A first-of-its-kind resource is now available to help medical providers recognize and respond to brain injury from intimate partner violence.
The Intimate Partner Violence Traumatic Brain Injury Medical Provider Resource is designed to educate doctors and nurse practitioners in treating brain injury for survivors of intimate partner violence (IPV). Created by an interdisciplinary team of 11 clinicians, researchers, advocates and persons with lived experience in Canada and the United States, the guide is a first step to providing better medical care for a currently underserved patient population, says Dr. Paul van Donkelaar, a Faculty of Health and Social Development Professor at UBC's Okanagan campus.
Globally, one in three women will experience violence at the hands of a partner--Statistics Canada puts that number at 44 per cent in this country. Research indicates as many as 92 per cent of survivors may also experience one or more brain injuries from blows to the face, head and neck, and through strangulation.
Dr. van Donkelaar is an expert on concussions. He is co-founder and scientific advisor for Supporting Survivors of Abuse and Brain Injury through Research (SOAR) and one of the authors of the guide.
SOAR is a multi-disciplinary, community-engaged, non-profit initiative that applies scientific evidence to increase awareness, improve supports and services for survivors of intimate partner violence and brain injury.
Concussion, he explains, can cause a wide spectrum of physical, cognitive, neuro-behavioural and emotional symptoms. More severe forms of brain injury can cause seizures or sensorimotor, visual or language functioning deficits. Those who sustain IPV-caused brain injury are at risk of developing mental health and substance use conditions, and often face challenges related to housing and safety for them as well as their children.
Optimizing care for this unique population requires timely access to medical assessment and coordinated, interdisciplinary care that is currently unavailable to many survivors in Canada.
"We know failure to receive appropriate medical care following acute brain injury from IPV can lead to delayed diagnosis and treatment of injuries," he says. "It can also lead to the development of persistent symptoms and challenges and a return to environments where the survivor is at risk of recurrent and preventable injuries, and even death."
Despite this, knowledge and awareness of this issue remains low among frontline service providers in a variety of sectors, and there are no clinical practice guidelines outlining a comprehensive approach to the in-office, medical assessment and management of those presenting with IPV-caused brain injury.
"In response to this urgent and unmet need, our team used existing research and expertise to develop the guidelines," Dr. van Donkelaar adds.
The resource includes extensive information on the complex intersection of IPV and brain injury. It details how to conduct medical assessment, management and follow-up that includes multi-disciplinary referral considerations while honouring the unique needs of the patient population.
"Beyond providing clinical care for these patients, physicians and nurse practitioners can play an important role in advocacy," says Lin Haag, a social work doctoral student at Wilfrid Laurier University and an investigator in the Acquired Brain Injury Research Lab at the University of Toronto. "They can advocate for necessary intersectional, trauma-informed, anti-racist and equitable health and social care systems as well share knowledge among other key stakeholders."
The resource is free, and is the first of its kind addressing specific and targeted care for survivors of IPV-caused brain injury.
The goal is that it will act as a starting point to be refined by additional clinical experience and research, and help encourage and inform the development of international consensus clinical practice guidelines in the future, explains leading concussion expert Shelina Babul, who developed the Concussion Awareness Training Tool as part of her work with the BC Injury Research and Prevention Unit at BC Children's Hospital.
"We hope this resource will empower more physicians and nurse practitioners throughout Canada, and worldwide, to step forward and help care for this frequently under-recognized and underserviced patient population," she adds. "Ensuring women get the diagnosis and care they need to achieve healthy outcomes after abuse is way past due."
The Intimate Partner Violence Traumatic Brain Injury Medical Provider Resource and the full list of expert contributors are available to download at: abitoolkit.ca/resource-library/service-provider-resources