Policy

The National Center on Domestic Violence, Trauma & Mental Health works to promote accessible, culturally relevant, and trauma-informed national-level responses to domestic violence through our work with the behavioral health field and federal agencies. Our work in this area has focused on some of the following topic areas:

Access to Behavioral Health Care

Access to mental health care and substance abuse treatment is a critical issue for survivors of domestic violence, many of whom experience the traumatic effects of abuse. The Affordable Care Act (ACA) and other recent legislative and policy changes have the potential to bring about significant improvements in access to behavioral health care. It is important for those working in the DV field to stay informed of these developments and potential opportunities for collaboration. As access to services increases, it is also critical for behavioral health care to incorporate trauma-informed principles and to be responsive to the safety and privacy needs of those experiencing ongoing domestic violence.

The Affordable Care Act and Mental Health Care Coverage: Implications for Survivors and Opportunities for Advocates, A Question & Answer with Sarah Steverman, Director of State Policy, Mental Health America (Fall 2012)

Screening & Responding to Domestic Violence

Among the changes ushered in by the Affordable Care Act, health care providers now have an incentive to screen women for domestic violence. This is because the ACA now provides that new insurance plans must pay for screening and brief counseling for DV without any cost to the patient. In addition, the Institute of Medicine (IOM) and the U.S. Preventive Services Task Force, which typically make recommendations on health-related testing and treatment procedures, both recently recommended for the first time that health care providers regularly screen and counsel for DV.

Among other national efforts in this area, a recent symposium brought representatives of federal agencies together with experts and researchers to discuss issues related to screening. NCDVTMH’s Director, Carole Warshaw, MD, presented a talk at this symposium, which is available online along with other conference materials: Trans-HHS Intimate Partner Violence Screening and Counseling: Research Symposium.

For those working in the health care field, resources on screening for DV in health care settings can be found at Health Cares About IPV, a web-based collection of helpful tools created by the National Health Resource Center on Domestic Violence (HRC), a program of Futures Without Violence. Visit this site to find resources for clinicians, including web-based trainings, and to download the new resource, Relationships, Support and Wellness, developed collaboratively by NCDVTMH and Futures Without Violence. This small brochure makes the connection between experiencing trauma or unsafe relationships and the impact on mental health and well-being, as well as resilience and supportive relationships.

Additionally, helpful tools are available on our page, Resources for Mental Health and Substance Abuse Treatment Providers.

Privacy & Electronic Health Records

Many recent changes in the health and behavioral health field have raised questions about how mental health and substance abuse records can be shared between providers. NCDVTMH supports improved information sharing to achieve more coordinated patient care, but only with the right protections in place. For domestic violence survivors at risk of experiencing coercive controlling behavior related to their mental health and substance use, protections for mental health and substance abuse treatment records can be critical for safety and well-being.

As part of our work in this area, NCDVTMH recently submitted Comments on Changes Being Considered to 42 CFR Part 2.

We also  submitted public comments on the Federal Health IT Strategic Plan (2015-2020), prepared by the Office of the National Coordinator for Health Information Technology (ONC). In our comments, we identified three opportunities presented by the widespread adoption of EHR technology, namely the following: (1)  the opportunity to use EHR technology to promote appropriate response to DV in behavioral health settings;  (2)  the opportunity to develop robust informed consent mechanisms in the context of behavioral health records; and (3) the opportunity to develop the technological capacity for granularity so as to support patient choice with regard to sharing of information.

Read the full comments here: NCDVTMH Public Comments Submitted on the Federal Health IT Strategic Plan (2015-2020), Prepared by the Office of the National Coordinator for Health Information Technology (ONC) (PDF)

Gender Stereotypes, Stigma & Impact on Survivors’ Access to the Legal System

Gender stereotypes and stigma associated with mental health and substance often intersect in ways that impact the ability of survivors to access support and assistance through the legal system. This policy brief addresses two prevalent misconceptions that frequently impact legal cases: that women with mental health conditions or substance use disorders (1) are not credible, and cannot be believed when they disclose abuse; and (2) are necessarily unfit parents or not as good parents as others without these conditions. These misconceptions have a significant impact on the ability of many survivors of domestic violence to access support and assistance through the legal system.

How Gender Stereotypes and Stigma Associated with Mental Health & Substance Use Impact Survivors of Domestic Violence & Sexual Assault (PDF)

Responses to National Crises

Recent tragedies including the Sandy Hook school shooting have raised a number of issues that have implications for domestic violence advocacy work, including issues related to gun control and mental health services. The domestic violence field has joined in mourning these tragedies. We have also been involved in policy conversations designed to create more a peaceful tomorrow.

The following document analyzes some of the public policy issues raised following the Sandy Hook school shooting and their relevance for DV advocacy: Mental Health Initiatives in the Aftermath of the Sandy Hook Tragedy: Implications for the DV Field, Rachel White-Domain, JD (Winter/Spring 2013)

 

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