Looking Beyond the Injuries: Identifying the complex healthcare needs among survivors of interpersonal violence

Background: More than 1 in 3 women in America (35.6%) experience some form of interpersonal violence (IPV) during their lifetime (Black et al, 2011). The long-term negative impact on the physical and mental health of women experiencing violence has been well documented in the literature. There is evidence that IPV survivors have complex health needs and high health care utilization patterns (Rivara et al., 2007). However, a gap exists in the alignment of the nature of services provided versus the needs of IPV survivors. Services offered by IPV organizations are often geared towards meeting immediate needs for housing, financial assistance, and other forms of tangible support, particularly for individuals using emergency shelter services. Furthermore, these crisis periods are also aggravated by an increased risk for physical violence and stalking, and/or involvement in the criminal justice system. The purpose of this study was to understand the complex and holistic health needs of survivors who are utilizing IPV services. Methods: This study utilized data collected during a needs assessment conducted among 99 women residing in Tarrant County. Participants were recruited from three service providers actively providing services to IPV survivors. The survey tool incorporated questions regarding victimization history, healthcare utilization, and Self-Regulation Questionnaires (SRQ-20) to capture the distress symptoms demonstrated by IPV survivors. Results: The majority (80%) of participants reported at least one chronic health condition, yet 30% of the women mentioned not going to the doctor for routine healthcare. One-third of participants reported utilizing the ER for non-emergency reasons. While 70% of the sample reported having a place to go when sick and injured, 43% identified that place to be the ER. Among the participants, 53% reported experiencing 7 or more psychosomatic distress symptoms, meeting the WHO threshold for psychiatric distress. Conclusions: This study illustrated that the needs of IPV survivors are complex and extend beyond physical injuries. It is imperative to look beyond the crisis indicators and address the stress and strains resulting from the violence that not only becomes burdensome for survivors but also results in greater health care utilization. Currently, the Technology Enhanced Screening and Supportive Assistance (TESSA) project is using this data to support the integration of IPV and healthcare services in the community.