1500 words, due 8-14-24. Unit 14 Advocacy Against Violence and Abuse

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Advocacy Against Violence and Abuse

Gale Schlogl

Herzing University

Nursing, 673-7D Psychiatric Mental Health Care

Dr.Sanders

December 11th, 2022

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Introduction and Statistics

"Interpersonal violence, which includes child abuse and neglect, youth violence, intimate

partner violence, sexual violence, and elder abuse affect millions of U.S. residents each year

(Sumner, 2015)". The statistics gathered from various government agencies are pretty

alarming.

 In 2021, nearly one million cases of aggravated assault were reported in the United

States (NCADV, 2022).

 On average, there are 20,000 calls made to domestic abuse hotlines daily. Every

minute, 20 people experience physical abuse from an intimate partner. 4.8 American

women experience physical assaults by their partners. An intimate partner most

commonly abuses women between 18-24. One in three women has experienced

slapping, shoving, and pushing. One in 10 women has experienced rape by an

intimate partner. Seventy-two percent of all murder suicides involve intimate partners,

and 94% of the victims are female (NCADV, 2022).

 54% of LGBTQ people have been in abusive relationships (NCADV, 2022).

 One in 15 children is exposed to violence. Two hundred seventy-five million children

globally witness violence firsthand at home (NCADV, 2022).

 43% of U.S. households own a gun. Firearms caused more than 10,000 deaths in 2021

(NCADV, 2022).

 "Since 1963, nearly 193,000 children and teens have been killed with guns on

American soil—more than four times the number of U.S. soldiers killed in action in

the Vietnam, Persian Gulf, Afghanistan, and Iraq wars combined (Peace Alliance,

2022)."

 African Americans are more likely to be victims than their Caucasian counterparts.

Ethnic minorities continue to face systematic and racial discrimination. Anti-Semitism

incidents of violence hit a record high in 2021, a 34% increase from the year prior.

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Approximately 25% of Asian Americans were targets of racial bullying in 2021,

fueled by racist rhetoric (Peace Alliance, 2022)

Victims of violence have a higher incidence of adolescent pregnancy, nutritional deficiency,

gastrointestinal disorders, neurological disorders, chronic pain, anxiety, depression, and post-

traumatic stress disorder (PTSD). They are at a higher risk of hypertension, cancer, and

cardiovascular diseases. Victims of violence are also at higher risk for developing addictions

to alcohol, tobacco, or drugs (NCADV, 2022).

What are abuse and violence against others?

Violence and other forms of abuse are patterns of behavior intended to establish or maintain

power or control over an individual, partner, family member, or group. There is often an

imbalance of power between the abuser and victim, profoundly impacting the victim's well-

being and health (New Foundland, 2022).

Violence and abuse may be a single event or escalate over days, months, or years.

Violence comes in many forms: cultural, emotional, financial, neglect, physical,

psychological, sexual, and verbal. Violence and abuse are a choice and are preventable (New

Foundland, 2022).

Vulnerable Population: Pregnant Women and Children

Domestic violence or intimate partner violence can happen to anyone regardless of age,

race, or socioeconomic status. Within the United States, one in three women will experience

intimate partner violence. The National Partnership for Women and Families (NPWF, 2022)

reports that 324,000 pregnant women are battered by their intimate partner each year in the

United States. Early evidence suggests that domestic violence has increased in severity

during the COVID pandemic (NPWF, 2022).

The NPWF (2022) states that domestic violence is more common in pregnancy than

gestational diabetes or preeclampsia, yet their providers do not routinely screen for it.

Intimate Partner Violence (IPV) during pregnancy harms both the mother and the baby

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Abused women are more likely to receive delayed or no prenatal care, three times more

likely to suffer from depression, and are at increased risk for low birth weight infants,

preterm birth, and perinatal death than those who do not suffer from IPV (NPWF,

2022).

According to the NPWF (2022), current or former partners kill on average three women

every day, and this is the leading cause of traumatic death in pregnancy. Those who survive

often suffer from physical and mental problems caused by trauma or violence. These include

PTSD, anxiety, gastrointestinal and GYN problems, and chronic pain. This has lifelong

effects and contributes to housing instability, unemployment, food insecurities, financial

instability, and entablement within the civil and legal systems (NPWF, 2022).

Two hundred seventy-five million children globally witness or experience violence

firsthand at home. Infants and children show signs of trauma that include: eating problems,

sleep disturbances, high irritability, anxiety, and developmental delays. According to the U.S.

Department of Health and Human Services (2021), those exposed are at risk for long-term

physical and mental health illnesses and increased substance abuse and addiction (USDHHS,

2021).

Vulnerable Population: Elder Abuse

Elder abuse is a single or repeated act causing harm or distress to an older person. Abuse

can include physical, sexual, emotional, financial, neglect or abandonment. The World Health

Organization (WHO, 2022) estimates that 1 in 6 people 60 years and older have experienced

abuse in the past year. Abuse within nursing homes and long-term care facilities is estimated

to be more prevalent and underreported. Abuse of the elderly increases when there is

functional dependence, physical and cognitive impairments, and those in lower

socioeconomic class. Elders suffer long-term mental and physical decline due to abuse and

neglect and are at an increased risk of mortality (WHO, 2022).

