Classification, etiology, and management of victims of abuse, harassment, and violence in India and in general.

1. VOILENCE ABUSE AND
HARRASSMENT
ARUNDHATI
ROLL NO. 11

2. INTRODUCTION
• Emergency department are often the first
place where victims of family violence, abuse
or neglect go to seek help. Each year in the
United States there are 4.8 million and 2.9
million men who experience physical
assaults involving their intimate partners.

3. EPIDEMIOLOGY
• Intimate partner voilence (IPV) caused 1544
deaths in 2004; of this victims 75% were
females and 25% were males.
• It is estimated that between 7,00,000 and 1,2
million elders are abused or neglected
annually.
Source
BRUNNER AND SUDDHARTH’S
TEXTBOOK OF MSN

4. In India…
• Men reported being perpetrators
of domestic violence with 22% reporting
some form of physical domestic abuse,
17% sexual, 59% psychological, and 59.5%
any form of domestic abuse. Men reported
experiencing higher prevalence of all forms
of violence, but reported experiencing
lowest rates of sexual violence.

6. "The intentional use of physical force or power, threatened
or actual, against oneself, another person, or against a
group or community, which either results in or has a high
likelihood of resulting in injury, death, psychological harm,
maldevelopment, or deprivation."
World Health Organization
DEFINITION

7. WHO'S CLASSIFICATION OF
VIOLENCE
1. Self-directed violence
• Suicidal behavior
• Self-mutilation
• Risk factors include female gender,
adolescence/college age, and previous
history of self-abuse.

8. 2. Interpersonal violence
• Family/partner violence —stalking,
domestic battering, elder abuse, child
abuse, rape
• Community violence—robbery, carjackings,
aggravated assault, rape, homicide, sexual
harassment

9. 3. Collective Violence
• Violence directed at a specific nation or population:
armed conflicts; genocide, repression, and other
human rights abuses; terrorism; organized violent
crime
• Violence directed at women as a group: female genital
mutilation, female infanticide, trafficking, acts of rape
during war

10. Perspectives on Violence
ETIOLOGY
1. Events that “trigger” violence
• Not obeying one’s
husband/partner
• Talking back to one’s
husband/partner
• Not having food ready on time
• Failing to care adequately for
children or home

11. • Questioning one’s husband/partner about money
or girlfriends
• Going somewhere without permission
• Refusing one’s husband or partner sex
• Expressing suspicions of infidelity
2. Stresses of poverty
make violence more likely to occur (for women
and men).Women in families with the lowest
household incomes are victimized seven times
more than women with the highest household
incomes.

12. 3.Alcohol/Drug Influences
• 75% of victims report alcohol/drug use by the
offender at the time of the crime
• Substance use and abuse are consistently
associated with violence
4. Rural settings
5. Societies with regressive views about women
6. Low education
7. Growing up in a violent household

13.  People present with physical injuries
 Health problems related to stress such as
anxiety
insomnia
gastrointestinal symptoms
 Dependent person shows evidence of inattention to
hygiene or nutrition or to known medical needs.
 Unexplained bruises, lacerations, abrasions, head
injuries or fractures
 Malnutrition and dehydration most common c/m of
neglect
CLINICAL MANIFESTATIONS

14. ASSESMENT AND DIAGNOSTIC FINDINGS
 A careful history taking is crucial in screening process.
 Asking questions in private-away from others- helpful
in eliciting information about abuse, maltreatment and
neglect.
 Assessment of patients general appearance
 and interactions with patient’s significant others
 Examination of entire surface area of body
 Mental status examination

15. NOTE: Whenever evidence leads
one to suspect abuse or neglect,
an evaluation with careful
documentation of description of
events and drawings and
photographs of injuries is important
because the medical record may
be used as a part of legal
proceeding

16. MANAGEMENT
• Primary concern should be the safety and
welfare of the patient.
• Treatment focuses on consequence of the
abuse, violence or neglect and on prevention
of further injury.
• Nurses, physicians, social workers and
community agencies work collaborately.

17. • If the patient is in immediate danger he or
she should be separated from the abusing or
neglecting person.
• Referral to a shelter
• When abuse is result of stress experienced
by a caregiver who is no longer able to cope
with burden of caring for an elderly person or
a person with chronic disease or a disability
respite services may b necessary. Support
groups may be helpful.

18. • Some patients insist on remaining in home
environment where the abuse or neglect is
occurring, the wishes of patients who are
competent and not cognitively impaired
should be respected. But safety plans should
be explored.
• Mandatory reporting laws in most states
require health care workers to report
suspected child or elder abuse to an official
agency usually Adult (child)Protective
Services.

