Episode 36: See BI Series: Domestic Violence and Brain Injuries- Helping Domestic Violence Advocates Best Reach Survivors with Julianna Nemeth PhD, MA
Domestic violence survivors are a unique subset of brain injury. Many have experienced several types of brain injury from blunt force trauma and strangulation inflicted on them by their abusers. They commonly experience several types of trauma and mental health struggles. Substance use and limited social support can also play a role. Getting survivors the services they need to address all the challenges they face requires a unique set of interventions. The Ohio State University’s health equity intervention scientist, Julianna Nemeth, is working on just this. Her research focuses on developing, providing, and evaluating sets of interventions that are used by laypeople to guide conversations with survivors, identify their needs, and connect them with services to best meet the survivor where she is at. You won’t want to miss hearing about this transformative work!
In this episode:
Julianna’s research focuses on how DV survivors with brain injuries can get better access to services
One in three women are affected by domestic violence (DV): some groups have even higher incidences. It is a widespread public health issue
Julianna started doing community-based action research to better understand the needs of the survivors and centers that help them. Her research focuses on modifying interventions to better meet all their needs.
Many DV survivors develop BI because blunt force head trauma and strangulation are common types of abuse.
Ohio Domestic Violence Network received a federal grant focused on developing interventions for domestic violence service organizations to better meet the mental health needs of DV survivors with brain injury
Julianna did a needs assessment. What she found was that the advocates who help DV survivors were unaware of brain injury as being an issue
They also interviewed survivors and found that over 8 in 10 had been hit in the head or had their head hit into something. Over half of the survivors had this happen so many times that they couldn’t report a number
Over 8 in 10 survivors also reported strangulation
Many survivors do not realize they have brain injuries
In the DV population, many survivors experience TBI from blunt force trauma combined with an anoxic or hypoxic brain injury from strangulation. This is a unique population as many brain injury studies do not focus on brain injury due to multiple causes
These survivors suffer from trauma, ongoing stress, mental health struggles, racial trauma, and sociocultural trauma.
The DV brain injury population is highly complex and suffers from a type of brain injury that hasn’t been studied at all. Her team reached out to The Ohio State University's CBI mouse research program to shine a light on this gap
Current interventions to help this population were not effective to support the DV BI population. Julianna’s work focuses on bridging this gap.
There are also many unmet mental health needs in this population
Check out the work of Cecilia Mengo to learn more
Julianna’s work made interventions for advocates in community based organizations to better meet the needs of the DV BI population
They made Care Tools to help advocates directly communicate with survivors about brain injury and mental health
Their tools are free on the Ohio Domestic Violence Network website
Interventions need to focus on all the pieces of the puzzle to meet survivors needs: mental health, trauma, brain injury, substance abuse
They found that you have to focus on the big picture and ask survivors what symptoms are getting in the way of their lives today. What is it they need relief from and lets try to advocate for the right type of help
Some may need medical help while others need more of a mental health focus
They found in this population you can’t isolate a symptom to a certain cause. They have to match the survivor to the many services they may need
These tools give the advocates the education they need to best be able to meet the survivor where they are. The tools are formed to be used in the organizations survivors are already going to for services (which may be culturally specific or civil services and are usually not medical)
The Ohio Domestic Violence Network’s job is to educate the organizations
Many organizations rely on survivors being cognitively intact which may not be the case in survivors with BI
The Center on Partner Assisted Brain Injury’s website contains the tools
C.A.R.E. is a framework that advocates can use for connecting with survivors based on strategies that advocates reported as being successful
Connecting with survivors and performing genuine and healthy relationships
Acknowledging that head trauma and brain injuries are common and educating on this
Responding by accommodating needs related to TBI, strangulation, and mental health and referring appropriately
Evaluate the referrals made for effectiveness
Advocates also reported needing tools to directly talk to survivors in non-medical terms. These tools are also on the site.
These trauma informed approaches to care were found to be very effective. The tools were easy to use and effective because the tools are easy to use
They are made for lay people to use to be able to easily have conversation
Links to any resources mentioned:
Learn more about Julianna Nemeth
Cecilia Mengo: Mental health, BI, and DV
The Center on Partner-Inflicted Brain Injury
Brain Injury Materials:
Invisible Injuries Overview (4 pages)
Invisible Injuries Booklet: When Your Head is Hurt (16 pages)
C.A.R.E. framework
The Ohio State Chronic Brain Injury Home: discovery.osu.edu/cbi
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