Tag Archives: Women and Girls

How Can We Help Survivors of Domestic Violence Struggling with Homelessness?

Worried Child

By Stephanie Hargrove (Clinical Psychology Doctoral Student, George Mason University)

It is an unfortunate reality that many women and children who are able to escape their abuser end up homeless. A recent survey found that 17 percent of cities cited domestic violence as the primary cause of family homelessness (U.S. Conference of Mayors, 2014). This prevalent issue is something that many people do not realize is happening. Here are some of the myths about domestic violence and homelessness that need to be dispelled.

 

Myth Busters:

Only women can experience domestic violence

  • In fact, domestic violence can happen to anyone, men, women and children. The U.S. Department of Justice defines domestic violence as “a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner. Domestic violence can be physical, sexual, emotional, economic, or psychological actions or threats of actions that influence another person”. Domestic violence is abuse that occurs in the home by a family member or intimate partner. Therefore, even children who are abused by their parents experience domestic violence.
  • However, it is true that DV survivors are primarily women. More than 1 in 3 women (35.6%) and more than 1 in 4 men (28.5%) in the United States have experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime.

 

People who are experiencing DV can leave anytime they want

People end up homeless or in poverty because of their own bad decisions

People who are affluent now, will never end up homeless

  • There are many survivors of DV who are affluent. There are also several cases of women who lost their homes and finances because their abuser took it all and they did what was necessary to survive.

 

So what does homelessness due to domestic violence look like in real life?

Imagine you have endured days, months, or even years of abuse at the hands of someone you love. One day you decide that it is no longer safe to remain in the same home as this person. Now what?

  • If you are married to this person, you made a commitment to love and honor this person for the rest of your life.
  • If you have children with this person you do not want the children to have to grow up without their other parent in their life.
  • If you are dating, you love and care about this person, you made plans with them and planned your future together.
  • If it is your parent, you are supposed to obey them, you rely on them for love, advice, support, and protection.

Imagine that despite the deep investment you have in this person, you decide that you must leave. Now what?

  • You have to figure out where you would go and how you would end the relationship – all the while knowing that this person has threatened you and your family if you were to leave.

Let’s say you manage to escape your abuser’s home unharmed. Now where do you go?

  • Your abuser made sure to isolate you from the rest of your family so they are not too sympathetic to your situation.
  • Even if you do manage to find a family member to stay with, it will most likely be temporary and it is not always safe to stay in places where your abuser knows they could find you.
  • So what’s another option? Maybe you could stay in a hotel. Well, that could work but that option will get pricey quickly. It’s not a long term solution.
  • How about find a new place to live? That is a long term solution but that takes money and time. If you have to work during the day it can be very difficult to search for a new home.
  • If you are living in poverty, the costly options are not options at all.
  • If you are middle class or affluent, all of your money may not be available to you. Imagine that you share a bank account with your abuser, they may move the money so that you can’t leave. They might have put their name on the house the car and other items you both own so that you cannot legally try to take those things.
  • So now you are at the point where you’ve left your abuser, you’ve used up your immediate housing resources (e.g., a hotel for a couple nights, staying with a family member for a week or two, searching for a new place) and you need a place to go. Now you start reaching out to domestic violence shelters because there is no other option for safe housing.

When you call the DV agency it is still not guaranteed that you will get housing.

  • They ask you if you have a son over the age of 13. You do and they tell you unfortunately your son will not be able to stay with you in the shelter.
  • Or you call and find out that their shelter is at capacity.

Let’s say you are able to find a domestic violence shelter that will be able to house you and your children. Now you are able to utilize the services available in the shelter.

  • However, you now have a curfew, they have limited food options, you cannot tell anyone the location of your residence, you have strict visitor rules and requirements, and you have to check in with someone regularly.
  • This is a huge adjustment, it may even be slightly traumatizing to be in another controlling environment. What are your options now?
  • Pretty much the streets, a homeless shelter with less rules but no guaranteed protection or services for survivors, or stay in the DV shelter where you will at least be safe until you no longer need their services.

As a former domestic violence shelter volunteer and hotline counselor, I have witnessed people deal with every scenario in the previously presented hypothetical situation. One of the most unfortunate things I have come to realize is that in the midst of escaping an abuser, someone who is limited financially has very few good options available to them. It is also unfortunate that some of the policies put in place to protect survivors can end up making it more difficult for them to seek services.

There are several laws and regulations in place for domestic violence shelters. The regulations vary by state but many shelters across the country are tasked with the same obligations to ensure the safety of the residents. These regulations include keeping the shelter location secret, not allowing males in many of the shelters (even if it is an older son of the woman escaping abuse), enforcing a curfew, limiting visitors, and they typically are instructed to keep close tabs on the residents.

