Category:spousal assault

The Need for a Healthcare Response to Violence in Canada

Interpersonal violence is often approached from different facets such as criminal, economic and health yet rarely are the actual health implications looked into, other than the immediate physical damage caused by violence. Yet, as the Global Status Report on Violence Prevention 2014 has found, the non-fatal consequences of violence are the greatest part of the social and health burden arising from violence and this burden is generally carried by women, elderly people and children throughout the world. This can include negative behavioural, cognitive, mental health, sexual and reproductive health problems, chronic diseases and social effects that all outweigh the physical injuries sustained from the violence.

It has been found that violence against women and children contributes disproportionately to the health burden, particularly child maltreatment and women who have experienced intimate partner and sexual violence have more health problems, incur considerably higher healthcare costs, make more visits to healthcare providers over their lives and have more hospital stays (including longer durations) than those who have not experienced violence.

This violence has also been linked to other adverse health reactions such as afflictions of the brain and nervous system, gastrointestinal and genitourinary systems, and immune and endocrine function. For the women going through or having survived intimate partner violence and other forms for violence associated with that, there are also sexual health implications, as chances for HIV and other sexually transmitted infections (such as syphilis), unwanted pregnancies and other reproductive problems skyrocket with experience of violence. This can include having low birth weight babies (16% higher risk) and chances twice as high of an induced abortion.

Evidently this violence also affects the behaviours of the victims and thus being exposed to violence is linked to high-risk behaviours such as alcohol and drug abuse, as well as smoking, which all increase the risks of several leading causes of death (i.e., cancer, chronic lung disease, liver disease, etc.). This can affect young victims as well, either as a learned behaviour or as backlash to their suffering, which becomes very dangerous.

There are also repercussions on victims’ mental health. The risk for anxiety, depression, post-traumatic stress disorder and suicidal behaviour is also heightened, not to mention that exposure to violence and men’s perpetration of violence against women have been shown to be associated with high-risk sexual behaviours. This can tie in with the aforementioned sexual health risks.

Unmistakably, with all of the health menaces associated with violence there are also a wide range of indirect costs, such as spells of unemployment, absenteeism and other health problems that can affect the victim’s job performance. There are also indirect costs that relate to lost productivity because of things such as premature death, long-term disability, the provision of places of safety for children and women, and disruptions to daily life for fear regarding personal safety. Obviously these indirect costs affect people at varying degrees and those with a less stable income to begin with, from poorer social economic classes are disproportionally affected. Those without proper social support (i.e. family/friends) can also be disproportionately affected.

Relatedly and just as importantly, there is the issue of other violent crimes like homicide and non-domestic assault, both of which can have long-term implications on health. The hazards associated with being victimized by violent crime also include engaging in negative coping mechanisms, such as substance abuse and said victims are at a much higher risk to turn to such behaviour versus the general public. Anxiety, depression and post-traumatic stress disorder also pose as huge perils. Furthermore, all of the aforementioned health risks have an impact and contribute to problems in regards to unemployment, loss of productivity and disruptions to normal, daily life.

Sadly, Canada does not take a public health stance towards victimization as a result of interpersonal violence or other forms of violent crime. We have chosen to instead focus on the causes of violence, over the impacts. Research done on restorative justice programs shows the positive impact RJ seems to have on the improvement of the psychiatric and physical health of victims. This is possibly because such programs focus on the harm (caused and suffered) versus justice processes. In Canada, many of the short and long-term health needs of victims and survivors alike go untreated as a result of this focus on justice. With violent crime being sudden and unpredictable, victims and survivors are at the highest risk for severe impacts from victimization, yet they have very few low-cost or free mental health supports or other healthcare services at their disposal. The CRCVC believes we must move toward a healthcare response to violence, without linking the services offered to offenders or perpetrators, in order to more fully address the impacts of violence on survivors.

Every 6 days a woman in Canada is killed by her intimate partner. Action is needed!

The CRCVC mourns the recent homicides of Carol Culleton, Anastasia Kuzyk, and Nathalie Warmerdam, outside of Ottawa, in Wilno, Ontario. All are believed to be killed within hours of each other on September 22, 2015 by Basil Borutski, their former intimate partner, who has since been charged with first-degree murder. Since their tragic deaths, two other women have perished at the hands of former or current partners. In Fort Saskatchewan, Alberta, the family of Colleen Sillito, who was shot by a former boyfriend in a murder-suicide October 2nd, wants the provincial government to call a public inquiry. In Manitoba, 20-year-old Selena Rose Keeper was found bleeding to death outside a Winnipeg home October 8th. She loved and feared the man who has been charged in her death, her sister says. It is also reported that she was denied a protection order.

The lives of these women mattered, yet in this country women continue to be killed —one every six days nationally—without much ado. Indigenous women continue to face indifference with the number of girls and women stolen now tallying more than one thousand. The topic of violence against women is not a major election issue, even though it should be.

Men like Borutski are not “unstoppable”; in fact, violence against women is preventable. Professor Irvin Waller reminds us that the World Health Assembly (which has oversight of the World Health Organization) adopted in 2014 a milestone resolution on the role of the health sector in preventing violence against women.

We know how to prevent these crimes. The Ontario Domestic Violence Death Review Committee reviews deaths of persons that occur as a result of domestic violence, and makes recommendations to help prevent such deaths in similar circumstances. Waller states, “Among the priorities must be partnerships between police, health, social services and others that are essential to providing for prevention and the greatest protection to possible victims. Another priority is funding social investment in reducing the well established risk factors, including mental illness, as well as to support victims and their children, particularly in rural areas where the home and livelihood are interconnected.”

Borutski somehow evaded the criminal justice system for the crimes he committed against his partners. While he was convicted of causing property damage, assault police and failure to provide a breath sample, the serious charges for threatening his ex-wife with death and assaulting her, for assaulting Warmerdam, for criminal harassment of a fifth woman and for assault against a sixth, were all stayed by Crown prosecutors. Professor Elizabeth Sheehy says “the criminal justice system completely failed to appropriately condemn Borutski’s violence or to capture the acute endangerment his victims faced. And without convictions for serious crimes of violence he could not have been designated the “dangerous offender” that he appears to be.” She is right and this happens too commonly in domestic violence cases across Canada.

Too many women in Canada are living in fear of current or ex-partners. Many use monitoring devices and safety plans to try to keep safe. Escaping violence is not easy, especially where children are involved. Let’s call on our elected officials to take the epidemic of violence against women in Canada seriously. We can combat it together by mobilizing feminist organizations and addressing it as a major public health concern.

The Canadian Resource Centre for Victims of Crime offers support, research and education to survivors and stakeholders.

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