Intimate partner violence (IPV) is a public health crisis and most deadly when a gun is involved. Clinicians should screen patients for IPV, ask about firearm possession, and refer those at risk of IPV to appropriate services.
Lifelong Learning in Clinical Excellence | February 25, 2021 | 2 min read
By Lisa Geller, MPH, Educational Fund to Stop Gun Violence
Gun violence and intimate partner violence are both public health crises. Each day, more than 100 Americans are killed with a gun and nearly 200 Americans visit the emergency department for nonfatal gun injuries. It’s estimated there are nearly 400 million firearms in the U.S., which is more than the population of the entire country. Access to firearms increases the risk of homicide victimization, suicide, and unintentional gun deaths.
Intimate partner violence (IPV), also referred to as domestic violence (DV), is also a public health crisis. Nearly one in four (23.2%) women and one in seven (13.9%) men will experience severe physical violence at the hands of an intimate partner in their lifetime. The most severe form of IPV is intimate partner homicide. More than one in four homicides in the U.S. are related to domestic violence, and the presence of a firearm in a DV situation increases the risk of severe injury and death. Specifically, a woman is five times more likely to be killed when her abuser has a gun.
What you can do
Healthcare professionals are in a unique position to identify individuals experiencing IPV. Clinicians can screen patients for IPV and other forms of interpersonal violence, counsel about the risks of firearms in the home, and refer those at risk for IPV to available services. Additionally, healthcare professionals make great advocates for changing public policies regarding firearms and should engage in the advocacy process. This can include writing op-eds and testifying for or against relevant legislation.
Clinicians should be aware of two policies exist to protect individuals experiencing violence—domestic violence protection orders (DVPOs) and extreme risk protection orders (ERPOs). Domestic violence protection orders give victims and survivors of DV a way to protect themselves from further abuse. All states have some type of DVPO, but the protections offered vary greatly between states. Some provisions DVPOs may include are no contact provisions, stay away provisions, move out provisions, counseling provisions, and firearm provisions.
Extreme risk protection orders are civil orders modeled after DVPOs. As of January 2021, 19 states and and Washington D.C. have ERPOs. They differ from DVPOs in that they solely focus on access to firearms. Specifically, ERPOs temporarily prohibit individuals at risk of interpersonal violence or self-harm from purchasing and possessing firearms.
These laws also differ in who can petition for the order. Typically, only family or household members, including intimate partners, can petition for a DVPO, while more individuals may petition for an ERPO. ERPOs are most often available to law enforcement and family or household members, but in some states like Maryland, clinicians can petition for ERPOs. Allowing clinicians access to the life-saving tool is just one of the ways healthcare professionals can intervene and protect patients. Including clinicians as petitioners is a critical step in addressing the limited tools that they currently have to protect their patients.
Being aware of these options and knowing how and when to use them may be the difference between life and death.
Here are 3 resources you should know about:
1. The Educational Fund to Stop Gun Violence materials on Extreme Risk Laws and domestic violence and firearms.
2. The Consortium for Risk-Based Firearm Policy’s 2020 report on Extreme Risk Protection Orders.
3. The Bullet Points Project’s clinical tools for preventing firearm injury.
This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.