The State & Community Intimate Partner Violence & Perinatal Depression Resource Development Project: Policy and Legislation & Standards of Care Health Resources and Services Administration & Social Solutions International, Inc. August 2012 IPV/PD: A Comprehensive Approach
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IPV/PD: A Comprehensive Approach
The State & Community Intimate Partner Violence & Perinatal Depression Resource Development Project:
Policy and Legislation & Standards of Care
Health Resources and Services Administration
&Social Solutions International, Inc.
August 2012
IPV/PD: A Comprehensive Approach
Webinar Moderators
Moderators:
• Keisher Highsmith, DrPHDirector of Special Initiatives and Program Planning and EvaluationHRSA/Maternal and Child Health Bureau
• Kristen Stier, MAResearch and Logistics AssociateSocial Solutions International, Inc.
• Gloria Aponte Clarke, MPHSenior Policy AssociateAltarum Institute
IPV/PD: A Comprehensive Approach
Webinar Speakers
Speakers:
• Jeanette Valentine, PhDDirector, Business DevelopmentPathways LA
• Lisa L. Derrick, M.Ed. BAMProject DirectorSouth Phoenix Healthy Start, Maricopa County Department of Health
• Kim DartezExecutive DirectorFamilyTree Health CareWomen of Color-Chair, The AZ Coalition Against Domestic Violence
IPV/PD: A Comprehensive Approach
Objectives
• Provide examples of existing Standards of Care for Intimate Partner Violence and Perinatal Depression
• Describe the process of implementing Standards of Care in your organization
• Describe the role policy and legislation play in addressing IPV/PD
• Provide examples of strategies/tactics used to advance policy and legislative initiatives concerning IPV/PD
IPV/PD: A Comprehensive Approach
Toolkit Goals – Policy and Legislation
• Provide an overview of the policy process and why it is important in addressing IPV/PD
• Highlight select federal and state policies related to IPV/PD
IPV/PD: A Comprehensive Approach
Toolkit Goals – Standards of Care
• Provide an overview of the importance of having IPV/PD Standards of Care Guidelines
• Provide an overview of national resources and IPV/PD Standards of Care Guidelines
• Provide an overview of training materials and resources available to help address IPV/PD
IPV/PD: A Comprehensive Approach
Grassroots to Treetops:How Local Programs Can Impact Policy &
Legislation on Intimate Partner Violence & Perinatal
Depression
Jeanette Valentine, Ph.D.LA County Perinatal Mental
Health Task ForceLos Angeles CA
August 2012
IPV/PD: A Comprehensive Approach
Learning Objectives
1. To understand how to have an impact at different levels of policy processes
2. To appreciate the breadth and depth of influence that local programs have
IPV/PD: A Comprehensive Approach
Key Principles
1. Know your audiences
2. Appreciate your power
3. Apply advocacy tools
IPV/PD: A Comprehensive Approach
Audience
• Elected and Appointed Officials• Community Leaders• Business Leaders• Thought Leaders
IPV/PD: A Comprehensive Approach
Power
• Knowledge• Passion• Access
IPV/PD: A Comprehensive Approach
Tools & Tactics
• Inform & Educate• Collaborate• Mobilize• Lead
IPV/PD: A Comprehensive Approach
Know Your Audience
THERE ARE MULTIPLE AUDIENCESIN THE POLICY PROCESS
• One Bright Idea:• Define your community
• – GEOGRAPHY OR DEMOGRAPHICS – • & determine who has a stake in it
IPV/PD: A Comprehensive Approach
Audience, cont.
LEGISLATIVE & BUDGETARY:
• For Elected Officials – Geography Counts
IPV/PD: A Comprehensive Approach
Audience - Officials
ELECTED AND APPOINTED OFFICIALS
• Legislative Bodies• Legislative Committees
• Administrative Agency Heads• Special Commissions
• Staffers• Appointed Officials
IPV/PD: A Comprehensive Approach
Civic Leaders
Community LeadersThought LeadersBusiness Leaders
IPV/PD: A Comprehensive Approach
Power - Knowledge
•Problems•Solutions
•Costs of doing nothing•Costs of doing something
IPV/PD: A Comprehensive Approach
Power – Sources of Knowledge
•Experts Speak: Evidence-based & Best Practices
•Experience Speaks: Personal Stories•Wisdom Speaks: Community-defined
Illustrations: LA County Perinatal Mental Health Task Force
http://maternalmentalhealthla.org
Assembly Concurrent Resolution 105
Designating May as Perinatal Depression Awareness Month
Proclaimed the month of May of each year to be Perinatal Depression Awareness month across the state of California and requested that a number of
stakeholders work together to explore ways to improve women's access to mental health care at the local and
state level, facilitate increased awareness about perinatal depression, explore and encourage the use of prenatal screening tools and improve the availability of effective treatment and community support services.
California Assembly Bill 159/2009 Healthy Mothers Act
Established and convened a statewide perinatal mood and anxiety disorders task force to develop recommendations and educational materials for the State Department of Public Health's perinatal health programs.