Vulnerable Population: Minorities

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Vulnerable populations include racial, ethnic, and religious minorities, socioeconomically

disadvantaged, LGBTQ, homeless, immigrants, uninsured, and those with chronic mental

health and physical ailments or disabilities (Interventions Alliance, 2021).

Vulnerable populations face discrimination and harassment and can be targets of abuse,

violence, and hate crimes. According to the Interventions Alliance (2021), research shows

that abuse disproportionately affects those within minority groups due to long-standing

structural inequities. Structural inequality is pervasive and extends to healthcare, housing, and

the criminal justice system, which impedes access to services like domestic abuse agencies,

healthcare professionals, and social services. Violence, power, and control intersect with

social dimensions of class, disability, gender, sexual orientation, and race and profoundly

impact the quality of life and mental and physical health. (Interventions Alliance, 2021).

Screenings

The need for screenings, detection, and prevention of abuse directly affects nursing practice.

According to the Adult Protective Services Library (APSL, n.d.), healthcare providers must be

aware of the importance of a comprehensive history with meticulous attention to the person's

individual needs and presenting problem. Valid and reliable screening tools should be utilized

upon initial contact and continue with subsequent interactions (APSL, n.d.).

Healthcare providers should be alert for clinical presentations inconsistent with the patient's

history. In addition, mental status, observation of cognitive defects, confusion, or disorientation

should be identified as functional or organic. This is especially important when working with

the elderly or cognitively impaired (APSL, n.d.).

The challenge of screenings is that the abused is often reluctant to report the incident for

fear of consequences or retaliation. Consequently, screenings should be performed in a gentle

manner that does not provoke anxiety, fear, or mistrust. While signs of abuse are not always

evident, suspicion should be raised in the presence of anxiety, displays of aggression, or fear

(APSL, n.d.).

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PMHNPs should act to promote, advocate and safeguard a patient's well-being and

optimize health and abilities to prevent illness and injury. The American Nurses Association

(ANA, 2014) states that the role of the PMHNP is to alleviate suffering through

comprehensive, patient-centered care in various settings across the lifespan. PMHNPs should

employ purposeful nursing, psychosocial and neurobiological evidence to implement

interventions to assist patients in achieving recovery-oriented outcomes (ANA, 2014).

The PMHNP has the same obligations to self as to others, including preservation of

integrity and safety, maintaining competence, advocacy for dignity and worth, and continuing

personal and professional growth. A PMHNP should work to eliminate abuse by helping

patients make positive life changes through advocacy, counseling, and community outreach

(ANA, 2014).

Conclusion

Significant burdens of violence increase the vulnerability and mortality of many within the

United States and worldwide. Violence and abuse are interconnected across relationships,

communities, and intergenerationally. The lifelong negative impact of abuse plague the

communities in which we live. Structural inequality is pervasive and extends to healthcare,

housing, and the criminal justice system, and impedes access to services like domestic abuse

agencies, healthcare professionals, and social services. Violence, power, and control intersect

with social dimensions of class, disability, gender, sexual orientation, and race and

profoundly impact the quality of life and mental and physical health. (Interventions Alliance,

2021).

Efforts to understand, prevent and respond to violence often include a policy change,

family-focused programs, early childhood education, therapeutic counseling, and medical

interventions; however, many of these interventions fall short due to barriers and lack of

resources. As PMHNPs, we must recognize these disparities, explore the challenges, identify

prevention opportunities and improve our outreach within our patient populations so that we

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References

Adult Protective Services Library (n.d.). Recognizing Abuse: An Assessment for Nurses.

https://www.apslibrary.oucpm.org/recognizing-abuse-an-assessment-tool-for-nurses/

American Nurses Association (2014). Psychiatric-Mental Health Nursing. Available from:

Bookshelf, (2nd Edition).

https://ambassadored.vitalsource.com/books/9781558105577.

Interventions Alliance (2021). Domestic Abuse in Black, Asian and Minority Ethnic Groups.

https://interventionsalliance.com/domestic-abuse-in-black-asian-and-minority-ethnic-

groups/

National Partnership for Women and Families. (2022). Intimate Partner Violence Endangers

Pregnant People and Their Infants. .https://www.nationalpartnership.org/our-

work/health/moms-and-babies/intimate-partner-violence.html

National Coalition Against Domestic Violence (NCADV) (2022). Statistics.

https//www.ncadv.org/statistics

New Foundland Labrador (2022). Violence Prevention Initiative. Defining Violence and

Abuse. https://www.gov.nl.ca/vpi/about/defining-violence-and-abuse/

Sumner, S. A., Mercy, J. A., Dahlberg, L. L., Hillis, S. D., Klevens, J., & Houry, D. (2015).

Violence in the United States: Status, Challenges, and Opportunities. JAMA, 314(5),

478–488. https://doi.org/10.1001/jama.2015.8371

The Peace Alliance (2022). Statistics of Violence and Peacebuilding in the US and

Worldwide. https://www.peacealliance.org/tools-education/statistics-on-

violence/#:~:text=•%20Violence%20causes%20more%20than%201.6%20million

%20deaths,al.%2C%20eds.%20World%20report%20on%20violence%20and

%20health.

U.S. Department of Health and Human Services (2021). Office on Women’s Health. Effects

on Domestic Violence on Children. https://www.womenshealth.gov/relationships-and-

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World Health Organization (2022). Abuse of Older People. https://www.who.int/news-

room/fact-sheets/detail/abuse-of-older-people

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