Victims of Domestic Violence
Deserve Safe Shelters
Domestic violence and abuse
has increasingly been recognized as a major public health issue in the
United States, and the role of health care providers in detecting and preventing
domestic violence is becoming better accepted. A recent article in
the New England Journal of Medicine (Eisenstat & Bancroft, Domestic
Violence, Sept. 16, 1999) advocates that medical providers should “routinely
screen patients for a history of abuse…refer patients for appropriate services,
and assess whether the patients are in immediate danger.” Implicit
in any referral is the promise that the victim will be safe—or at least
safer—under protection provided by support agencies. The authors
define domestic abuse or battering as “a pattern of psychological, economic
and sexual coercion of one partner in a relationship by the other that
is punctuated by physical assaults or credible threats of bodily harm.”
In Houston, an irate husband
recently shot his way through glass doors at the entrance of a women’s
shelter, found his wife, and chased her to the cafeteria. The man
ran out of bullets, no one was physically injured, and security at the
shelter has been tightened. This widely reported incident is particularly
unfortunate since health care providers already have a difficult time convincing
victims of domestic violence that resources are available to increase their
It is clear that whatever
the risks of violence within a shelter (real or perceived), the risks of
remaining with an abusive spouse are greater. In its 1997 report
titled Family Violence
and the Health Care System in Texas, the Health Law & Policy Institute
(Institute) reported the following chilling statistics:
A spokesperson for the Texas
Council on Family Violence (Council) testified before the Senate Finance
Committee of the Texas Legislature earlier this year in support of additional
funding for family violence programs. Recent statistics cited by
the Council indicate the continued pervasiveness of family violence in
Texas as follows:
nationally, 30% of female murder
victims were killed by their “loved ones.”
Injuries to women sustained
from domestic violence exceed the number of injuries women suffer from
car accidents, muggings, and rapes combined.
In 1994, Texas had 166,657 arrests
for spousal abuse—and 283 of such arrests were for spousal murder.
39% of women in Texas have suffered
physical, emotional or sexual abuse since they were age 18.
In its report, one of the Institute’s
recommendations was to develop better-coordinated, more comprehensive,
and readily available support services for victims of abuse. Texas
law requires that health care providers refer victims of domestic violence
to available services. Texas has family violence shelters http://www.dhs.state.tx.us/programs/familyviolence/shelters.html
in at least sixty communities. Some of these shelters may now be forced
to dip into already limited resources to increase physical security.
However, Texas is devoting additional resources to help curb family violence.
In addition to increased funding, the 76th Texas Legislature should be
commended for passing a number of innovative laws addressing family violence
including: Protection of Child and Victim in Visitation Orders--H.B. 1411
Mediation Waiver in Family Law Cases—H.B. 819 http://www.capitol.state.tx.us/tlo/76R/billtext/HB00819F.HTM,
Mediation Prohibited in Criminal Cases—S.B. 1124 http://www.capitol.state.tx.us/tlo/76R/billtext/SB01124F.HTM,
Magistrate’s Orders for Emergency Protection—S.B. 23 http://www.capitol.state.tx.us/tlo/76R/billtext/SB00023F.HTM,
Domestic Violence Training for Judges—S.B. 1187 http://www.capitol.state.tx.us/tlo/76R/billtext/SB01187F.HTM,
and Funding for Shelters—S.B. 461 http://www.capitol.state.tx.us/tlo/76R/billtext/SB00461F.HTM.
181,773 family violence incidents
were reported in Texas in 1997.
824,790 women were battered
in Texas in 1998.
the 1998 level of funding left
95% of battered women and their children without services. (The 76th Texas
Legislature appropriated significant additional funds to programs combating
As efforts to better educate
health care providers about domestic violence yield promising results (and
therefore more referrals), we must be ready to assist the victims of domestic
violence and at a minimum ensure their physical safety.