THE
POLICE INVESTIGATION
DOMESTIC
VIOLENCE
Screening
for Domestic Violence
Still Point: Moving Beyond Survival
Division of Victim Services Conference
August 6, 1999
Sheridan, Wyoming
I.
abAttitudes about Domestic Violence
A.
abNone of our business
1.
abIt's a family matter
2.
abIt's a law enforcement matter
B.
abThe victim won't do anything to help herself so why should we do anything
to help her.
1.
abI.e., she won't leave
II. abThe reality of family violence
A.
abWhy won't she leave
1.
abReasons are varied
a. abLove
b. abEconomic dependence
c. abFear
d. abIsolation
(1) abChurch
(a) abAttitudes about separation and divorce
(2) abFamily
(a) abAttitudes about separation and divorce
(b) abShame that the victim "puts up with it"
(3) abFriends/Colleagues
(a) abHer shame/guilt about the violence
(b) abHis cultivation of her isolation
i) abWe know that many of these perpetrators will go to inordinate
extremes to isolate the victim from supportive sources.
ii) abThey may not understand it in these sophisticated terms.
For them it may be as simple as taking the steps necessary to protect
themselves from being found out.
e. abEmotional Blackmail.
(1) abChildren
(2) abThe fate of the perpetrator
f. abDenial
(1) abFaith that the violence will stop
(2) abOr the belief that no one else can do anything to stop it
g. abOr any other reason you'd like to add to the list
2.
abWhen we ask why she won't leave we are asking the wrong question.
a. abInstead we should ask:
(1) abWhat business is it of ours why she won't leave? We are
not the arbiters of which relationships are worth saving.
(2) abWhy, when we don't try to help, are we aiding him in his
efforts to isolate her?
(3) abWhat may happen to her and her family if we don't act?
3.
abThe reality is that if she leaves she may be at greater risk than if
she stays
a. ab25X greater risk to be attacked. [USDOJ, Violence Against
Women: Estimates from the Redesigned Survey; August 1995].
b. ab75% of dv assaults reported to police occur after separation.
[DOJ, 1983]
c. ab73% of battered women seeking emergency room service sustained
their injuries after they left. [Stark, et. al., 1981].
d. abMost likely to be murdered when attempting to report abuse
or leaving an abusive relationship. [Sonkin, et. al., 1985; Browne, 1987]
(1) abThe violence may escalate to coerce her to stay.
(2) abor in retaliation for her rejection. [Saunders & Browne,
1990; Dutton, 1988; Bernard, et. al., 1982]
(3) abStudies have found that between 25-50% of women murdered
by their intimate partners were separated at the time. [Casanave &
Zahn, 1986; Berard, et. al., 1982]
e. abHer fear of leaving has a basis in fact.
4.
abThe decision to leave, or to even report, is a process, not an event.
B.
abIt's a family matter, i.e., it's not our business, not our problem.
1.
abThis is a dangerous rationalization that we sometimes use to play it
safe, to remain uninvolved.
2.
abJury selection: Crime in the kitchen is no different that crime in the
streets.
3.
abWe all have a stake in domestic violence:
a. abConsider the impact on the victim:
(1) abDV is the leading cause of injury to US women between ages
15 to 44. [UCR, FBI 1991].
(a) abMore than car accidents, muggings or rapes combined.
(2) ab21% of all women using hospital emergency services are there
as a result of domestic violence. [USDOJ, Violence between Intimates:
Domestic Violence; November 1994]
(3) abOver 1 million American women are hospitalized each year
due to domestic violence. [USDOJ, Violence between Intimates: Domestic
Violence; November 1994]
b. abThose are the lucky ones:
(1) ab28% of female homicide victims are known to have been killed
by their husbands, ex-husbands or boyfriends. [DOJ. Women usually Victimized
by Offenders they know, 1995]
c. abConsider the health care costs:
(1) abEach year, medical expenses from domestic violence total
at least $5 billion. [Domestic Violence for Health Care Providers, 3rd
ed., Colorado Domestic Violence Coalition, 1991].
d. abConsider the effects on other family members:
(1) abBattered women are more likely to suffer miscarriage or give
birth to low birth weight babies. [Surgeon General of the United States,
1992]
(2) abIn 1992 the Journal of the American Medical Association reported
that 1 in 4 pregnant women have a history of domestic violence.
(3) abThe March of Dimes reported in 1991 that domestic violence
is the number one cause of birth defects in this country. More than all
the diseases and illnesses we immunize pregnant women for combined.
