Why people stay in violent relationships

In an effort to identify the social and family pressures that compel women and men to return to and remain in violent relationships, University of Rochester Medical Center researchers are conducting interviews at Monroe County Family Court and at psychiatric and medical clinics.

The ultimate goal of the project is to train primary care physicians and mental health care providers to screen their patients effectively so they can refer patients to appropriate community domestic violence services or support patients choosing to live in abusive relationships.

“Unfortunately, though primary care physicians are front line professionals, most physicians do not screen for intimate partner violence, leaving the majority of female and male patients without support from their physicians,” said Susan H. Horwitz, Ph.D., assistant professor of psychiatry and the project’s principal investigator. “Our project will train health care professionals to ask the right questions, in the right context, and make the right decisions regarding this problem.”

An estimated 50 percent of women who leave an abusive relationship return to the relationship an average of five times.

“We know why women who seek domestic violence shelters or family court make these decisions, but we do not have information on women from all walks of life in the community,” Horwitz said. “We know nothing about why men, whether they are perpetrators or victims, make decisions to stay, leave or return.”

Given the high rate of return to abusive relationships, physicians, physician assistants, nurse practitioners and metal health care providers need to understand how to identify, manage and refer their vulnerable patients to service providers trained in domestic violence, Horwitz said.

Several studies have shown that when victims of domestic violence are asked about their situation, they will answer. But, in a recent pilot project, Horwitz said she and her colleagues found that physicians and mental health care providers do not know the right questions to ask, how to approach their patients, how to insure privacy while screening or what to do if their patients respond.

“So, health care professionals treat the bruises, cuts, and broken bones. Mental health care providers treat the depression and anxiety with medications, never understanding the source of the problem, or referring their patients to services that could reduce or eliminate the violence,” Horwitz said.

The interview questions were developed by the Rochester/Monroe County Domestic Violence Consortium. Researchers expect to interview 150 women and 100 men. Information from the interviews will be used to develop training programs for health care professions in various fields and for medical students. Horwitz said there also is a need to create a model for health care intervention of intimate partner violence that could be used nationwide.

The one-year project is supported by several grants, including $85,000 from the William G. McGowan Fund, $25,000 from State Sen. James Alesi, $20,000 from the Bank of America, $6,000 from Rochester Area Community Foundation, $5,000 from Wynne Center for the Family and $1,000 from Saathi, a non-profit organization based in Nepal.