to the local community/groups vision of what their health needs are
and how they can best address those needs.
Increase education of domestic violence, effects on children, and child abuse
as public health care issues.
Develop in-house policies and procedures for Department of Health and Social
Services (DHSS) and State of Alaska staff.
Promote a coordinated public health response to domestic violence. |
