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Helping the Helpers : Addressing Knowledge & Service Gaps in IPV related TBI

Learn about the intersection of intimate partner violence and traumatic brain injury in Canada and how we can help survivors. Discover common signs and symptoms of TBI, its consequences, and communication challenges post-injury.

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Helping the Helpers : Addressing Knowledge & Service Gaps in IPV related TBI

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  1. Helping the Helpers: Addressing Knowledge & Service Gaps in IPV related TBI Nneka MacGregor, LL.B. Executive Director nneka@womenatthecentre.com Women’s Centre For Social Justice, o/a WomenatthecentrE

  2. What’s The Issue? • This IS a gendered issue – about male violence against women • Socially constructed, but individually willed • Canadian Femicide Observatory for Justice & Accountability 2018 Report https://femicideincanada.ca/callitfemicide.pdf

  3. Call It Femicide: Understanding gender-related killings of women & girls in Canada 2018 - CFOJA https://femicideincanada.ca/callitfemicide.pdf • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com

  4. Chilling Facts Did you know? 1 in 4 women in Canada will experience intimate partner violence (IPV) over their life time • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com IPV is a significant cause of injury to women aged 15-44 in Canada Did you know?

  5. Chilling Facts 30-74% of women survivors of IPV have possibleTBI • (Kwako et al., 2011) • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com

  6. ‘The Perfect Storm Effect’ • Area of Violence • Type of Injury • Resultant Damage Image source: econews.com This perfect storm results in women left vulnerable to continued violence, exponentially compounding the damage to the brain in an ongoing cycle • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com

  7. Key Takeaways: So How Can We Help You Help Survivors? • TBI 101: What is it & what does it look like? • TBI & IPV: How is it relevant to you in your work? • What are we doing about it? • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com

  8. Common Signs & Symptoms of TBI • Decision making / Judgement • Reasoning / Impulsivity • Multi-tasking • Concentration • Memory • Organization • Reduced processing speed • Inability to read facial expressions • Communication challenges 1. Cognitive: • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 8

  9. Common Signs & Symptoms of TBI • Depression • Anxiety • Suicidality • Anger • Emotional lability • Changes to personality 2. Psychological: • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 9

  10. Common Signs & Symptoms of TBI • Headaches • Ringing in the ears (Tinnitus) • Chronic fatigue (physical & mental) • Dizziness • Blurred vision • Hormone & endocrine system involvement 3. Physical: • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 10

  11. Consequences of TBI • Increased rates of mental illness • Higher amounts of unemployment and homelessness • Higher rates of divorce • Higher rates of substance use challenges • More likely to experience poverty • Higher rates of social isolation • Potential for challenges to credibility and capability based on being ‘disabled’ or ‘brain damaged’ • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 11

  12. Communication After Brain Injury • Individuals with TBI often report communication challenges • Not always obvious • More subtle (but debilitating) communication issues can be misconstrued as poor attitude, disinterest, disrespect, low intelligence or even substance use • (Wiseman-Hakes, C., 2017) • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 12

  13. What Changes? • Difficulty with concentration i.e. paying attention, especially in noisy environments and for sustained activities • Slow to follow and process information (reduced rate, reduced amount, reduced complexity) • Poor memory; inconsistent and inefficient recall • (Wiseman-Hakes, C.,2017) • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 13

  14. What Does It Feel Like For The Individual? • Dread and shy away from multi-person conversations, noisy environments and conversations with strangers • Difficulty blocking out stimuli • Internal: pain, mood • External: noise, visual sound • Attention is effortful and hard to sustain over time • Easily fatigued, feeling of ‘brain fog’ • Easily overwhelmed by too much information • Like someone following a conversation in a new language ... just give up and tune out • (Wiseman-Hakes, C., 2017) • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 14

  15. To Screen Or Not To Screen… • Complex issue…does diagnosis increase risk through vulnerability? • Can it be used against women in family law courts? • No validated TBI screen tool that is sensitive to the IPV context • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 15

  16. What Is Needed • Include prompts relevant to the events that can result in TBI in this population • Allow for safe and private endorsement of an event • Offer ease of administration by IPV knowledgeable staff, without the need for special training in TBI • (Goldin, Haag & Trott, 2016) • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 16

  17. What Is Needed • Can be used by front line workers who are untrained in TBI • Quick and relatively non-invasive • Suggests likelihood of potential TBI • Needs to be adjusted for safety and non-traumatizing • (Goldin, Haag & Trott, 2016) • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 17

  18. Best Options From Available Tools • Brain Injury Severity Scale – Dr. Eve Valera • Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) • the HELPS Screening Tool (adapted) to determine possibility of brain injury • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 18

  19. Some Challenges, Supports & What We’re Doing The work is hard: • VAW sector & challenges • TBI professionals & challenges • Academics & researchers & challenges • Funding scrambling • Burnout & disillusionment It takes a village: • Of survivors • Of researchers • Of VAW support services • Of advocates • Of like-minded citizens • Of partnerships, of kindness and empathy and compassion, of dedication and allyship • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 19

  20. Key Challenges For Survivors: THE 6 Ss Shame Feelings brought on by societal pressures and feeling she’s to blame 6 1 Stigma Associated with being a victim of violence Safety The Survivor Fear of repercussions and further violence if she discloses 2 5 Silence Either because she may have told and not been believed or from fear of repercussions Solitude / Isolation Abusers dismantle her social support networks, including family & friends 3 4 Silos VAW support services disconnected from TBI support services • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com 20

  21. Key Challenges For Sectors: SILOING Brain Injury Research & Support VAWResearch & Support Primary Healthcare Social Work Nursing Gender Studies 21 • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com

  22. Battered & Brain Injured Programme of Research • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com

  23. Allyship, Collaboration & Participatory Research • Battered & Brain Injured: Identifying and supporting brain injured women survivors of intimate partner violence • Haag H.L. (co-PI), Sokoloff, S., MacGregor N., Broekstra, S., Cullen N., (co-Is) & Colantonio, A. (co-PI) • Funded by Women’s College Hospital Xchange Grant Program & the Canadian Institutes of Health Research • Women Survivors of Violence and Traumatic Brain Injury: Addressing gaps in knowledge and support • Colantonio A. (PI), Haag H.L., Samsa S., Sing G., Cullen N., MacGregor N., Brayton B. (Co-Is) • Funded by the Department of Justice Canada

  24. ThanksforListening • Helping the Helpers - Addressing Knowledge & Service Gaps in IPV-Related TBI – 2019 • www.womenatthecentre.com

  25. Q&A

  26. Get In Touch +416-964-0892 nneka@womenatthecentre.com 18 Wynford Drive, Suite 502, Toronto, ON CONTACT US WomenatthecentrE www.womenatthecentre.com 36

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