So not only does the person have to deal with the severe psychological trauma stemming from the abuse they endured from a loved one, they also have to deal with losing their home, sometimes their job, friends, and family. On top of all of those things, the rules in the shelter might make them feel like prisoners. Sometimes even with the best intentions of helping to protect survivors, shelter policies may end up further traumatizing residents by restricting their power. That type of complex trauma experience can have extremely negative consequences on survivors .

 

How You Can Help

 

If you want to change policies:

First of all, get active in state and local elections. Know your member of congress and your senator. Find out what their plan is to address domestic violence and homelessness, if they have a plan at all. Then gather constituents and make your case for policy development and reform for survivors of domestic violence. Do the same for national level policies.

If you are a provider who works with survivors of IPV:

Know the signs of abuse. Support your client whether they want to leave their abuser or not. Be prepared to provide resources information such as shelters, crime victims fund, trauma counseling, how to get restraining orders, and how to help their children cope. Allow the survivor to make decisions for their own lives. Most of all advocate for the empowerment of survivors. Make sure to be mindful of power dynamics when working with survivors.

If you have never thought about this issue:

Spread the word about this issue. Help dispel the common myths. Learn more about the reality of homeless survivors of abuse. If there is someone you know who is dealing with abuse in their home, be there to support them in any way you can. Even if it is just being an empathetic listener.

 

 

Resources:

 

The National Domestic Violence Hotline

1-800-799-7233 (SAFE)

http://www.ndvh.org/

 

National Coalition for the Homeless

1-202-737-6444

http://www.nationalhomeless.org/

 

National Dating Abuse Helpline

1-866-331-9474

http://www.loveisrespect.org/

 

Americans Overseas Domestic Violence Crisis Center

International Toll-Free (24/7)

1-866-USWOMEN (879-6636)

http://www.866uswomen.org/

 

National Child Abuse Hotline/Childhelp

1-800-4-A-CHILD (1-800-422-4453)

http://www.childhelp.org/

 

National Resource Center on Domestic Violence

1-800-537-2238

http://www.nrcdv.org/ and http://www.vawnet.org/

 

National Center on Domestic Violence, Trauma & Mental Health

1-312-726-7020 ext. 2011

www.nationalcenterdvtraumamh.org

 

 

Biography:

Stephanie Hargrove is a second year clinical psychology doctoral student at George Mason University. She is an alumna of Howard University and has lived in the DC area for nearly 6 years. Stephanie has a passion for advocacy and community service. She has served as an advocate in domestic violence shelters, on the community service committee of the Greater Washington Urban League’s young professional chapter, and as a rape crisis hotline counselor. Stephanie’s research interests are focused on social justice, women’s empowerment, and client centered practices for women who have experienced gender based violence such as intimate partner violence, rape, and human trafficking. Her clinical interests are trauma and personality disorders. Stephanie hopes to utilize her research to inform her clinical work, develop interventions, and influence policy.

 


Filed under: Violence, Women and Girls Tagged: domestic abuse, domestic violence, homeles, homeless families, homeless shelters, homelessness, intimate partner violence

How Can We Help Survivors of Domestic Violence Struggling with Homelessness?

Worried Child

By Stephanie Hargrove (Clinical Psychology Doctoral Student, George Mason University)

It is an unfortunate reality that many women and children who are able to escape their abuser end up homeless. A recent survey found that 17 percent of cities cited domestic violence as the primary cause of family homelessness (U.S. Conference of Mayors, 2014). This prevalent issue is something that many people do not realize is happening. Here are some of the myths about domestic violence and homelessness that need to be dispelled.

 

Myth Busters:

Only women can experience domestic violence

  • In fact, domestic violence can happen to anyone, men, women and children. The U.S. Department of Justice defines domestic violence as “a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner. Domestic violence can be physical, sexual, emotional, economic, or psychological actions or threats of actions that influence another person”. Domestic violence is abuse that occurs in the home by a family member or intimate partner. Therefore, even children who are abused by their parents experience domestic violence.
  • However, it is true that DV survivors are primarily women. More than 1 in 3 women (35.6%) and more than 1 in 4 men (28.5%) in the United States have experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime.

 

People who are experiencing DV can leave anytime they want

People end up homeless or in poverty because of their own bad decisions

People who are affluent now, will never end up homeless

  • There are many survivors of DV who are affluent. There are also several cases of women who lost their homes and finances because their abuser took it all and they did what was necessary to survive.

 

So what does homelessness due to domestic violence look like in real life?

