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DA Announces Standards for Healthcare Response to Domestic Violence

District Attorney Summer Stephan announced on Wednesday the release of a collective set of guidelines for healthcare organizations on how to screen for and respond to domestic violence. The first-of-its kind standards provide a countywide roadmap for medical professionals, who are often the only individuals able to see domestic violence victims alone away from their abusers.

This effort builds on the steps taken by the District Attorney’s Office and the County Health and Human Services Agency over the past five years in the Strangulation Protocol under which training was provided to over 5,000 peace officers on how to detect strangulation signs and symptoms.

“Domestic violence, including strangulation, goes largely under-reported by survivors,” District Attorney Summer Stephan said. “Healthcare staff can be a critical point of intervention and connection to help in a safe and private setting and that’s why I am so proud of the partnership with our County’s Public Health Officer along with other healthcare experts that is saving lives.”

The data-driven effort has been led by the District Attorney’s Office, County Medical Care Services, Emergency Medical Services and Public Health Services. Together, the partners worked with healthcare staff over the past year to develop this evidence-informed document.

Since the Strangulation Protocol went into effect, domestic violence homicides dropped by 15 % between 2017 and 2020 according to the Domestic Violence Fatality Review Team.

In 2019, the DA’s Office in partnership with HHSA released launched the Health CARES initiative, bringing training and resources to healthcare staff countywide. The release of the Healthcare Standards comes on the anniversary date of national Health Cares About Domestic Violence Day. Healthcare staff across the county will take part in efforts to raise awareness about domestic violence including resources fairs, training and outreach events.

Included in the Healthcare Standards are evidence informed practices for:

  • Conducting screening for domestic violence
  • Assessing for signs and symptoms of strangulation
  • Reporting suspicious injuries to law enforcement
  • Evaluation of the patient by a trained forensic examiner
  • Safety planning with the patient and connect them to resources

“The purpose behind these standards is to have a collective and coordinated healthcare community response as we see and treat patients who have experienced violent crime,” said Dr. Wilma Wooten, Public Health Officer for the County of San Diego Public Health Services, HHSA.

Implementing better documentation and connecting forensic health service examiners when strangulation or other domestic violence related injury has occurred has been critical.

“These steps are saving lives and we hope the implementation of these Standards for Healthcare staff countywide help drive this change home,” said Michelle Shores, Director of Forensic Health Services for Palomar Health.

Abusers are being held accountable and justice is better served through these efforts.

“Our office has seen a threefold increase in felony charges for strangulation-related crimes that we can attribute to better forensic evidence,” DA Stephan said. “The most compelling data point that the partnership between healthcare and public safety is working is the dramatic decrease in domestic violence strangulation homicides that have dropped to 2.3 %.”

The San Diego County Domestic Violence Council has assisted in bringing together countywide staff representatives from healthcare organizations such as UCSD, Rady Children’s Hospital, Sharp, Palomar Health, military hospitals, and the County of San Diego in the collaborative development of this document.

“Our hope is for universal screening in healthcare settings, where every patient is asked whether they are experiencing abuse and received education and resources,” said Claudia Grasso, the San Diego Domestic Violence Council President. “Even if that patient is not personally experiencing abuse, odds are that they know someone who is and this information could make a difference to someone who needs help.”

If you or someone you know is being abused by a current or former partner, call the National Domestic Violence Hotline (1-800-799-7233) for confidential support and assistance with planning.