In 2016, there were nearly 5,000 reported cases of interpersonal violence (IPV) in Monroe County, higher than anywhere in New York State outside of New York City.
These numbers only tell part of the story, however.
“The cases that get reported are a small fraction of the actual incidents,” says Ellen Poleshuck, Ph.D.,associate professor of URMC’s Departments of Psychiatry and Obstetrics/Gynecology. “We realize through our work just how prevalent and vastly under-reported interpersonal violence is, for a variety of reasons.”
Poleshuck is the director of HEAL (Healing through Education, Advocacy and Law), a collaborative program founded by associate professor of Psychiatry Catherine (Kate) Cerulli, J.D., Ph.D., in October of last year. Headquartered within Strong Memorial Hospital, the groundbreaking program is among the first in the nation to offer interpersonal violence victims access to physical and mental health services, as well as legal and social support, all in one place.
“So many victims are afraid to come forward and identify themselves as in an abusive relationship,” says Poleshuck. “They not only fear repercussions from their perpetrator, but they fear the logistical hurdles they may have to navigate to access varied resources. They worry that the system is going to fail them somehow. The HEAL program aims to remove access barriers and dramatically simplifies the process for them.”
In its first year, coordinators say the program has received hundreds of referrals for victims who want to feel safe and get healthy physically and mentally.
But connecting more individuals with the program remains an issue, and that’s where those on the front lines—health care providers—must play a part, she says.
As the program marks its first anniversary in October (National Domestic Violence Awareness month) it is working to ramp up awareness, within the health care profession and elsewhere, to reach more people across the community.
“Physicians, nurses, residents, technicians, and social workers are often the first to become aware of an IPV issue when caring for a patient in the Emergency Department, an inpatient unit, or outpatient practice,” says Poleshuck. “Left untreated, interpersonal violence impacts health tremendously, so it’s imperative that health care providers know about available resources. Locally, the HEAL program should be the first place they think of to improve the safety, health and well-being of these patients. We need to be top-of-mind.”
Linking victims with safe housing options, addressing acute and chronic health care needs, assisting with filing police reports and orders of protection, and providing personalized, trauma-focused counseling, are just a few of the services HEAL offers. One of its most unique aspects is a comprehensive needs assessment conducted with every patient.
“Abusive relationships present a very real health care issue in terms of patient care, safety, and cost,” says Marsha Wittink, M.D., M.B.E., associate professor in the Departments of Psychiatry and Family Medicine, who is a co-principal investigator on a PCORI-funded study—in partnership with HEAL—to examine two different interventions for improving outcomes for patients affected by IPV and depression. “Victims of interpersonal violence often have complex concerns that impede their health, resulting in chronic conditions and repeated hospitalizations and office visits.”
Wittink says IPV victims are proven to be at particular risk of asthma, bladder/kidney infections, cardiovascular disease, gastrointestinal issues, fibromyalgia, sexually-transmitted diseases, sleep disorders, anxiety and depression. They are also more likely to have substance abuse issues, and more vulnerable to unplanned pregnancy and homelessness.
“It’s a major societal problem that the health care community is just beginning to address more thoughtfully and holistically,” she says. “We look forward to HEAL helping to close a very real gap in care for this population, and decrease the burden on patients and the health care system.”
Referrals and appointments can be made by calling 275-HEAL, or visit theHEAL website. Providers also can make referrals to the HEAL Collaborative via eRecord.
HEAL partners include the URMC Department of Psychiatry, Willow Domestic Violence Center (formerly Alternatives for Battered Women), the Rochester Police Department, RESOLVE, the Legal Aid Society of Rochester, Lifespan and Monroe Family Court.