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Contact Us Fall 2001; Volume 2, Number 2
Feature: Violence and Healthcare

Interview with Esta Soler and Lisa James

Conducted by Sarah Park

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HHPR: What distinguishes the Family Violence Prevention Fund (FVPF) from other national domestic violence organizations?

ES: The FVPF, as a national organization working both nationally and internationally, has decided to focus a lot on health care. There are many other organizations that work on domestic violence - such as the National Coalition Against Domestic Violence and the National Network to End Domestic Violence, which is a state coalition - but health care isn’t a key component for them. There are also state coalitions who have health care as a main focus, but the national organizations currently do not. We are the nation’s resource center on health care and domestic violence. We have a federal grant to do that.

HHPR: How do you see the Family Violence Prevention Fund’s role in healthcare policy?

ES: We have been working on the issue of domestic violence and healthcare policy since the early eighties. We started by working with emergency rooms.We saw very early on that it’s important to look at the main entry points where people go who may be victims of domestic violence, including those who are suffering from a whole host of sequelae because of domestic violence.

On the side of public policy and domestic violence, there have been two main strategies. One has been the community-based shelters - crisis housing programs. The other has been the law enforcement, criminal justice system. And while we have worked in those areas, what we saw around health care was that very few people actually wind up going to shelters and a significant number of people call the police. However, many more people go and get health care.

The opportunities we saw in the healthcare system were huge because everybody winds up in the healthcare system for one reason or another. It may not even be because you’re going to seek help around an incidence of violence. We saw that if we could create an overarching and comprehensive healthcare policy, then we would have the opportunity to work with hundreds of thousands of people because that’s where they’re at.

We believe that screening should be part of the routine exam that you have when you go in for your annual physical or your gynecological exam. The medical exam, which includes a whole host of questions about a variety of social and health-related behaviors, should also ask about domestic violence.
I think one of the main principles of service provision - and organizing - is that you’ve got to meet people where they’re at. You can’t wait for them to call you. It just doesn’t work.

The Players

HHPR: How would you describe the relationship between academia, public policy makers, and non-profit organizations in working together to accomplish major goals such as passing legislation?

LJ: I think that partnership is critical, particularly the role of academia in the area of research and evaluation - not only of the health impact of domestic violence - but of what the interventions’ outcomes are. We need to see significant funding and collaboration put towards evaluationing screening and intervention for domestic violence in healthcare setting. In order to promote that practice nationwide, we’ve got to have both the data that supports its effectiveness and the policies that encourage healthcare providers and health systems that do so in a way that respects the safety and the confidentiality of victims.
We’ve got to have the advocacy groups at the table to represent victims of violence and to make sure those laws and policies - or any research that’s being conducted - don’t, in fact, cause more harm than good. So that’s a great question - the relationship between researchers, legislators, and advocates is a critical partnership that we’re trying to continue to foster as we develop a national health initiative on domestic violence.

And the Pieces

HHPR: What are the key areas that the FVPF sees as critical to promoting an improved healthcare response to domestic violence?

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