Home is not always a haven: The domestic violence crisis amid the COVID-19 pandemic

Abstract

The novel Coronavirus (SARS-CoV-2) and the associated disease it causes, COVID-19, have caused unprecedented social disruption. Due to sweeping stay-at-home orders across the United States and internationally, many victims and survivors of domestic violence (DV), now forced to isolate with their abusers, run the risk of new or escalating violence. Numerous advocates, organizations, and service centers anticipated this: upticks in domestic violence were reported in many regions soon after stay-at-home directives were announced. In this commentary, we delineate some of the recent events leading up to the reported spike in DV, review literature on previously documented disaster-related DV surges, and discuss some of the unique challenges, dilemmas, and risks victims and survivors face during this pandemic. We conclude with recommendations to allocate resources to DV front-liners and utilize existing DV guidelines for disaster preparedness, response, and recovery.

The novel COVID-19 pandemic has created exceptional circumstances that have altered nearly all facets of society. Public safety measures including physical distancing, self-quarantine, and “safer-at-home” mandates have been widely implemented across the U.S. Unfortunately, in the pursuit of large-scale mitigation efforts to protect public health, the vulnerabilities of some at-risk populations have been magnified. Ironically, ‘safer-at-home’ has proved perilous for a significant portion of the population as the danger of domestic violence (DV) has intensified. DV, often used interchangeably with intimate partner violence, includes emotional, physical, or sexual abuse by a current or former intimate partner (Centers for Disease Control [CDC], 2018). Decades of work have documented DV’s far-reaching health (Campbell, 2002; CDC, 2008) and societal and economic consequences (CDC, 2003; Max, Rice, Finkelstein, Bardwell, & Leadbetter, 2004; Peterson et al., 2018). While DV has been a pervasive public health issue for women—overwhelmingly on the receiving end of partner violence—the current crisis has compounded this chronic and highly traumatic experience.

As governors announced stay-at-home directives, numerous advocates, organizations, and service centers warned of a possible surge in DV given that many victims and survivors would have to isolate at home with their abusers. As foreshadowed, reports of an uptick from various county police, crisis text and hotlines, and DV shelters began saturating various media outlets as shelter-in-place orders became widespread. After the first month of stay-at-home orders, nine major metropolitan cities reported approximately between 20-30% increases in domestic violence service calls (Tolan, 2020), with some regions as high as 62% (Northern Regional Police Department; Hartmann, 2020). Yet data from DV hotlines are mixed. Some, like the National Domestic Violence Hotline (NDVH), reported call volume increases, particularly for COVID-19-specific concerns (Lee, 2020), and others reported substantial drops in regular call volume (Southall, 2020)—both tell an unsettling story. While it is the case that many DV victims might utilize text and hotlines to get help under normal circumstances, being in close and constant proximity to violent partners might make it nearly impossible for many to do so during stay-at-home orders. Thus, many might not call for help until violence has escalated to the point that they necessitate 911 service calls.

Documented surges in DV have occurred during prior catastrophes (e.g., natural disasters, anthropogenic events). For example, in the aftermath of Hurricane Katrina, one study reported a four-fold increase in rates of gender-based violence, primarily driven by partner violence, among displaced women in Mississippi (Anastario, Shehab, & Lawry, 2009). Another study documented a staggering 98% increase in prevalence of physical victimization of women from pre- to post-Katrina in Southern Mississippi, one of the hardest hit regions. Similar spikes in DV have been reported in the U.S. during and after other hurricanes (e.g., Laudisio, 1993), earthquakes (e.g., Wilson, Phillips, & Neal, 1998), floods (e.g., E. P. Enarson, 2012), and oil spills (Lauve-Moon & Ferreira, 2017; Palinkas, Downs, Petterson, & Russell, 1993; Rodin, Downs, Petterson, & Russell, 1992). More globally, spikes were seen after the 2004 Indian Ocean earthquake and tsunami (Fisher, 2010) and the Black Saturday bushfires in Australia (Parkinson, 2019). Importantly, while the initial rise is observed during the disaster, these surges in DV are often sustained for years during the recovery period.

Observed upturns in DV may stem in part from existing social and systemic issues that can be exacerbated by disaster-related stress and strain, economic downturn, displacement, and uncertainty (Enarson, 1999; Wilson et al., 1998). The current pandemic shares key similarities with previous disasters. However, it also presents a unique and distressing paradox for victims. If they decide or are forced by their partner to stay home, they risk the danger of enduring or escalating violence. If they are able to leave, they risk exposure to a highly infectious, dangerous virus. Coercive control is a hallmark of abusive relationships (Stark, 2009), and already, representatives of the NDVH have reported disturbing accounts of abusers harnessing COVID-19 to instill fear and compliance in their partners (Godin, 2020; Sandler, 2020). Some medical professionals fear that this type of coercion might also result in fewer victims seeking medical care for DV-related injuries or otherwise (Godin, 2020; Meritus Health, 2020; Warnica, 2020), one of the most vital avenues for screening and detecting abuse.

DV is a largely “hidden” epidemic, and never more so than in our current state of necessary and mandated seclusion. While many uncertainties lie ahead, it is clear that the impact of the COVID-19 pandemic will bear heavily on those navigating these unprecedented circumstances while isolating—indefinitely—in unsafe homes. For those disproportionately affected by DV (e.g., low-income and ethnic minority women; Black et al., 2011; Rennison & Welchans, 2000), it may be devastating. It is important to note that often the most dangerous and potentially lethal time for a victim or survivor of an abusive relationship is immediately after leaving the relationship (Campbell, Glass, Sharps, Laughon, & Bloom, 2007). During this time they are at the highest risk for serious bodily harm, injury, and homicide (Shipway, 2004), adding an additional level of complexity to an already difficult decision to leave one’s abuser. Coincidentally, some shelters, ordinarily impacted and under-resourced, are either nearing or at capacity as they implement social distancing guidelines to ensure a safe, socially distant communal environment (Tolan, 2020). Moreover, many shelters only have the capacity to house women (and very often, their children) short-term, increasing their risk of returning to an abusive partner when alternatives like hotel vouchers are not available.

Across the country, clinicians, researchers, advocates, policy makers and government agencies are working tirelessly to mitigate the current fallout. With the threat of a second wave of COVID-19, it is imperative that there is a collective effort to ensure as many DV safeguards as possible are continually integrated into COVID-19 disaster response and recovery. As mentioned, surges in DV are often sustained long after disasters strike (Sety, James, & Breckenridge, 2014). It follows that appropriate funds and resources should be allocated to victims and survivors, as well as frontliners in the DV crisis like service centers, shelters, and agencies. Equally important will be mitigating the psychological sequalae of experiencing DV during an evolving collective trauma. Post-traumatic stress disorder is the most common mental health disorder associated with traumatic events and disasters (Galea, Nandi, & Vlahov, 2005) and DV (Dutton et al., 2006). In combination, these events could serve as an additional trigger, as traumatic stress is often tied to mental health comorbidities (e.g., depression, anxiety; Brady, Killeen, Brewerton, & Lucerini, 2000) and other negative health outcomes such as pain, gastrointestinal, and respiratory issues (Pacella, Hruska, & Delahanty, 2013). In the wake of other disasters, organizations like the National Resource Center for Domestic Violence have compiled comprehensive DV guidelines and recommendations for response and recovery (VAWnet, 2020), which we recommend to be implemented at the local, state, and national level. Long-term, the pandemic may serve as a critical inflection point for implementing planning and preparedness guidelines to protect DV victims and survivors in the face of the ongoing threat of COVID-19 and the promise of future disasters.