(4) abChild Abuse is 15X more likely to occur in homes where there
is domestic violence. [Stacy & Shupe, The Family Secret, 1983](5)
abConsider the effects that simply witnessing domestic violence has on
children within the home:
(a) abEmotional problems
i) abActing out and inappropriate aggressiveness. [Pfouts, Shopler
and Henley, Social Work, July 1982; Saunders, Social Work, January 1994;
Fantuzzo and Lindquist, 1989; Hughes, Journal of Family Violence, 4(2)
1986; Jaffe, Wolf and Wilson, Journal of Family Violence, 1990; Rosenberg,
1987; Peled, Jaffe and Edelson, Ending the Cycle of Violence: Community
Responses to Children of Battered Women, Sage Publications 1995]
ii) abGreater frequency of anxiety. [Pfouts, Shopler and Henley,
Social Work, July 1982; Hilberman & Munson, 1977-78]
iii) abGreater frequency of depression. [Pfouts, Shopler and Henley,
Social Work, July 1982]
iv) abWithdrawn behavior. [Saunders, Social Work, January1994;
Fantuzzo & Lindquist, 1989; Hughes, Journal of Family Violence, 4(2)
1986; Peled, Jaffe and Edelson, Ending the Cycle of Violence: Community
Responses to Children of Battered Women, Sage Publications 1995]
v) abLow self esteem. [Peled, Jaffe and Edelson, Ending the Cycle
of Violence: Community Responses to Children of Battered Women, Sage Publications
1995]
vi) abGreater frequency of nightmares. [Peled, Jaffe and Edelson,
Ending the Cycle of Violence: Community Responses to Children of Battered
Women, Sage Publications 1995]
vii) abMay exhibit all the symptomology of PTSD. [Silvern and Kaersvang,
Child Welfare, August 1989]
(b) abLearning difficulties:
i) abGreater likelihood of developing hearing speech and learning
difficulties. [Penfold, 1982; Westra & Martin, 1981]
ii) abGreater frequency of below average or failing school performance.
[Pfouts, Shopler and Henley, Social Work, July 1982; Hilberman & Munson,
1977-78]
iii) abGreater levels of truancy. [Pfouts, Shopler and Henley,
Social Work, July 1982]
(c) abCriminal behavior:
i) abGreater frequency of delinquency. [Saunders, Social Work,
January1994; Fantuzzo & Lindquist, 1989; Hughes, Journal of Family
Violence, 4(2) 1986; Jaffe, Wolf and Wilson, Journal of Family Violence,
1990; Rosenberg, 1987]
a) abIt has been found to be the most significant difference between
delinquent and non-delinquent children. [Miller, Journal of Juvenile Justice
Digest, XVII (12) 1989]
(6)
abFuture generations, future victims:
(a) Men who witness their parents domestic violence are 1000X more
likely to abuse their wives and girlfriends as adults. [Kalmuss, 1984]
(b) abBoys who witness their fathers abuse their mothers are more
likely to inflict severe violence as adults. [Kalmuss, id.; Hotaling &
Sugarman, 1986]
(7)
abAmerican businesses:
(a) abBusinesses forfeit an estimated $100 million in lost wages,
leave, absenteeism and non-productivity each year. [Domestic Violence
for Health Care Providers, 3rd ed. Colorado Domestic Violence Coalition,
1991]
e. abIf it's not our business, not our problem, then who's is
it? With so much at stake, how can we not act?
III.
abWhat can we do?
A.
abIn 1983 the FBI in its Report to the Nation on Crime and Justice 55%
of all homicides were found to have been perpetrated by family members,
former spouses, boyfriends, girlfriends or ex-boyfriends.
B.
abIn 1988 the rate had jumped to 58%. [FBI, Report to the Nation on Crime
and Justice, 1988].
C.
abThe 90's have seen a reversal in that trend. Though we should keep
in mind that these are only the cases where the perpetrator is known.
In 1995 the FBI reported that 11% of all homicide victims were killed
by family members. 34% were killed by other acquaintances including boyfriends,
girlfriends, ex-spouses or former dating partners. [FBI, Report to the
Nation on Crime and Justice, 1996
D.
abWhy the reduction? In part it is the result of more and more communities
adopting a strategy that is proving to be effective.
1.
abIn Newport News, Va., they cut their domestic violence homicide rate
nearly 80% in 4 years
2.
abIn Knoxville Tenn. the percentage of homicides that were the result
of domestic violence dropped from 76% to 7%
3.
abIn Nashville Tenn. their domestic violence homicide rate dropped 40%
4.
abSan Diego has been able to cut their dv homicides by 50%
5.
abAnd in Quincy Mass. a domestic violence homicide is nearly unheard of.
a. abMost cops dream of investigating homicides. When I train
police on domestic violence I tell them that when they work a DV case
they're working homicide prevention. Isn't that a better place to be?
