The Institute of Medicine (IOM) made headlines back in July 2011 when it released a report that recommended adding domestic violence screenings to the preventive services that health plans would cover at no cost to patients under the Affordable Care Act (ACA).
The ACA did just that, and the provision went into effect on August 1, giving millions of women free access to eight preventive services, including those screenings.
But now research appearing in the Journal of the American Medical Association seems to fly in the face of the IOM's recommendation, saying those domestic violence screenings don't have the intended effect. The study compared three groups of women; those who were screened and given a list of local resources; women who were only given a list of resources; and women who were neither screened nor given the list.
After following up one year later, the study found that "providing a partner violence resource list with or without screening did not result in improved health."
But Kaile Shilling, who's the director of the Violence Prevention Coalition of Greater Los Angeles, says a single screening, or a doctor asking questions one time, usually won't have an effect on domestic violence victims.
"Most people who work in the field of domestic violence would say the more you can ask the question – the more you can create a space to talk about it – the better," she said. Shilling added that even if that particular visit or screening doesn't yield anything, being asked the question might trigger the willpower to go seek help elsewhere.
The director explained that there's a multitude of reasons a domestic violence victim may not immediately respond to a person who's reaching out. For one, there's the "normalization of violence," where a person who's grown up in a violent home perceives that violence is simply a part of life.
There are also financial reasons – a person who's being abused physically and emotionally may have nowhere else to go.
"[Sometimes] there are no other options for them," Shilling said. "If they leave they might be going into a worse situation."
And, of course, there's fear.
She added that it usually takes more than a few times of being abused or being reached out to before a person will accept help and/or leave an abuser.
"If you have this screening as a routine part [of primary care], it doesn't take one time," Shilling said. It takes several – "and the more you can do that, the quicker you're going to be able to get to them."
But those considerations didn't seem to be on the radar of the study's authors.
"The results of this study suggest providing a partner violence resource list with or without computerized screening of female adult patients in primary care settings does not result in significant benefits in terms of general health outcomes," they wrote, according to HealthDay. "These findings provide important information for clinicians and others to consider in light of recent professional recommendations calling for routine screening."
If you're a victim of domestic violence, you can call the 24-hour National Domestic Violence Hotline at 1-(800)-799-7233; the Southern California Domestic Violence Hotline at 1-(800)-978-3600 or the L.A. City Attorney's Victim Assistance Unit at (213) 978-2097. The Centers for Disease Control and Prevention has more on domestic violence here.
Photo by Hibr via Flickr Creative Commons.