MEDSCAPE: Domestic Violence Amid COVID-19: Helping Your Patients From Afar

Missions Inc.Featured, In the News

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By Batya Swift Yasgur, MA, LSW

Home Free Community Program’s Elsa Swenson was featured in a Medscape article about how medical professionals can assist those facing domestic violence while conducting virtual visits.

Medscape is an online news source for doctors, nurses and other medical professionals.

Find the full article here. Below is the portion featuring Missions Inc. Programs and Elsa.

Trust Your Clinical Gut
How can you tell if your patients might be experiencing abuse when you’re not seeing them in person?

Pay attention to subtle signals and “trust your clinical gut when something doesn’t feel right,” Nyachogo advised.

If a patient’s demeanor is jittery or anxious or if someone next to him or her is answering all the questions or interrupting the visit, these could be red flags.

Cronholm added that telemedicine visits offer a “rare window into a patient’s home life that would not be available in an office visit.” For example, a house in disarray, the presence of broken objects, or the presence of another person hovering in the background suggests the need for further exploration.

The starting point of screening and intervention is to recognize that any domestic violence situation is potentially explosive. “The main thing for all providers to keep in mind is ‘first, do no harm,’ ” Nyachogo emphasized.

“Our agency has been working for years with medical professionals in how to screen and connect folks with help most effectively and safely, and — although the specific situations posed by COVID are new — the overall approach is the same, which is to proceed with caution in how you approach the subject and how you make referrals,” she said.

Begin by asking if it is a convenient time to talk.

“This question takes the onus off the patient, who may not know how to communicate that she has no privacy or is in the middle of an argument,” explained Elsa Swenson, program manager of Home Free Community Program, which serves individuals experiencing domestic violence. The program is part of Minnesota-based Missions Inc Programs, which serves those experiencing domestic abuse and chemical dependency.

If the patient indicates that it isn’t a convenient time to talk, find out when would be a better time. “This might be difficult for busy physicians and may not be what they’re accustomed to when calling a patient at home, but the patient’s circumstances are unknown to you, so it’s essential to organize around their ability to talk,” Swenson noted.