Imagine you have endured days, months, or even years of abuse at the hands of someone you love. One day you decide that it is no longer safe to remain in the same home as this person. Now what?

  • If you are married to this person, you made a commitment to love and honor this person for the rest of your life.
  • If you have children with this person you do not want the children to have to grow up without their other parent in their life.
  • If you are dating, you love and care about this person, you made plans with them and planned your future together.
  • If it is your parent, you are supposed to obey them, you rely on them for love, advice, support, and protection.

Imagine that despite the deep investment you have in this person, you decide that you must leave. Now what?

  • You have to figure out where you would go and how you would end the relationship – all the while knowing that this person has threatened you and your family if you were to leave.

Let’s say you manage to escape your abuser’s home unharmed. Now where do you go?

  • Your abuser made sure to isolate you from the rest of your family so they are not too sympathetic to your situation.
  • Even if you do manage to find a family member to stay with, it will most likely be temporary and it is not always safe to stay in places where your abuser knows they could find you.
  • So what’s another option? Maybe you could stay in a hotel. Well, that could work but that option will get pricey quickly. It’s not a long term solution.
  • How about find a new place to live? That is a long term solution but that takes money and time. If you have to work during the day it can be very difficult to search for a new home.
  • If you are living in poverty, the costly options are not options at all.
  • If you are middle class or affluent, all of your money may not be available to you. Imagine that you share a bank account with your abuser, they may move the money so that you can’t leave. They might have put their name on the house the car and other items you both own so that you cannot legally try to take those things.
  • So now you are at the point where you’ve left your abuser, you’ve used up your immediate housing resources (e.g., a hotel for a couple nights, staying with a family member for a week or two, searching for a new place) and you need a place to go. Now you start reaching out to domestic violence shelters because there is no other option for safe housing.

When you call the DV agency it is still not guaranteed that you will get housing.

  • They ask you if you have a son over the age of 13. You do and they tell you unfortunately your son will not be able to stay with you in the shelter.
  • Or you call and find out that their shelter is at capacity.

Let’s say you are able to find a domestic violence shelter that will be able to house you and your children. Now you are able to utilize the services available in the shelter.

  • However, you now have a curfew, they have limited food options, you cannot tell anyone the location of your residence, you have strict visitor rules and requirements, and you have to check in with someone regularly.
  • This is a huge adjustment, it may even be slightly traumatizing to be in another controlling environment. What are your options now?
  • Pretty much the streets, a homeless shelter with less rules but no guaranteed protection or services for survivors, or stay in the DV shelter where you will at least be safe until you no longer need their services.

As a former domestic violence shelter volunteer and hotline counselor, I have witnessed people deal with every scenario in the previously presented hypothetical situation. One of the most unfortunate things I have come to realize is that in the midst of escaping an abuser, someone who is limited financially has very few good options available to them. It is also unfortunate that some of the policies put in place to protect survivors can end up making it more difficult for them to seek services.

There are several laws and regulations in place for domestic violence shelters. The regulations vary by state but many shelters across the country are tasked with the same obligations to ensure the safety of the residents. These regulations include keeping the shelter location secret, not allowing males in many of the shelters (even if it is an older son of the woman escaping abuse), enforcing a curfew, limiting visitors, and they typically are instructed to keep close tabs on the residents.

So not only does the person have to deal with the severe psychological trauma stemming from the abuse they endured from a loved one, they also have to deal with losing their home, sometimes their job, friends, and family. On top of all of those things, the rules in the shelter might make them feel like prisoners. Sometimes even with the best intentions of helping to protect survivors, shelter policies may end up further traumatizing residents by restricting their power. That type of complex trauma experience can have extremely negative consequences on survivors .

 

How You Can Help

 

If you want to change policies:

First of all, get active in state and local elections. Know your member of congress and your senator. Find out what their plan is to address domestic violence and homelessness, if they have a plan at all. Then gather constituents and make your case for policy development and reform for survivors of domestic violence. Do the same for national level policies.

If you are a provider who works with survivors of IPV:

Know the signs of abuse. Support your client whether they want to leave their abuser or not. Be prepared to provide resources information such as shelters, crime victims fund, trauma counseling, how to get restraining orders, and how to help their children cope. Allow the survivor to make decisions for their own lives. Most of all advocate for the empowerment of survivors. Make sure to be mindful of power dynamics when working with survivors.

If you have never thought about this issue:

Spread the word about this issue. Help dispel the common myths. Learn more about the reality of homeless survivors of abuse. If there is someone you know who is dealing with abuse in their home, be there to support them in any way you can. Even if it is just being an empathetic listener.

