Why Doctors Should Start Screening Men To Spot Potential Abusers

CREDIT: SHUTTERSTOCK

There’s been a lot of conversation about domestic violence lately, thanks to the ongoing controversy over the way the NFL has responded to a surveillance tape of former Baltimore Ravens running back Ray Rice punching his then-fiancee in the head. Public figures ranging from the newly crowned Miss America to the president of the United States have weighed in about the fact that violence against women is never acceptable.

Even as public opinion is moving toward sharp condemnations of domestic abuse, however, the right way to prevent these crimes from happening is less clear. But a team of researchers from the University of Michigan Medical School have one innovative idea: Start figuring out how to identify the men who are most at risk for abusing their partners.

An increasing number of medical groups — including the U.S. Preventive Services Task Force, which helps determine what services are covered under the health reform law — now recommend that doctors should screen all of their female patients for evidence of intimate partner violence (IPV). Since domestic violence leads to both short-term and long-term health problems, medical professionals are uniquely positioned to be able to spot the signs. The federal guidelines specifically apply to women of childbearing age, since they’re most at risk for becoming victims of domestic abuse.

But what if doctors shifted the focus and also started looking for potential abusers? Although very little work has been done in that field so far, the men who engage in IPV are regularly coming into contact with medical professionals, according to a new study examining the characteristics of abusers. It may be possible to teach doctors about the warning signs that suggest a male patient could be abusing his partner.

“Health care encounters provide an opportunity to identify and potentially intervene in IPV,” Dr. Vijay Singh, the lead author of the new report, told ThinkProgress via email. “Men who report perpetrating IPV seek routine health services. Of those who report perpetrating IPV, over half reported a routine health visit in the past year, and nearly one third had an emergency room visit in the past year.”

Singh and his colleagues also found some correlations between domestic abuse and certain health issues that could come up in a routine exam. According to their research, male aggression is linked to irritable bowel syndrome, insomnia, substance abuse, and a history of either experiencing or witnessing violence as a child. While Singh noted that “people should not jump to the conclusion that men with irritable bowel syndrome are all abusers,” the correlation could give medical professionals more insight into the complex profile of a man who’s at risk to be too aggressive at home.

In general, there isn’t much scientific research on the people who perpetrate sexual violence and domestic abuse. But, when we turn our attention to the abusers rather than the victims, some important insights arise. For instance, a groundbreaking global study published last year discovered that rapists don’t fully understand what constitutes “sexual assault,” grow up feeling entitled to taking control of women’s bodies, and are often repeat offenders. Similarly, research into college-age rapists has challenged many popular assumptions about how campus sexual assaults happen, finding that the men who perpetrate assaults are making calculated decisions in order to carefully select their victims.

Singh’s study has similar implications for the way we think about men who abuse their girlfriends or wives. He and his colleagues found that IPV is very common — one in five men reported pushing, grabbing, shoving, or hitting their partners. Ultimately, abusers aren’t just the prominent people like Ray Rice who make the news; they’re men interacting with the average American. “It’s likely that we’ve all met these men in our daily environment. This is an issue that cuts across all communities, regardless of race, income, or any other demographics,” Singh explained in a press release about his findings.

This represents the first nationally representative investigation into domestic abusers’ routine health visits, and the study authors conclude there needs to be follow-up research to try to figure out how doctors can effectively screen men. But if we do get to a point where health professionals can start spotting the warning signs, Singh told ThinkProgress there are some existing community resources that can help.

Doctors start referring their patients to batterers’ intervention programs, which focus on reforming men’s behavior and holding them accountable for abuse. Experts in the field have pointed out that batterers’ intervention programs currently serve a very small portion of the male population, since they typically only see the men who are mandated by court to complete a program. Referrals from the health care sector could help widen that scope.