By ANDREW C. ALLISON, D.O.
Director of Emergency Services at Monongahela Valley Hospital

Domestic violence comes in many forms, but there is help for victims.

People should be aware that domestic violence is a problem that affects approximately 2.4-million people a year and accounts for between 2,000 and 4,000 deaths each year.

Domestic abuse is most commonly thought of as physical assaults, but there are many other manifestations that people should be aware of. They include verbal, emotional and sexual abuse; isolation, and intimidation and threats.

People who are caught in an abusive situation stay in that relationship for any number of reasons financial, children, lack of options, etc., and may not be able to change immediately. However, it is important for them to recognize that they need to make a change.

Women typically don't leave after being abused because there is usually a "honeymoon" phase when the abuser is very remorseful and repentant about his actions. Unfortunately that phase will go away and the person will be back to a violent or abusive phase again.

Some warning signs that someone may be in an abusive relationship are:

1. If your partner tries to control your daily activity or doesn't allow you to handle money.
2. If your partner threatens you, frequently insults you, makes you feel inadequate or tries to humiliate you in public.
3. If your partner has assaulted you, either by kicking, pushing, punching or hitting with a hand or object.
4. If your partner forces you to have unwanted sexual contact.
5. If your partner threatens to harm you or your children if you try to leave.
6. If your partner continues to harass, intimidate or threaten you (or "stalk") after a relationship has ended.

Again, it is important that people be aware of the issues of domestic violence every day. People need to understand what causes the problem, how it affects more people than just the victims, and the variety of support and assistance that is available. They need to be cognizant that it is a major issue in the United States and, yes, even in our community.

The National Coalition Against Domestic Violence (NCADV) notes that acts of domestic violence generally fall into one or more of the following categories -- physical battering, sexual abuse, psychological battering. While women are most commonly the victims of violence, abuse of the elderly and children also is prevalent.

The NCADV also stresses that assault, battering and domestic violence "are crimes."

At Monongahela Valley Hospital, staffs are keenly aware of signs that an individual may be a victim of domestic violence.

We screen people who come into the Emergency Department for any kind of abuse that might exist. Our staff is trained to recognize the indicators of violence, physical or emotional abuse. We ask the patient if someone is hurting them and do they need someone to talk to about the problem. If they ask for help, we do everything we can to provide it -- to point them in the right direction. Even if they say no, we offer information that can help them.

Educating staff on the issues of domestic violence is very important. It's an ongoing thing. We work with community agencies to present educational programs for staff here.

Monongahela Valley Hospital is part of a Westmoreland County coalition funded by the Pennsylvania Coalition Against Domestic Violence grand and coordinated by the Blackburn Center that will extend educational programs, provide on-site consultation services, and form a task force comprised of representatives from all agencies participating in the coalition. The coalition will extend our roles as advocates of those who are victimized by domestic violence.

Part of the advocacy efforts is making domestic violence victims aware of resources that can help them.

It truly is a team effort here. Physicians, nurses, social workers and others work together to make the patient and others offering support aware of how they get help, how they can escape the violence in their lives.

Staffs at MVH come in contact with domestic violence victims of all ages -- women, men and children -- almost on a daily basis. The victims are men, women, children and the elderly. Our responsibility is to help the victims. Often, victims refuse our help out of fear of the perpetrator or their belief that it is their fault they're being abused.

Victims need to know they can seek help by coming to the hospital. They need to understand it is not their fault. By talking with the victims, we can learn why they're in this situation. The majority of them really need -- and want -- someone to talk with; someone who will listen to and understand their anguish. Our role is to link the victim with the appropriate resources for legal, emotional, financial and other help. And we need to continually reinforce to them the need to seek help and that they do not have to live in an abusive environment.

Communications also is a vital part of treatment in the Emergency Department.

When the red flags go up and we suspect domestic violence, we encourage the patient to talk about his or her situation. Our nurses are trained and qualified to gather evidence and take whatever steps are necessary to protect the patient. We work with law enforcement agencies, children and youth services, and protective service groups to provide help.

We recognize the need for and importance of confidentiality in protecting the victims of domestic violence, especially if children are involved. But they need to understand their lives may be in jeopardy. They need to know help is available, that they can make the break and leave the situation they are in.

Typical of community resources are safe-houses, shelters and similar programs. Hotlines, counseling and therapy, medical and legal advocacy also are available.

We'll take whatever action we feel is in the best interest of the patient. We have detained children and geriatric patients here when we thought they were being abused. We see x-rays that reveal things that are inconsistent with injuries for which the patient originally sought treatment.

National studies show an alarming rate of 70 percent of women have been battered victims at one time or another in their lives. A battered women study conducted at Monongahela Valley Hospital in conjunction with the University of Pittsburgh revealed one of four women over age 60 in the mid-Monongahela Valley Hospital is also in that category.

The reality is that. The problem does exist in our community. We want the victims to understand, however, there are safe ways to get out and people are here to help them before the problem escalates and becomes life-threatening. It's not a hopeless situation.

For help, call 911, 1-888-832-2272, 1-888-772-9227, or 1-800-791-4000. For more information on domestic violence, use the HealthGate link on Monongahela Valley Hospital's web site www.monvalleyhospital.com.