Veteran intimate partner violence recommendations urge wider VA screening

An expert panel has issued veteran intimate partner violence recommendations calling for broader screening across the Department of Veterans Affairs and more training for health care workers. The report matters because disclosures can emerge in any part of the VA system, not only in mental health appointments, according to researchers led by the Keck School of Medicine of USC.

The recommendations stem from a provision of the Deborah Sampson Act of 2020, a law intended to expand access to government medical care for women veterans. The VA commissioned researchers to assess what is known about intimate partner violence and veterans’ health, according to Susanne Hempel, a professor at the Keck School of Medicine of USC and director of the Southern California Evidence Review Center.

The findings were published in Women’s Health Issues. The authors said the recommendations have been sent to senior VA leaders.

What did the panel recommend for veteran intimate partner violence?

The panel recommended wider screening for veterans who may be experiencing intimate partner violence or using it against a partner. It also called for education and training so VA staff can spot warning signs and respond appropriately, according to the report.

The group backed a “no wrong door” approach, meaning any clinical encounter should be able to connect a veteran with help. Hempel said disclosures may arise during care such as physical therapy or a blood draw, rather than during a visit focused on mental health.

The panel also urged targeted screening and safety planning for veterans reporting suicidality, post-traumatic stress disorder, substance use or sleep problems. The report pointed to an especially serious overlap among veterans involving firearm ownership and suicide risk.

Who was on the panel?

The authors convened a virtual panel of 12 advocates and experts, including patient representatives, frontline clinicians, researchers and government policymakers. Researchers prepared summaries for the group using findings from more than 100 studies, many of them systematic reviews that combined evidence from large numbers of peer-reviewed papers.

Elizabeth Yano, senior author of the report, said policymakers need to know which actions are most urgent and most likely to help. Yano directs the Center for the Study of Healthcare Innovation, Implementation & Policy at the VA Greater Los Angeles Healthcare System and is a UCLA professor-in-residence of medicine and public health.

What counts as intimate partner violence?

The panel said intimate partner violence should be understood as more than physical or sexual assault. The report said definitions should include examples of other harmful conduct, including stalking and psychological abuse.

Hempel said the way clinicians define intimate partner violence affects whether they identify and treat it. The panel also found that intimate partner violence is more common among veterans than in the general population, but said firm statistics are hard to establish because studies use different sampling methods and lack data on some subgroups.

The report identified veteran-specific risk factors, including PTSD, higher suicide rates and long separations tied to deployments. Those factors informed the panel’s call for screening practices that reflect veterans’ experiences.

How did the panel view current VA programs?

Veterans currently receive help through the VA’s National IPV Assistance Program. According to the report, the program uses principles that put people first, center veterans’ perspectives, account for trauma and support recovery.

The panel unanimously found those principles essential to the program’s work. Hempel said the report supported the direction of the VA’s existing program while urging the agency to strengthen screening, staffing and practical tools for clinicians.

This story draws on original reporting from Phys.org.