Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Help When Home Isn’t Safe


The pandemic has resulted in everyone spending more time at home, which has increased the potential for being physically, sexually, and psychologically harmed by others. After ensuring that patients feel safe during telehealth appointments, clinicians must directly ask if they are experiencing intimate partner violence and develop a safety plan.

What is Intimate Partner Violence? 

Intimate partner violence (IPV) includes physical violence, sexual violence, stalking, or psychological harm by a current or former intimate partner. In the United States, about one in four women and one in ten men report experiencing IPV.



IPV and COVID-19

For individuals experiencing IPV, any disruption to normal life, such as the current pandemic, can mean increased potential for harm. Although physical distancing and stay-at-home orders help protect us from the virus, they may isolate individuals experiencing IPV just as violence in the home may be increasing. Quarantine with a violent partner can occur while stress levels are increasing (for example, due to school closures and lost work) and typical coping strategies (like going to the gym or movies) are limited. Further, those who experience IPV may have difficulty connecting to safe friends and family, as well as reduced access to IPV resources and support like hospitals, court houses, and shelters. Withholding access to medical care and safety resources, like masks and sanitizer, or sharing misinformation to further fear, are other ways abuse occurs in violent relationships during the COVID-19 pandemic.



5 ways you can help

Healthcare professionals have an essential role in helping keep patients safe from violence in relationships. With social contact limited, providers may be some of the few people patients are able to speak to in private.


1. Be mindful of safety (and who else might be in the room) during telehealth appointments.

It’s important to talk about IPV with your patient, but first, be sure that it’s safe. Telehealth appointments could increase the risk of a partner listening. If on video, complete an environmental safety check by visually scanning the background for presence of other people over the age of two. You can ask patients to use headphones, or when talking by phone, use “yes/no” questions to assess safety and privacy. Some patients may ask to complete the appointment in their car, or while taking a walk—don’t discourage this—it may be for their safety.



2. Ask directly if your patient is experiencing IPV.

We’ve learned that patients want providers to ask if they are experiencing IPV and that most will not volunteer this information if not asked. We ask our patients structured questions informed by research supported measures such as the Hurt, Insult, Threaten, Scream screening tool.



3. Have local and national resources on hand.

The National Domestic Violence Hotline is available for free by calling 1-800-799-7233, logging onto thehotline.org, or texting LOVEIS to 22522. Be able to provide up-to-date contact information for local advocacy organizations and domestic violence shelters.



4. Collaborate with your patient to develop a safety plan.

A safety plan is a personalized, practical plan that includes ways to remain safe while in a relationship, planning to leave, or after leaving. There are many options to safety planning, including self-directed phone apps like myPlan and printable or interactive guides.



5. Explore ways to increase your own self-care.

Providing support to those impacted by IPV, especially during a pandemic, can be stressful for providers as well. Take time to engage in self-care activities and reach out for help and support when needed.



Reference to Federal positions is for information only. The information presented is based on the views of the authors and does not necessarily represent the views of the Department of Veterans Affairs or its Components.