•Time, talent and treasure to conduct policy work are limited in local programs, but …
•Policy and systems change is embedded in the Healthy Start mission
•Individuals at every level of the policy-making process want to hear from you, but …
•The message has to be policy-relevant and actionable
IPV/PD: A Comprehensive Approach
Contact Us
Jeanette Valentine, PhDDirector, Business DevelopmentPathways LA3550 W. 6th Street-Ste 500Los Angeles CA 90020Ph: 213-427-1651Email: [email protected]
IPV/PD: A Comprehensive Approach
A Comprehensive Approach for Community-Based Programs to Address
the Intersection of Intimate Partner Violence & Perinatal Depression: Policy
and LegislationKristen Stier, MA
Social Solutions International, Inc.
August 2012
IPV/PD: A Comprehensive Approach
Policy and Legislation
Understanding the process for creating policy and legislation is an important part of addressing Intimate Partner
Violence (IPV) and Perinatal Depression (PD), whether it is at the
local, state or federal level
IPV/PD: A Comprehensive Approach
Public Policy Making
• Citizens Being Heard• Writing the Bill• Formulating the Policy• Policy Implementation• Policy Evaluation
IPV/PD: A Comprehensive Approach
Federal Policies
• Violence Against Women Act• Affordable Care Act
IPV/PD: A Comprehensive Approach
State Policies
• Massachusetts legislated the creation of a commission to strengthen PPD support programs in the state, including treatment, screening and public-awareness efforts
• New Jersey law requires health care providers to screen women who recently have given birth for postpartum depression, and provides funding to do so.
IPV/PD: A Comprehensive Approach
State Strategies
• Mandated Screening of IPV.• Mandated Reporting of IPV.• Home Visiting Programs• New Parent Programs• Workgroups/Consortia for Perinatal
Health• Health Care Providers’ Trainings• Awareness Campaigns
IPV/PD: A Comprehensive Approach
Policy Brainstorming Tool
• What are the key issues and challenges around IPV/PD in your community? Consider awareness of the issues, stigma, rates of IPV/PD, and resources available for screening, referral and treatment.
• Are there policies that would help your organization be able to screen, refer and treat women for IPV/PD?
• What are some policy ideas for how to address IPV/PD in your community?
IPV/PD: A Comprehensive Approach
Healthy RelationshipsIntegrating IPV/PPMD Standards of Care and Service into Healthy Start
PracticeLisa L. Derrick Program Director
South Phoenix Healthy Start, Phoenix Arizona
Kim Dartez Executive Director Family Tree Health Care, Tempe Arizona
and Women of Color-Chair, The AZ Coalition Against
Domestic ViolenceAugust 23, 2012
IPV/PD: A Comprehensive Approach
Outline of Presentation
• Introduce SPHS method of integrating IPV screening with PPMD screening
• Present key components of Standards of Care and Service
• Overview of SPHS IPV/PPMD strategies
• Tools, techniques and training for SPHS staff
• Community involvement in migration and sustainability
IPV/PD: A Comprehensive Approach
Screening Tools and Methods
Perinatal Mood Disorders
– Edinburgh Depression Scale
– Self administered or facilitated by CHW
– Pregnant and post partum participants
– 10 questions– Focus on feelings in past
week– Scores of 10 or above
receive referral and plan for follow up
– Crisis intervention on Q10– Re administer within 2
weeks, if no follow up– Supervised by RN and MSW
Intimate Partner Violence
– Modified Abuse Assessment Screen (AAS)
– Administered by CHW– All female participants– 4 questions– Focus on real acts of violence
and strong fear over the past year or since last visit
– Yes answers receive referral and plan for follow up
– Crisis intervention for injuries– Re administer within 2 weeks,
if no follow up– Supervised by RN and MSW
IPV/PD: A Comprehensive Approach
Key Components of Standards of Care and Service
• All women are screened for PPMD and IPV upon initial intake and routinely
• Affirmative screening = referrals to programmatic and community resources
• Affirmative results = Level 1 Risk with at least 4 contacts per month; at least 1 face to face
• Readiness for change is assessed and documented• Barriers to follow through on referrals are identified• Plans for overcoming barriers and follow up care are
created and documented• In person support provided to first visits or group• All HS staff are initially trained and receive annual
training and regular in-services• Critical incident briefings conducted within 2 working
days
IPV/PD: A Comprehensive Approach
Strategies and Interventions
• Crisis Support Referrals– Mental Health Crisis Line– Crisis Housing & Nursery for Respite
• Medical Care– Center for Healthcare Against Domestic
Violence• Legal Services• Pro bono therapeutic counseling• Peer led support groups
– Teen specific– Adult specific– Language/Culturally Specific
Care/Protocols• Legal processes• Infant Mental Health
• In-services• Data on IPV and PPMD• Teen Dating Violence vs.
Bullying• Female to male and
same sex IPV• CDC Guide to IPV during
pregnancy
• Community and Consortia Awareness• IPV and PPMD 101• Power and Control
Dynamics• Roots of Violence• International Trafficking
• Male Support Services• Fathers Mentoring Fathers• Court and Custody• Financial Stability
“Violence is a problem for many women. Because it affects health and well-being. I ask all my participants about it.”