E.
abSo what can we do?
1.
abWe can adopt that same effective strategy.
2.
abRequires a community response. The action of the courts, law enforcement
or the victims movement is not enough. It requires the assistance of
the health care community, education and the business community, indeed
as many aspects of our society as we can successfully recruit.
IV.
abThe strategy can be summarized by the acronym SIC.
A.
abSIC stands for
1.
abSafety of the victim
2. abIntervention
3. abContainment
B. abHealth care providers and related fields play a role in each
of these three prongs.
1. abSafety
a. abWe must take the steps we reasonably can to protect the victims
(1) abLaw enforcement agencies can help with an effective response
to violence
(2) abFamily violence programs provide an essential link in providing
security to the victim
(a) abtraining in creating a safety plan
(b) aba statewide network of resources to help provide security
for those victims that do make that decision to leave
(c) abthey can also provide support
i) abremember that abusers frequently isolate their victims from
support systems. The sooner this needed support may be given the more
quickly victims may be able to assist themselves.
(3) abHealth care providers play an important role as well.
(a) abScreen for dv
(b) abAccurately and effectively record and document
(c) abMake appropriate referrals
2. abIntervention
a. abWhen we intervene our intervention must be effective.
b. abThat means
(1)
abTake reasonable steps to keep the victim and family safe
(2)
abWe must conduct an effective investigation that leads to effective prosecution
(3)
abThe effective investigation that leads to successful prosecution requires
appropriate documentation, including records of health care and other
service providers
(4)
abWe need to provide as much support for the victim as possible and provide
that support as soon as possible
(a)
abHealth care is often that first opportunity.
(b)
abEach time we provide support we help to break down the wall of isolation
put up by the abuser
3.
abContainment
a. abAfter conviction provide where appropriate the necessary
means for effecting rehabilitation. Including:
(1) abSupervised probation, where necessary
(2) abBatterer's Treatment
(3) abSubstance abuse treatment
(4) abNo contact orders
(5) abSurrender of firearms
(6) abEtc.
b. abBut the first step in containment is often that act of providing
support to the victim. That comes from first from
(1) abFirst responders, like ambulance personnel, law enforcement,
the medical or social service community, victim advocates and service
providers or friends.
(2) abIt's later that the Courts, Prosecution, batterer's treatment
programs and probation and parole can provide their support to the victim.
(3) abEach time we provide that support to the victim we knock
down that wall of isolation that surrounds her and the brick and mortar
from that wall encircles her abuser. Finally he feels that the eyes of
the whole community are on him.
C.
abFor victims of dv leaving is a process, not an event.
1.
abThey maybe victimized repeatedly before they are ready to leave or to
have someone intervene and some are never ready for that day.
2.
abTherefore, for the same reasons that they may not leave, they may, after
the initial event is over, and after coaxing or courting by the defendant,
become uncooperative with the prosecution. They may even testify on behalf
of the abuser. With proper documentation by all involved, we may not
need her assistance in order to effectively intervene.
3.
abIt is therefore crucial to effective intervention that we are always
ready when the opportunity to effectively intervene presents itself.
4.
abHopefully the balance of my presentation will help you to be ready when
the time comes. It may not be available to law enforcement or prosecutors
immediately, but it will be available when the opportunity presents itself.
V.
abScreening for domestic violence
A. abAlways screen when indicators of domestic violence are present.
1.
abIndicators
a. abAdmission to past or present physical abuse or restraint.
b. abPatient presents with unexplained bruises, whiplash incidents,
redness consistent with slapping or strangulation, grab marks on arms
or neck, cuts, burns, scars, fractures, multiple injuries in various stages
of healing, broken jaws or punctured eardrums.
(1) abbathing suit pattern are common areas of abuse
c. abThe extent or type of injury is inconsistent with the explanation
of the injury
d. abPatient presents with evidence of sexual assault or sexual
battery
e. abThe patients intimate partner accompanies the patient, insists
on staying close to the patient and may try to answer all questions directed
to her
f. abPatient expresses fear of returning home or fear for safety
of her children
g. abSubstantial delay exists between the time of injury and presentment
for treatment.
