How One Pandemic Highlighted Another: Domestic Violence as a Global Health Emergency

At just 17, Elise Roberts fell victim to intimate partner violence. Her boyfriend at the time physically, sexually, and emotionally abused her—he manipulated her into believing that he was the only person who could ever love her. Once Elise was able to identify that what was happening was abuse, she opened up to her therapist, contacted assault hotlines, and finally gained the strength to leave her abusive relationship. But her experience as a victim-survivor did not end there. Instead, that moment marked the beginning of a long, arduous journey of healing. She would have to deal with constant flashbacks in future relationships, perpetual urges to self-harm, and debilitating symptoms of depression. The abuse does not end when a survivor leaves his or her abuser; it comes back in flashbacks, anxiety attacks, waves of depression, and a host of other mental health symptoms. And unfortunately, severe intimate partner violence—as well as its lasting impact on mental health—has become a reality for one in four women

While domestic violence has always been a prevalent global health issue, COVID-19 and stay-at-home-orders have exacerbated the problem world-wide. Following self-isolation measures, domestic abuse rose threefold in China, 32-36% in France, and 25% in the UK. For several reasons, the restrictive measures associated with the virus play into the hands of abusers. Dr. Delanie Woodlock, a sociologist who studies domestic violence and sexual assault, found that perpetrators have been using COVID-19 as an excuse to intensify their control of women and children. “[Perpetrators] are restricting women’s contact with friends and family and monitoring their calls and use of their phone…. [their] reasoning now is that these actions are taken out of care and protection.” Control, surveillance, and coercion become “justifiable” by abusers during a pandemic; abusive behavior is hidden behind the illusion of care.

The psychological and economic stressors accompanying the pandemic also intensify and mediate abusive behavior. For example, isolation is a well-known domestic abuse risk factor. In a systematic review conducted by Gerino et al., social support was identified as a primary protective factor against intimate partner violence. Essential support networks are diminished during self-isolation, and victims are dangerously cut off from their support systems. Because people around the world are now spending more time inside their homes, largely away from the rest of the world, abusers are free from scrutiny and consequence from anyone outside the family unit. Power dynamics thus become distorted inside the home, and the abusers’ intensified control over victims cannot be checked by others. The stress associated with financial strain and economic struggle is another domestic abuse risk factor. As millions and millions become unemployed due to the pandemic and financial stress increases globally, people become more likely to abuse their partners. Financial strain due to the pandemic may also keep some women in their abusive relationships, as those who are financially unstable on their own find it more difficult to leave their partner whom they economically rely on. Additional harmful coping mechanisms for the stressors associated with the pandemic, such as excessive alcohol consumption or substance misuse, further trigger an increase in family violence.  

The widespread shut-down of non-essential businesses inadvertently shut down many traditional avenues of escape or help-seeking for victim-survivors. Family justice centers and nonprofit offices have shifted their operations online and suspended social worker home visits, proving detrimental to women and children victim to domestic abuse who rely on home visits for support and protection. Victim-survivors often report their abuse to school officials or co-workers—as schools and businesses close down, many domestic abuse cases dangerously go unnoticed. Domestic abuse and women’s shelters are a critical option for many women looking to quickly escape their violent living situations. While these shelters have remained open, many victims have decided against going to the shelter due to fear of contracting the virus, forcing them to choose between two options affecting their physical and mental health. The stay-at-home orders have turned into a living nightmare for some: victim-survivors become stuck with their mental, physical, and sexual abuser 24/7 with little means of escape or coping. 

Not only does domestic violence inflict immediate psychological, emotional, and physical pain on millions of women every year, but it also puts victim-survivors at increased risk for a myriad of mental health disorders.  The Australian Burden of Disease Study in 2015 found that domestic violence contributes more to the burden of disease—which includes depression, anxiety disorders, suicide, and self-harm—more than any other risk factor in women aged 18 to 44. The suicide rate is drastically higher among survivors compared to other women: 17.9 % of intimate partner violence victims have attempted to commit suicide. Studies have found that experiencing violence changes an individual’s biological susceptibility to developing mental illness through epigenetic modifications. Epigenetic changes provide the process by which the environment changes gene expression without changing the DNA sequence. A study by Serpeloni et al. found that lifetime exposure to violence caused epigenetic changes that led to an increased susceptibility to the development of PTSD, depression, and anxiety. These biological modifications are also heritable. In a study published in Nature by Radtke et al., researchers found that experiencing violence during pregnancy caused epigenetic modifications in the child that led to an increased susceptibility to psychopathology. The impact of domestic violence thus stretches far beyond the immediate violence; the consequences of intimate partner violence bleed throughout lifetimes and cross over generations. 

Treating mental health specifically for the trauma endured by domestic violence survivors remains an underresearched area in academia. This lack of research translates to lack of training and expertise in treating victim-survivors, contributing to the high prevalence of these mental health disorders among those who have experienced domestic abuse. In one study, researchers found that more than half of mental health provider participants believed they lacked the necessary skills to identify instances of intimate partner violence. Another barrier to effective mental health treatment for victim-survivors is the media’s stigmatization of domestically violent relationships. The stigma leads women to view their abuse as a personal problem which public services cannot help and increases their own debilitating self-blame for the violence they endured. Funding more research in treating victim-survivors struggling with their mental health, as well as actively mitigating the stigma around domestic abuse in the media, is essential to bettering and increasing their access to mental health treatment. 

While there are many theories about what drives abusers to abuse, one theory conceptualizes domestic violence against women as a pattern of domination by a male partner to undermine the victim’s autonomy and dignity. Dr. Shula Ramon, a psychology professor at the University of Hertfordshire, cites that an underlying reason for abuse is that society “continue[s] to believe that women are a group that has to be controlled because they are perceived as both impure and seductive.” The passive construal of women in society, the continuous election of leaders who have committed violence against women, and the over-sexualization of women in media contribute to these cultural factors mediating male abuse against female victims. According to Dr. Delanie Woodlock, male violence against women and children is also at the root of our oppression as women. Domestic violence is therefore simultaneously a byproduct and a contributing factor to female oppression. 

We have to call it what it is. Domestic violence is a pandemic, harming more than 5 million new women around the world every year, detrimentally affecting the long-term mental and physical health of victim-survivors as well as exacerbating gender inequality. A reversal of responsibility is necessary: it should not be regarded as an individualized problem blamable on victims but, rather, a societal public health issue. Elise, like other victim-survivors, believes communities should confront physical and sexual violence head on, rather than treating it as a taboo subject in order to spread awareness about the warning signs of abuse. Combating the taboo nature of the important issue, increasing general education about domestic violence, investing in research for mental health services treating victim-survivors, and rejecting those society members who continue to abuse women are all important steps in fighting this raging pandemic. But the first step that governments, policy-makers, and higher education institutions have yet to take is simply recognizing it exists. 

Edited by Sophia Blyth

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