Trying Times and Trying Out Solutions: Intimate Partner Violence Screening and Support for Women Veterans During COVID-1
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VA Palo Alto Health Care System Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA; 2Center for Primary Care and Outcomes Research (PCOR) and Center for Health Policy (CHP), Stanford University, Stanford, CA, USA; 3National Intimate Partner Violence Assistance Program, Veterans Health Administration, Washington, DC, USA; 4Presence Center, Stanford University School of Medicine, Stanford, CA, USA; 5 Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; 6Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
Initial reports indicate widespread increases in intimate partner violence (IPV) rates during the coronavirus disease 2019 (COVID-19) pandemic. Women veterans are at particular risk for experiencing IPV, and the COVID-19 pandemic and resulting stay-at-home orders may be exacerbating this risk. IPV screening and intervention are an integral part of the care provided to women veterans in the Veteran’s Health Administration (VHA). Current changes in healthcare delivery during COVID-19 may present challenges to the VHA’s standard methods of initiating IPV screening and intervention with women veterans. We discuss the potential challenges VHA healthcare providers may be encountering when conducting routine IPV screening during the COVID-19 pandemic and when providing resources and support to women veterans experiencing IPV. We describe solutions to these challenges, including existing efforts led by the VHA IPV Assistance Program (IPVAP) as well as additional potential solutions. New ideas and partnerships will be critical for helping the VHA continue to assist women veterans experiencing IPV as the COVID-19 pandemic evolves. Though our focus is on women veterans and the VHA, the challenges and solutions we discuss are likely applicable to other populations experiencing IPV and other health care systems screening for IPV. KEY WORDS: intimate partner violence; women veterans; COVID-19; screening; pandemic. J Gen Intern Med DOI: 10.1007/s11606-020-05990-0 © Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2020
partner violence (IPV), defined as physical or I ntimate sexual violence, stalking, psychological aggression, or co-
ercion by a past or current intimate partner,1 is an all too Received May 18, 2020 Accepted June 12, 2020
common experience in the lives of women. Women veterans may be at particular risk2 as up to 60% of women veterans in relationships report experiencing IPV.3 The burden of IPV on women veterans is often compounded with experiences such as sexual assault and harassment during military service.4, 5 In 2019, the Veteran’s Health Administration (VHA) issued a national directive calling for routine IPV screening and provision of intervention across VHA facilities.6 IPV screening and intervention are necessary for maintaining women veteran safety and, thus, an integral part of the care provided to w
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