(1) abPatient may have been prevented from seeking treatment earlier
or may have had to wait for the abuser to leave.
h. abPatient describes the "accident" in a hesitant,
embarrassed or evasive manner or avoids eye contact.
i. abPatient has psychosomatic complaints such as panic attacks,
anxiety, choking sensation, or depression.
j. abComplaints of chronic pain (back or pelvic) with no substantiating
physical evidence often signifying fear of impending or actual physical
abuse.
k. abPsychiatric, alcohol or drug abuse history in the patient
or partner, e.g, eating disorder, self mutilation
l. abHistory of suicide attempts or suicidal ideation.
(1) abBattering accounts for 1 in every 4 suicide attempts by women.
m. abReview of medical records reveals repeated use of medical
and/or social services.
(1) abMedical history reveals many "accidents" or remarks
by health care worker indicating that previous injuries were of suspicious
origin.
B.
abScreen outside the presence (or earshot) of any accompanying spouse,
friends, or family members
1. abShame or fear may prevent the victim from accurately reporting.
2. abDon't ask "Have you ever been the victim of domestic
violence?"
a. abAsk instead:
(1) abYou have a number of bruises. Could you tell me how they
happened? Did someone hit you?
(2) abYou seem frightened of your partner, has your partner ever
hurt you?
3) abSometimes patients tell me they've been hurt by someone close
to them. Could this be happening to you?
(4) abYou mentioned your partner sometimes loses their temper with
your children. Does he lose his temper with you? Does he ever physically
hurt you when he loses his temper?
(5) abHave there ever been times during your relationship when
you have had physical fights?
(6) abDo your verbal fights ever include physical contact?
(7) abHave you ever been in a relationship where you have been
hit, punched, kicked or hurt in any way? Are you in one now?
(8) abYou mentioned your partner uses drugs/alcohol. How does
your partner act when on drugs/alcohol?
(9) abSometimes when others are overprotective and as jealous as
you describe, they react strongly and use physical force. Is this happening
in your situation?
(10) abYour partner seems very concerned and anxious. Was he responsible
for your injuries?
3.
abIf the patient acknowledges violence give them time to verbalize before
conducting a physical assessment.
a. abLet her control the timetable for the discussion.
4.
abRemain non-judgmental, supportive and relaxed.
5.
abReassure her that no one has the right to hurt others and she is not
responsible for someone else's abusive behavior.
C.
abTake a history.
1.
abOf this injury
2.
abOf prior incidents.
a. abSupplement with subjective and objective information from
past medical records.
3.
abDocumenting the Statement
a. abIdentify those present at the time the statement is made.
b. abPresent sense impression Rule 803 (1)
(1) abStatement describing or explaining an event or condition
(2) abStatement is made while the declarant was perceiving the
event or condition or immediately after
(a) abphone calls
(b) abstatements to ambulance personnel
(c) abstatements made to the rescuing neighbor or chaffeur
i) ab"He just beat me up. I'm so scared. I don't know
what I should do."
ii) ab"I could hear her screaming, `Oh God no, don't hit
me again."
c. abExcited utterance. Rule 803 (2).
(1) abA startling event or condition must have occurred or existed.
(a) abVictim of an attack
(2) abThe statement was made while the speaker was under the stress
or excitement of the startling event or condition.
(a) ab"Excitement" refers to any highly wrought emotional
state.
(b) abTest is whether the speaker was still laboring under the
excitement of the startling event or condition.
(c) abMust describe the emotional condition of the victim or the
circumstances from which we concluded the victim was "excited"
i) abStatement made to ambulance personnel
ii) abStatement to counselor
iii) abstatement to neighbor
iv) abER personnel
v) abdispatcher
vi) abinitial responder
d. abStatement of a then existing mental, emotional or physical
condition. Rule 803 (3)
(1) abStatement of the speaker's then existing:
(a) abstate of mind
i) ab"I'm so scared that Jim's going to come back."
ii) ab"I'm going to kill him for what he did to me."
iii) ab`I'm afraid he'll kill me."
(b) abemotional condition
i) ab"I'm so afraid he's going to kill me."
ii) ab"I can't stop shaking, crying, etc."
iii) ab"I'm afraid he'll kill the baby."
a) abStatements of the speaker's then existing state of mind or
emotional condition may be used to establish the "excitement"
necessary to admit an excited utterance.
(c) absensation
i) ab"My ears are ringing"
ii) ab"I can't feel my fingers"
(d) abor physical condition
i) ab"My head hurts."
ii) ab"My stomach feels like its bleeding inside."
iii) ab(Pregnant mother) "I think there is something wrong
with the baby."
e. abStatements made for purposes of medical diagnosis and treatment.
