MEDICAL ADVOCACY CORNER

Many people are unaware of the resounding effects Domestic Violence can have on an individual’s health and wellbeing. These effects extend far beyond the bruises and battering often associated with physical abuse. Survivors are at significantly heightened risk for numerous psychological disorders, substance use disorders, reproductive health challenges, cognitive and sensory disabilities, and – most insidious and least understood – brain injury. Did you know that as many as 92% of survivors in shelter have accrued at least one brain injury?

What’s more, many survivors face significant barriers to seeking necessary healthcare. As identified by the Survivor Leadership Cohort at Futures Without Violence, these barriers may include:

• Financial Abuse – When the person using abuse maintains control of finances and insurance policies, survivors may be unable to seek care without that person’s approval. If they are able to seek care, survivors may be hindered from doing so independently of the person using abuse. Unless the provider is able to create an opportunity to speak alone with the survivor, it may be impossible for them to fully and openly disclose the reasons for needing to seek care. 
• Lack of Resources – Many survivors find it challenging to make and maintain appointments due to lack of transportation access, childcare needs, accessibility concerns, and difficulty finding providers who accept Medical Assistance and/or offer sliding scale payment systems. 
• Fear – Survivors of abuse have learned to operate within a system of power and control which significantly limits their personal autonomy. The perceived power dynamic between a healthcare provider and a patient can be very intimidating for survivors, especially without certainty that the provider understands the impact which trauma has on a person’s health and wellness. Fear associated with seeking care is further emphasized for individuals who have been told not to seek help; for individuals who do not wish to see their experience documented by mandated reporters; for parents who fear having their children taken away by a system which is not designed to understand their experience of abuse; for individuals with accessibility needs such as translators or interpreters; and for marginalized populations concerned about lack of confidentiality in regards to such matters as immigration status and gender identity.
• Impact and Invisibility of Brain Injury – There are countless acute and ongoing symptoms which may be experienced by survivors of brain injury. In particular, it may be difficult for survivors to make and keep appointments, regulate their nervous systems in unfamiliar settings, and adequately communicate their needs and concerns to providers. 

How can Medical Advocacy help?

For providers, Crisis Center North’s Medical Advocacy Program can provide free materials, trainings, and consultation on supporting patients who may be impacted by Domestic Violence. It is recommended that all providers have Domestic Violence resources, such as Crisis Center North’s emergency hotline number, plainly visible within their facilities and readily available for all patients. All patients should be safely and privately screened for relationship health at all appointments.

For patients, Crisis Center North will work to connect you with trauma-informed healthcare professionals equipped to meet your specific physical, psychological, and cultural needs. Speak with an advocate about how to ensure that you are prepared for upcoming appointments and equipped to advocate for yourself to your care team. You are in charge of your own healthcare. Crisis Center North can empower you to embrace this. 

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Are you a healing professional or hospital administrator, or a survivor of Domestic Violence who is interested in learning more about the health impacts of abuse and/or improving medical system responses to DV? We want to hear from you! Contact Crisis Center North’s Medical Advocate, Marsha Mayhak, to share your questions, stories, and topics of interest – or to arrange a training session for your healthcare setting today!

Marsha Mayhak

Medical Advocate

(412) 491-8689

mmayhak@crisiscenternorth.org

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This article and more is included in Crisis Center North's Spring 2025 Newsletter, available for download here!

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