Idaho Summit, October 2010

1. The Idaho Risk Assessment Of Dangerousness In Domestic Violence: Expanding Beyond The Criminal Justice System To Promote Early InterventionLisa Growette Bostaph, Ph.D.Jennifer Landhuis Idaho Summit, October 2010

3. Idaho Coordinated Response to Domestic & Sexual Violence A state-level committee of governmental and non-governmental organizations to stimulate a more coordinated response to domestic and sexual violence to enhance safety for victims, increase offender accountability, improve inter-agency collaboration and to look for broader system outcomes.

4. Usefulness of Risk Assessments • Powerful indicators of dangerousness to victim or public • Organize case information and assess the likelihood of escalation • Provide a touchstone for victims on their own risk • Potential to educate everyone along the continuum • Improve consistency of decisions • Improve agency accountability and a higher degree of care and caution – risk management system • Encourage a shared language of risk for everyone in the criminal and non-criminal justice response

5. Supporting Research National Research: Neil Websdale, Ph.D.; Death by Intimacy: Risk Factors for Domestic Violence (2000) Jacqueline Campbell, R.N. Assessing Risk Factors for Intimate Partner Homicide (2003) Dr. Philip Resnick Dr. Michael Johnson Dr. George McClane and Dr. Dean Hawley Idaho Fatalities Idaho Case Law

6. Most Prominent Antecedents • Relationship variables, such as: • Prior history of domestic violence or police contact • Obsessive-possessiveness; morbid jealousy • Use of weapon in prior abusive incidents • Threats with weapons, threats of suicide, and threats to kill the victim and/or children • Serious injury in prior abusive incidents • Forced sex of partner • Attempted strangulation • Abusive incidents while victim is/was pregnant • Violence increases in severity & frequency

7. Offender variables, such as: • Perpetrator is familiar with the use of violence and sometimes has a prior criminal history of violence • Drug or alcohol abuse • Access to/ownership of guns • Victim variables, such as: • Victim has a civil protection order • Victim hasseparated or attempted to separate from the relationship or filed for divorce • Victim is afraid that she might die

8. Idaho Fatalities • May 10, 2007, Calder, ID - Ricky Turner shot his wife (not fatal), shot and killed his wife’s mother and father, then was fatally shot by his wife • History of Domestic Violence • Prior Police Contact • Separation • Obsessive/Coercive Controlling Behavior • Threats to kill • Threats of Suicide/Mental Illness/Recent Stress

9. May 19, 2007, Moscow, ID – Crystal Ann Hamilton, Officer Lee Newbill, and Paul Bauer were shot to death by Jason Hamilton who then committed suicide History of Domestic Violence Prior Police Contact Threats to Kill Threats of Suicide/Mental Illness Alcohol and Drug Use/Abuse

10. May 13, 2007, Meridian, ID – Ricardo Benitez was fatally shot by a Meridian Police Officer who was responding to a report that Benitez threatened the family with a knife and was in violation of a protection order History of Domestic Violence Prior Police Contact Separation Threats to Kill Threats of Suicide/Mental Illness

11. Idaho Case Law • State v. Charboneau, 116 Idaho 129 (1989) – Husband shot wife to death • History of Domestic Violence • Prior Police Contact • Separation • Obsessive or Controlling Behavior • Threats to Harm or Kill

12. State v. Jensen, 137 Idaho 240 (2002) – Wife murdered husband’s new girlfriend History of Domestic Violence Separation Obsessive or Controlling Behavior Threats to Harm or Kill Threats of Suicide

13. OtherResearch • A USDOJ five-year study ending in 2007 reports that instruments designed to help professionals organize case information and assess the likelihood of escalation, including homicide, were more sensitive than other instruments (more likely to correctly classify most of the women that were re-assaulted.)

