by Sado Ali
Domestic abuse can affect anyone regardless of race, gender, social status or age. In England and Wales, domestic abuse affects 1 in 3 women and 1 in 6 men during their lifetime. A report published by the Crime Survey for England and Wales estimated that 2.4 million adults experienced domestic abuse in the year ending March 2022.
Leading international research has shown that domestic abuse is the primary cause of brain injury in women around the globe. Research undertaken by J. M Nemeth in 2019 and G. Zieman in 2017 found that more than 83% of women who suffered brain injuries reported being strangled, experiencing blows to their heads (81%), and being held in a way in which they felt they could not breathe (75%). These findings illustrate that brain injury is prevalent among survivors of domestic abuse, but the extent to which it is understood and looked at is one which calls for further research.
Current Research and Findings
The Disabilities Trust, which has since changed its name to Brainkind, is a nationwide charity offering support and services to people living with acquired brain injuries. The charity hosted an expert roundtable looking at the impact of domestic abuse survivors living with acquired brain injuries and the way in which they can be better supported.
Sixty survivors aged 18–72 took part in the discussion across eight sites in England and Wales. More than 55% of survivors screened positive on the Brain Injury Screening Index, which is an indicator of brain injury, while 80% of survivors reported at least one significant blow to the head. More than 75% of survivors reported they had been held in a way that they felt they could not breathe, and 46% reported being strangled at least once.
The findings demonstrate that acquired brain injury is a hidden disability impacting a large number of domestic abuse survivors. The figures are very concerning, and there are likely to be more survivors experiencing brain injury symptoms, who have yet to seek medical attention.
As a result of a brain injury, survivors may experience a variety of issues, ranging from difficulty concentrating, memory issues, speech difficulties and physical, emotional, and cognitive issues. These symptoms are often portrayed by many survivors of domestic abuse unknowingly as they never get diagnosed or receive the support they need. Survivors of domestic abuse with acquired brain injury need unique support that will enable them to deal with the trauma arising from the abuse while also managing the symptoms of brain injury.
The most frequent cause of domestic abuse injury cited by Brainkind survivors included ‘punching, slapping in the face, choking, and non-fatal strangulation’. The methods used that resulted in a brain injury, as reported by the survivors, included ‘suffocation, strangling, drowning in water, and choking’. Strangulation leaves very little sign of physical injury, but it has a long-term impact on the victim. This is highlighted by one Brainkind survivor;
“Strangulation was probably the main one and he would do it to the point that I would pass out, to the point I wet myself, which I would later learn wasn’t because I was scared. It was because I was dying.”
Strangulation is a matter of life and death, yet it is still not understood fully by medical practitioners, the police, and prosecutors who prefer physical signs of trauma. The intersection between brain injury and domestic abuse is one that must be understood so that survivors are provided with immediate support and fatalities are prevented.
A Lack of Understanding and Support
One of the key issues Brainkind found was that survivor’s experiences and symptoms were not investigated and screened in the context of brain injury. This is highlighted below by one survivor;
“I think I need to go to the doctors regarding memory because I can forget what happened an hour ago sometimes. I notice this a lot that I keep forgetting things. I need to write things down to make sure I do not forget things.”
Another key issue that Brainkind found was that survivors did not receive support from the agencies they were involved with, which highlighted a need for further training for all the services that interact with survivors on the links between domestic abuse and the impact of brain injury;
“With Social Services…. It’s likely they have one vision and that’s how you should have done something… I don’t think they could understand the severity of being in that situation and not being able to just get up and leave when you want to.”
It is clear there is an undeniable connection between domestic abuse and brain injury. Domestic abuse is not just a standalone problem; it is an issue that requires a holistic understanding among everyone who interacts with and supports survivors. The findings are just the tip of the iceberg, and there is still a need for further research, awareness, and training among all professionals so that the invisible impacts of brain injury arising from domestic abuse are not overlooked.
References
Nemeth, J. M., Mengo, C., Kulow, E., Brown, A., & Ramirez, R. (2019). Provider perceptions and domestic violence (DV) survivor experiences of traumatic and anoxic-hypoxic brain injury: Implications for DV advocacy service provision. Journal of Aggression, Maltreatment & Trauma
Zieman, G., Bridwell, A., & Cardenas, J. (2017). Traumatic Brain Injury in Domestic Violence Victims: A Retrospective Study at the Barrow Neurological Institute
The Disabilities Trust – An Invisible Impact: Expert Roundtable Discussion Paper