IPV/PD: A Comprehensive Approach
IPV Referral
• Referral card recommends screening all patients for domestic violence.
• The card lists screening questions to ask on one side.
• The other side lists hotlines and helpful phone numbers.
• Card is in both Spanish and English.
IPV/PD: A Comprehensive Approach
IPV PPMD Referral Card
• The Referral for Services Card has a space to include:– The reason for the referral– Date/Time– Signatures– And emergency number for help
IPV/PD: A Comprehensive Approach
Family Tree Healthcare
Peer Led Support GroupsMeeting Topics for Discussion
1. Introduction – Our story (confidentiality and safety)2. Definition of Intimate partner/dating violence awareness, prevention and warning signs of abusive relationships and prevention.3. Healthy relationships; tools needed for a healthy relationship, qualities of a healthy partner.4. Health disparities and healthy choices5. Identifying internalized racism, mainstream privilege and overcoming institutionalized racism and oppression.6. Character Counts (resources for character education- best practices)7. Youth conflict resolution (National youth violence prevention resource center)8. Goal setting; how to create and achieve short and long term goals9. Provide resources, referrals and community linkages, safety planning
IPV/PD: A Comprehensive Approach
FTHC Peer Led Support Groups
Steps to get your group started
1. Decide frequency of meetings. Be sure to remember this is best if it is for the long haul so do not commit to an unreasonable schedule. Choices may include weekly, monthly or quarterly.
2. Meetings should have a maximum of 8 participants. ( When having maximum number try to have an assistant in case someone may need one on one attention.) We want to keep the meeting flowing if possible. WE ARE NOT THERAPISTS and this is a community support group. If someone is in need of a professional, we can offer referrals from the resources supplied by FTHC.
3. The average group should be 90 minutes. You can however include an extra 15 minutes at the beginning for introductions when your group is first beginning.
4. Groups can be conducted in ten series cycles. The above meeting topics are a general guide, the last week is for any follow-up or extra discussion.
IPV/PD: A Comprehensive Approach
Peer Led Support Groups, cont.
• 5. You can design your group to either allow the same participants to continue or have new participants every ten groups meetings.
• 6. Secure location, (best places are neutral and non-threatening such as nail or hair salon, school, community centers and libraries) have signed confidentiality agreement with owners and/or management of business or property.
• 7. Think of innovative ways get participation. Some ways participants are invited are: a) word of mouth, b) social media (can call the group by another name), d) contacting the local Jr. and high schools. Particularly the counselors and the nurses of the school would be familiar with who would benefit from the support group. Be sure and share the ways you recruit with other facilitators.
IPV/PD: A Comprehensive Approach
Tools for Peer Led Support Groups
1. DV 101, include power and control wheel2. Multicultural perspectives3. Confidentiality4. Safety5. Communication and facilitation skills6. Meeting structure and navigating the meetings7. Develop a plan8. Contingency planning and resources
IPV/PD: A Comprehensive Approach
Community Involvement
• Train the Facilitator Workshops• Business, Civic and Faith based
Groups • Annual Conference
IPV/PD: A Comprehensive Approach
Lessons Learned
• Create a culture of support and trust • Work with entire families• Self care is important
IPV/PD: A Comprehensive Approach
Contact Us
Lisa L. Derrick, M.Ed. BAMProgram DirectorSouth Phoenix Healthy Start~ Maricopa County Department of Public Health Community Health ActionOffice of Family Health Services2737 W. Southern Avenue, Suite 8 ~ Tempe, AZ 85282602-438-7812 Office ~ 602-304-1166 Main Numberhttp://www.maricopa.gov/Public_Health/Community/Programs/HealthyStartfacebook.com/MCDPH | twitter.com/Maricopahealth | www.WeArePublicHealth.org
Kim DartezExecutive DirectorFamily Tree Health CareTempe, AZ 85282 Office ~ 480-529-1686www.familytreehealthcare.org
Physical, emotional, and combined abuse and harassment
Website
IPV/PD: A Comprehensive Approach
References
• American College of Obstetricians and Gynecologists. (2012). Committee opinion on intimate partner violence, No. 518. For more information visit the following website: acog.org/~/media/Committee%20Opinions/Committee%20on%20Health%20Care%20for%20 Underserved%20Women/co518.ashx?dmc=1&ts=20120123T1907367975
• Buist, A.; Condon, J., Brooks, J., Speelman, C., Milgrom, J., Hayes, B., Ellwood, D., Barnett, B., Kowalenko, N., Matthey, S., Austin, MP., & Bilszta, J. (2006). Acceptability of routine screening for perinatal depression. Journal of Affective Disorders, 93(1), 233-237.
• Seehusen, D., Baldwin, LM., Runkle, G., & Clark, G. (2005). Are family physicians appropriately screening for postpartum depression? Journal of the American Board of Family Medicine, 18(2), 104-112.
• Zeitler, M., Paine, A., Breitbart, V., Rickert, V., Olson, C., Stevens, L., Rottenberg, L., & Davidson, L. (2005). Attitudes about intimate partner violence screening among an ethnically diverse sample of young women. Journal of Adolescent Health, 39(1), 119.e1-119.e8.