19. • Family and intimate violence refers to violence between
individuals in a significant relationship; it can be directed
toward former or current spouses or partners, dates, elders,
and children.
• Violence against women is primarily intimate violence.
• Stalking is strongly linked with sexual violence. Although
every case is different, a stalker's behavior typically
becomes increasingly threatening, serious, and violent.
• Women who are being stalked should seek help
immediately.
Family and Intimate Violence:
Stalking

20. If women get stalked!!!

22. • Domestic violence, also referred to as battering, occurs
when a person subjects a current or former romantic
partner to forceful physical, social, and psychological
behavior so as to coerce her, without regard to her rights.
• Battering includes five types of interpersonal violence:
physical,
sexual,
property,
Psychological
social.
Domestic Violence (Battering)

23. Root causes:
• Growing up in a cycle of violence and abuse
• Distorted concepts of manhood
• Insecurity, feelings of loss of power and control
• Poverty and unemployment
• Lack of housing and displacement
• Alcohol and substance abuse
• Hopelessness and despair
• Circumstances of racism and injustice

24. What to do then…?
1090

25. • Child abuse and neglect includes any act or
failure to act on the part of a parent or
caretaker that presents an imminent risk of
serious harm or actually results in serious
physical or emotional harm, sexual abuse,
exploitation, or death of a child. Withholding
medically indicated treatment that in a
professional’s medical judgment would be
effective in improving or curing a life-
threatening condition also qualifies as
abuse.
Child Abuse and Maltreatment

26. WHAT TO DO??
• CHILDLINE is India's first 24-hour, free,
emergency phone service for children in
need of aid and assistance. Whether you are
a concerned adult or a child, you can dial
1098, the toll free number to access our
services. We not only respond to the
emergency needs of children but also link
them to services for their long-term care and
rehabilitation.

27. Seven types of elder abuse
1. Physical elder abuse
2. Sexual elder abuse
3. Emotional elder abuse
4. Financial exploitation
5. Neglect
6. Self-neglect
7. Abandonment
Elder Abuse
Elder abuse can be defined as "a single, or
repeated act, or lack of appropriate action,
occurring within any relationship where there is
an expectation of trust which causes harm or
distress to an older person“
- WHO

28. What to do??
• Doctors, nurses, and other medical
personnel can play a vital role in assisting
elder abuse victims. on average, make 13.9
visits per year to a physician. So we can
keep a check on their behaviour to identify
their problem.
• Help can be reached by calling the Toll-free
Helpline numbers if you have to report 1800-
233-1253 In BHOPAL

29. • Incidents are classified as involving
strangers if the victim identifies the offender
as a stranger, did not see or recognize the
offender, or knew the offender only by sight.
Violence by Strangers

30. Common crimes increasing
• Carjacking
• Robbery
• Murder
• Gang violence
• Sexual assault
• Rape
Hate crimes
• Roughly 7,500 hate crimes are reported a year
• Most motivated by race; but also by religion,
orientation, ethnicity or disability

31. • Although sexual harassment can occur in any
setting, it has been most commonly reported in
the workplace. The stereotype of sexual
harassment, as in many forms of violence,
involves a male harasser and a female victim. In
reality, sexual harassment recognizes no gender
boundaries—the victim and the harasser may
even be the same sex.
Sexual Harassment

32. Reducing Risk of Date Rape
• Be wary of dominance by partner in a relationship.
• Be wary when a date tries to control behavior or
pressures others in any way.
• Be explicit with communication and stating “no.”
• Avoid ambiguous messages with verbal and nonverbal
behavior.
• Consider first dates in a group setting.
• Avoid remote or isolated spots.
• Limit alcohol and drug use.

33. Sexual Harassment Doesn’t Just Occur at the Workplace!
If you are sexually harassed (or if you witness sexual
harassment):
•Let the offending person know that the behavior is unwanted
and inappropriate
•If the behavior continues…
• Inform appropriate authority figure (dean, supervisor, HR
department, etc)
• Let other people know about the behavior – can gain social
support, and you may not be the only victim.
More than half of female students have been subjected to
inappropriate sexual comments and jokes and more than 1/3
have experienced physical harassment. Less than 10%
reported the incident.

34. 100 Police
102 Ambulance
101 Fire
108 Disaster management
181 Women's helpline
EMERGENCY NO.

35. Summary???

36. THANK YOU