Domestic violence often leaves outward signs of abuse: bruises, black eyes, or broken bones. But, there鈥檚 often an invisible toll as well: traumatic brain injuries.
More than 80% of survivors of domestic violence sustain injuries to their head, face or neck, according to and the Ohio State University Department of Public Health. 83% reported being choked or strangled. Almost half of survivors said it happened too many times to count.
A new grant will allow the Ohio Domestic Violence Network to work with more than 200 providers to increase awareness on how these injuries could impact survivors鈥� brain health. The statewide organization will provide virtual trainings and conferences and establish best practices for shelters, crime victim services and healthcare providers.
鈥淚t is kind of something that has been really hidden in plain sight since the very beginning of doing domestic violence work,鈥� said Rachel Ramirez, director of ODVN鈥檚 health and disability programs and founder of The Center on Partner-Inflicted Brain Injury.
Increasing awareness
Despite the prevalence of these injuries among domestic violence survivors, Ramirez said concussions have rarely been talked about among service providers. The conversation around traumatic brain injuries has largely been siloed to sports and the military.
Ramirez said that鈥檚 partially because domestic violence is a private experience.
鈥淚t doesn't happen in front of other people. It's not like a football game 鈥� When we think about sports, you take a timeout, you assess for a concussion,鈥� she said. 鈥淭hat鈥檚 not possible in our spaces.鈥�
Brain injuries can have a long-term impact on survivors鈥� health. It may cause challenges with time management, anger management, problem-solving and impulse control. It can cause headaches and impact sleep.
Ramirez said many survivors report not feeling like themselves but not understanding why.
鈥淚 have survivors reach out to me who tell me 鈥業'm having a harder time reading, like I just can't think. It鈥檚 taking me so much longer at work. I lose my keys all the time because I can remember where I put them,鈥欌�� Ramirez said. 鈥淭he signs and symptoms and impacts of brain injury can be very widespread.鈥�
A new treatment model
The $10,000 grant from the Ohio Department of Mental Health and Addiction Services will train more providers to spot those symptoms in survivors and create treatment plans with brain injuries in mind, Ramirez said.
For example, if a survivor is struggling with time management, service providers will know to ask about their history with head injuries and work to accommodate the effects of a possible concussion.
鈥�If someone is living with us in a shelter and they know that they have a two o'clock appointment, can we make a plan with them to go do that? If we have people who are very sensitive to noises, to sounds, to lights, can we change our lighting? Can we provide people with sunglasses?鈥�
The hope is that providers can intervene earlier and connect more survivors to medical treatment.
That鈥檚 especially important, Ramirez said, since concussions can act as a barrier to escaping abuse. It can be more difficult to apply for a protection order or find new housing, if your brain feels cloudy or you鈥檙e suffering from debilitating headaches.
鈥淗elping survivors have a better understanding of what [brain injuries] are and understand, 鈥楴o, you're not crazy. You're not stupid. You're not making these things up, it's just that you've been hurt,鈥欌�� she said. 鈥淟et's come up with ways and strategies that'll work for you to be able to live your life in the way you want to.鈥