14. Seven Idaho Risk Factors • History of Domestic Violence • Prior Police Contact • Separation • Obsessive/ Coercive Controlling Behavior • Threats to Kill Victim or Children • Threats of Suicide • Alcohol or Drug Abuse

15. Non Criminal Justice Continuum Family Physician/ ER DV Shelter Program DV Advocate Friends Daycare/Headstart Neighbors Preschool/Elementary/Secondary Schools Higher Education Social Service Agencies H&W/Disability Advocacy /Child Protective Services/ APS Faith-based MH Counselor DV Shelter Counselor/Group Drug & Alcohol Treatment Batterer Treatment 211 Civil Attorneys– Protection Order/Divorce Offender Attorney Custody/DV Evaluators Judiciary - Civil Court (ILAS, IVLP, Attorneys, Pro Bono/ISC Court Assistance Office) Employers Disability or Specialized Advocacy Organizations Landlords • Advocates, civil attorneys, emergency room personnel • Confidentiality considerations • Knowing waiver by client • Who do you share information with?

17. Jack & Amanda Amanda arrives at the emergency room with injuries related to an assault. ER records indicate that this is the second time that Amanda has been seen at the hospital for similar injuries. On this occasion Amanda is accompanied by her children who provide additional details regarding the fights Amanda and their father have had over the years. Amanda’s oldest daughter tells the nurse that usually her father will just hit and shove her Mom, occasionally causing bruising. Amanda’s daughter says that on this particular occasion she awoke to the sounds of fighting and then the arguing stopped all of a sudden. When she went to the living room she found Amanda unconscious on the floor with her dad hovering over her. The kids all helped carry their mom to the car to take her to the hospital.

18. What if later in the examination you found out: • Amanda’s husband was laid off from work about six months ago and ever since he has been going out to the bars regularly by himself? He comes home really drunk and takes everything out on Amanda? • While Amanda demanded that she was fine and that she had just fainted while she was at the hospital, at a follow-up visit the next day bruising around her neck has begun to appear and it is obvious that she had been strangled?

19. What to do when the risk of dangerousness is high? • In the law enforcement field, officers reviewing the cases would make a determination of the next step based on their internal policy. • ICRDSV drafted a recommended policy for law enforcement agencies. • ICRDSV would like to assist in drafting a recommended policy for health care professionals.

20. Revisions for Health Care Professionals • Includes questions on each of the seven Idaho areas of risk • Takes into account same sex relationships • What revisions can we undertake to make this form more applicable to the health care environment? • Is there an existing common form used for intake that we could incorporate the risk assessment into?

21. Keep in Mind: • Abuser’s control results in: • Limited access to routine or emergency medical care • Noncompliance with treatment regimens • Not being allowed to obtain/take medications • Missed appointments • Lack of transportation, access to finances/phone • Failure to use contraceptives

22. Behavioral Indicators of Domestic Violence • Partner accompanies patient, insists on staying close, or answers questions for her • Reluctance of patient to speak in front of partner • Denial or minimization of violence by patient or partner • Exaggerated sense of responsibility for relationship • Patient overly-apologetic for taking up your time

23. Having the Conversation • Appropriate time/place • Routine screening- asking every patient • Appropriate referrals

24. Framing Questions: • I don’t know if this is a problem for you, but many of the women I see are dealing with abusive relationships. Some are too afraid or uncomfortable to bring it up themselves, so I’ve started asking about it routinely. • Because so many women I see are involved with someone who hits them, threatens them, continually puts them down or tries to control them, I now ask all my patients about abuse.

25. Sample Screening Questions • Do you feel safe at home? • How are things going in your relationship/marriage? • Tell me what happens when you and your partner argue. • Does your partner share in the parenting responsibilities? • Are you in a relationship where you have been hurt or threatened? • Are you afraid of your partner or anyone else in your family?

26. Questions and Responses • Patient says “no”: “I’ve seen people who are afraid or embarrassed to tell me they have been hit. I understand. I want you to know that if you are ever hurt, it’s okay to tell me about it. This is a safe place to come and talk.” • Patient says “yes”: “I’m glad you told me. Let’s talk about your options.” • Patient appears offended: “I’m sorry, I didn’t mean to offend you. It’s a routine screening we do.”

27. The 6 Fs Keeping Victims with Abusers • Fear • Finances • Family • Faith • Father • Fantasy

28. Contact Information Lisa Growette Bostaph, Ph.D. Boise State University lisabostaph@boisestate.edu (208) 426-3886