What Happens When Health Practitioners Report Domestic Violence Injuries to the Police? A Study of the Law Enforcement Response to Injury Reports

Article excerpt

This study was undertaken to leam whether law enforcement agencies in California ("agencies") have standard policies and procedures in place for responding to reports of domestic violence injuries from health practitioners ("HP reports"), and to describe the variation in policies and procedures across agencies. Using a structured interviewing tool with closed- and open-ended questions, a survey was taken of domestic violence experts from 39 agencies throughout California. Forty-one agencies were asked to participate in the study. Interviews were completed with 39. Almost all agencies reported that they have standard procedures in place for responding to HP reports when the reports are made by telephone. Agencies handle written HP reports differently than telephone HP reports. HP reports constitute a very small proportion of agencies' overall domestic violence caseloads. Emergency departments are the usual source of HP reports. Although the law requires both an immediate telephone report and a written report, fewer than one quarter of sampled agencies always received both types of HP reports. Most agencies use standard response protocols when reports of domestic violence incidents are made by telephone, whether the reporting party is a health practitioner or someone else. Written HP reports do not fit into the agencies' usual response protocol for domestic violence situations. Because agencies' protocols are best suited to situations requiring prompt dispatch of an investigating officer, only reports made by telephone have the opportunity to promote an effective law enforcement response.

In recent years law makers, public health officials, criminal justice experts, and others have acknowledged that violence against women is an important social and public health problem in the U.S. Domestic violence (i.e., violence inflicted by a current or former intimate partner) represents a large proportion of all physical assaults against women. According to the U.S. Department of Justice, intimate partners perpetrate 29% of all lone offender violence against women (U.S. Department of Justice, 1995). Nearly two million women in the United States are severely assaulted by an intimate partner each year (Straus, 1990). Some estimates place the number of women physically abused by intimate partners as high as six million annually (Straus, 1991). Nationally, 28.3% of murdered women are killed by current or former intimate partners (U.S. Department of Justice, 1995).

Physicians and other health practitioners see women victims of violence frequently in many types of medical settings (Burge, 1989). Although estimates of the number of battered women presenting at emergency departments vary, there is agreement that they represent a significant proportion of the emergency trauma caseload (Kurz, 1987,1990; McLeer & Anwar, 1989; Ochs, Neuenschwander, & Dodson, 1996; Rand, 1997; Stark & Flitcraft, 1979,1996). Medical settings other than emergency departments also include a large number of battered women (Campbell, 1991). In an urban hospital walk-in clinic, 45% of women victims of violence stated that the perpetrator was an intimate partner (Conway, Hu, Kim, & Bullon, 1994). Seventy-five percent of female psychiatric outpatients in one setting reported being the victims of partner assaults (Lipschitz et al., 1996). One in five women seeking elective abortions in a university hospital clinic was physically abused within the previous year. Nearly 8% of these women reported abuse during the current pregnancy (Evans & Chescheir, 1996). Estimates of the prevalence of physical assault during pregnancy vary from .9% to 20.1% (Gazmarian et al., 1996), sometimes resulting in increased morbidity in both mothers and infants (Martin, English, Clark, Cilenti & Kupper, 1996; Parker, McFarlane, & Soeken, 1994). Violence is so common that both the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the American Medical Association (AMA) recommend establishing protocols for the identification and treatment of victims of abuse (Council on Scientific Affairs, 1992; The Joint Commission on Accreditation of Healthcare Organizations, 1996). …