PATIENT-CENTERED PROVIDER BEHAVIORS AND DISCLOSURE OF INTIMATE PARTNER VIOLENCE IN A PSYCHIATRIC EMERGENCY SETTING

Violence and Injury Prevention has risen to the top of the nation's list of important public health mandates. As one of the most pervasive forms of violence facing our country today, Intimate Partner Violence (IPV) therefore constitutes a significant public health concern. Although screening for IPV with women by healthcare providers offers opportunities for intervention and treatment, little is known about screening for IPV in emergency psychiatric settings. This descriptive study was aimed at identifying women presenting for psychiatric emergency treatment who had been exposed to IPV and the demographic characteristics, clinical factors and/or patient-centered provider behaviors that were associated with disclosure of the abuse in this setting. The subjects for this study consisted of 216 women presenting to an emergency psychiatric setting. A self-report questionnaire elicited demographic information, history of mental illness, exposure to abuse, and screening by the provider. Respondents also scored providers on four patient-centered behaviors, including measures of trust, interpersonal interactions, communication, and knowledge of them as a person. The findings indicated that 75% of the respondents reported exposure to IPV. Those exposed to IPV attested to varying types of IPV abuse, including psychological, physical and sexual abuse. They also reported higher rates of depression, anxiety, post-traumatic stress disorder (PTSD), and bipolar disorder. The rate of abuse disclosure was then determined among the group of female abuse victims. Respondents were more likely to disclose abuse when screened by clinical staff. Other factors associated with an increase in disclosure included being unmarried and having PTSD, as well as the perception of a provider as being knowledgeable about the patient on a personal level.Emergency psychiatric providers should be alert to the potential for IPV among their patients. Additional research is needed into the factors that improve disclosure of IPV