Bridging the Gaps

For more than 20 years, NCDVTMH has worked to bridge the gaps between the domestic and sexual violence and the mental health and substance use fields so that survivors and their families can access the resources that are essential to their safety and well-being.

Policy Focus Areas

Access to Services: Survivors and their children deserve access to the resources and services they choose to support their healing, resilience, and well-being, including trauma, mental health, and substance use disorder recovery and treatment services.

Quality Care: To meet the needs of survivors, mental health and substance use disorder treatment providers need access to training that supports their ability to provide services that are trauma-informed, culturally specific, and domestic and sexual violence-responsive.

Safety and Privacy: It is essential that telehealth policy and services incorporate safety and privacy protections for survivors.

Emerging Issues: NCDVTMH works as a team across the areas of research, practice, and policy to identify and lift up emerging issues from the field to policymakers.

Substance Use Coercion: During the height of the opioid epidemic, NCDVTMH shared original research on substance use coercion with policymakers. This is a form of abuse targeted toward a partner’s use of substances that is essential to keep in mind when working with survivors across multiple settings and systems. More than 60% of those who sought help for substance use said their abusive partners had tried to prevent them from accessing treatment. Based on this understanding of substance use coercion and with the historic rates of overdose during COVID pandemic, NCDVTMH is leading on policy changes to reduce the barriers to safety and recovery faced by survivors.

Needs of Local Domestic Violence Providers: Local providers are reporting increased demand for mental health and substance use disorder services, even pre-COVID. In 2019, NCDVTMH’s needs assessment among local providers found over 70% saw increased need for mental health and substance use disorder services in their programs but most felt unprepared to meet this need.

Address Disparities: Support survivors and their families most impacted by harmful policies and systems, and support policies that address the structural inequities that harm survivors and their families, such as access to mental health and substance use disorder treatment and recovery support. We work with national partners to provide training on connections with other systems, such as child custody and criminalization of substance use.

Breaking Down Barriers: Support systems change and integrated models that ensure mental health and substance use disorder treatment and recovery systems are equipped to handle the unique needs of survivors and their children and vice versa for local domestic violence programs. This cross-system collaboration can happen with incentives at the federal, state, and local level.

Crisis Response: As states and localities receive large investments from COVID relief funds for suicide prevention hotlines, harm reduction programs, and mobile health funding, these programs should consider DV survivors and partner with local programs and experts.

Maternal Health and Domestic Violence: Intimate partner violence during pregnancy has been shown to contribute to maternal mortality from pregnancy-associated deaths (overdose, suicide, homicide). Our work informed the national legislation, Protect Moms from Domestic Violence Act, that would improve research and invest in innovative programs to prevent domestic violence, support survivors, and address structural barriers to health equity.

Policy Development and Analysis

NCDVTMH helps federal policymakers and partnering organizations analyze and provide recommendations on national legislation and regulations relevant to survivors, advocates, and mental health and substance use disorder treatment providers. In particular, the opioid epidemic and COVID-19 have illustrated the continued need for work on these issues in order to ensure survivors and their families are safe and supported in their recovery efforts.

NCDVTMH serves in several coalitions and member organizations, including the Domestic Violence Resource Network, Campaign for Trauma-Informed Policy and Practice, and National Health Collaborative on Violence and Abuse.

For additional information, please contact Sally Schaeffer, consultant, at sally@uncorkedadvoates.com, or Carole Warshaw, MD, Director of NCDVTMH, at cwarshaw@ncdvtmh.org or 312-726-7020.

Recent Resources

Collaboration Across Systems: Information Memorandum from the U.S. Department of Human Services (HHS) that calls for collaboration on domestic violence, substance use, and mental health. In addition to the memo, NCDVTMH offers infographics and other supportive materials.

Key Survey Findings from Domestic Violence Programs (2017-2019):

DV Programs and Survivors with Mental DV Programs and Survivors Who
Health Challenges Use Substances

Recommendations to the Biden Administration: Public recommendations to the White House Gender Policy Council for a National Action Plan on Gender Based Violence.

Substance Use and Substance Use Coercion:

Understanding Substance Use Coercion as a Barrier to Economic Stability for Survivors of Intimate Partner Violence: Policy Recommendations HHS brief report that includes the research on substance use coercion with policy and practice responses.

Substance Use Coercion: NCDVTMH Recommendations for Federal Policy

Saving Lives: Meeting the Needs of Intimate Partner Violence Survivors Who Use Opioids This research and policy brief released in 2019 still contains relevant recommendations for national and state policymakers along with recommendations for policy change.

Telehealth: As telehealth services expand, NCDVTMH’s comments seek a balance of improving access to care via telehealth while also protecting patients from coercive interference.