Rule 803 (4).
(1) abMust be a statement made for purposes of medical diagnosis
or treatment.
(2) abMust describe:
(a) abmedical history (prior instances of abuse)
(b) abpast or present symptoms
(c) abpain or sensations
(d) abthe inception or general character of the cause or external
source as pertinent to diagnosis or treatment
i) abincludes identity of the perpetrator. See Goldade v. State
f. abPrior consistent statement
(1) abThe victim has been impeached using statements made (during
a period of recantation, for instance) that are inconsistent with the
victim's testimony.
(2) abThe statements (regardless of content) are consistent with
the victim's testimony.
4. abThe importance of good documentation is best understood when
you consider that statements made about previous incidents may also be
admissible, not just statements made about the present offense.
a. abPrior Bad Acts
(1) abTestimony concerning prior bad acts of a defendant may not
be admitted to prove the character of a defendant (wife beater) to show
that he acted in conformity with that character.
(2) abPrior bad acts evidence may be admitted to show things like:
(a) abmotive
(b) abopportunity to commit the crime
(c) abintent
(d) abpreparation
(e) abplan
(f) abknowledge
(g) abidentity
(h) ababsence of mistake or accident
(i) aband corroboration.
b. abSpecific instances of conduct may also be admitted to rebut
a claim or defense.
5.
abDo you need to remember all these legal doctrines? No. But try to
remember to note these.
a. abCircumstances under which the report was made.
(1) abWas it during or immediately after the event?
b. abWhat was her emotional state?
(1) abCrying
(2) abShaking
(3) abAngry
(4) abFearful
(5) abEtc
c. abDid she make statements about her present state of mind,
emotional condition, sensation or physical condition?
D.
abMake a proper referral
1.
abLocal SA/FV agency
a. abEach time we give the victim additional means of support
we isolate the isolator.
(1) abInitial response
(2) abPolice
(3) abProsecution
(4) abVictim advocate
(5) abHealth care community
b. abExplain that the information given to the Family violence
agency is confidential and won't be provided to others such as law enforcement,
without her consent.
(1) abIt is more important that we break down the isolation than
that she immediately report.
(2) abThe victim taking action is a process, not an event.
c. abIf she wants to speak to an advocate contact the agency immediately.
Family violence advocates can explain the need for additional testing.
If she wants to report to law enforcement, the advocate can explain evidence
collection procedures.
d. abAdvocates can provide additional information about crisis
intervention, local shelters and safe house procedures, other personal
security measures that can be taken and legal procedures.
2.
abEncourage her to report to law enforcement so that intervention can
take place. So that the substance abuse, child abuse and violence can
stop. Be informational not controlling.
a. abBattering is a crime.
(1) abShe may be protected by the law or she may be able to obtain
a protective order.\
E.
abConduct the physical exam
1.
abExamine areas within the "bathing suit"
2.
abRecord the general condition of the patient
3.
abPerform a physical and neurological assessment
4.
abPerform a mental status exam, assessing emotional state, substance and
alcohol abuse, suicidal or homicidal ideation.
F.
abConduct a Safety Assessment
1.
abWhere is the abuser now?
2.
abDoes he know that you are here?
3.
abHas he ever used or threatened to use weapons?
4.
abAre weapons available to him?
5.
abHas he been using drugs or alcohol?
6.
abHas the abuse been increasing in frequency or severity?
7.
abDo you have children?
8.
abAre they safe now?
9.
abAre they being abused?
a.
abMandatory reporting
10.
abHas he verbally threatened you?
11.
abHas he threatened your relatives and friends?
12.
abHas he threatened to commit suicide if you leave?
13.
abHas he abused pets?
14.
abHas he ever physically hurt you in a public place?
G.
abDocumentation
1. abInclude data from available medical records for possible
prior abuse.
2. abNote all indicators of abuse (See above list)
3. abRecord size, pattern, estimated age, description and location
of all injuries.
a. abUse a body map
b. abBe specific, avoid language like "multiple contusions
and lacerations."
c. abInclude restraint marks - 3 linear ecchymotic areas on each
side of right arm/neck consistent with strangulation/manual restraint.
4. abRecord non-bodily evidence of abuse
a. abTorn clothing, damaged jewelry
5. abCollect items of evidence if possible, torn or blood stained
clothing
a. abExplain that this does not obligate her to report
b. abPlace in paper bag and seal
(1) abPlace identifiers on the bag
(a) abName
(b) abPatient's name
(c) abdate
6. abPhotograph (if possible)
a. abColor film
b. abBe careful with flash
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