 

 

Resources:

 

The National Domestic Violence Hotline

1-800-799-7233 (SAFE)

http://www.ndvh.org/

 

National Coalition for the Homeless

1-202-737-6444

http://www.nationalhomeless.org/

 

National Dating Abuse Helpline

1-866-331-9474

http://www.loveisrespect.org/

 

Americans Overseas Domestic Violence Crisis Center

International Toll-Free (24/7)

1-866-USWOMEN (879-6636)

http://www.866uswomen.org/

 

National Child Abuse Hotline/Childhelp

1-800-4-A-CHILD (1-800-422-4453)

http://www.childhelp.org/

 

National Resource Center on Domestic Violence

1-800-537-2238

http://www.nrcdv.org/ and http://www.vawnet.org/

 

National Center on Domestic Violence, Trauma & Mental Health

1-312-726-7020 ext. 2011

www.nationalcenterdvtraumamh.org

 

 

Biography:

Stephanie Hargrove is a second year clinical psychology doctoral student at George Mason University. She is an alumna of Howard University and has lived in the DC area for nearly 6 years. Stephanie has a passion for advocacy and community service. She has served as an advocate in domestic violence shelters, on the community service committee of the Greater Washington Urban League’s young professional chapter, and as a rape crisis hotline counselor. Stephanie’s research interests are focused on social justice, women’s empowerment, and client centered practices for women who have experienced gender based violence such as intimate partner violence, rape, and human trafficking. Her clinical interests are trauma and personality disorders. Stephanie hopes to utilize her research to inform her clinical work, develop interventions, and influence policy.

 


Filed under: Violence, Women and Girls Tagged: domestic abuse, domestic violence, homeles, homeless families, homeless shelters, homelessness, intimate partner violence

Postpartum Depression and Race: What We All Should Know

Give me break!

By Tanya Burrwell (Assistant Director, APA Women’s Programs Office)

“… Mothers are made to feel that a child is the pinnacle of achievement, and the only appropriate feeling on the birth of a child is joy. We’re expected to perform a certain femininity: to nurture and transmit traditions, to uphold honor” – Pooja Makhijani

While the birth of a child can be a wonderful and joyous time for many women, for some women it is a time of sadness, anxiety, loneliness, and worry that does not go away. In fact, up to 1 in 7 women experience postpartum depression, a very real and serious mood disorder (Wisner, et al., 2013).

What if I were to tell you that women of color experience postpartum depression at double the rate of the general population? Studies show that new mothers of color have rates of postpartum depression soaring close to 38% compared with the 13 – 19% rate for all new mothers (Keefe, Brownstein-Evans, & Rouland Polmateer, 2016).

This is because a disproportionate number of women of color are not screened for depression and do not receive the necessary treatment and services. In fact, it is estimated that up to 60% of women of color do not receive any services! Think about the devastating impact this can have on them and their families.

Research tells us that screening pregnant and postpartum women for depression can significantly reduce the symptoms of depression. In fact, the U.S. Preventive Services Task Force (USPSTF) just included pregnant and postpartum women in the new depression screening guidelines. If we know that screening works, we must ask ourselves why young moms of color experience this disparity.

Historically, studies show that women of color are less likely to seek mental health treatment due to cultural barriers and stigma surrounding mental illness. For many women of color, seeking the help of a mental health professional is seen as a sign of weakness.

“… No one talks about mental instability in the black community. The idea of seeking treatment never crossed my mind. I wasn’t some hysterical white woman with the privilege to lie in bed for days crippled by my emotions. There was nothing wrong with me, and besides, black people don’t do therapy.” – Tyrese Coleman

 

“Our cultures place a significant emphasis on us being silent about our struggles, taking care of everyone else before ourselves, turning to religion in an effort to overcome, and on being strong in the face of adversity-particularly in the face of oppression, racism and other socioeconomic stressors” – A’Driane Nieves

In addition, there are documented racial and ethnic differences in the perceptions and treatment experiences of low-income women of color vs. White women (Doulbier et al., 2013; Kozhimannil et al., 2011). These include:

  • limited access to health care services,
  • a disconnection with providers,
  • a lack of access to providers that look like them, and
  • unavailability of culturally/linguistically appropriate services.

A new study directly questioned low-income mothers of color about what they needed in order to access screening and treatment (Keefe, Brownstein-Evans, & Rouland Polmateer, 2016). Here’s what they found:

  • Access to Information and Resources: Educational campaigns must include women in all of their diversity. Information must be available in multiple languages (i.e., pamphlets, brochures, PSAs) and highly visible and accessible in communities (i.e., schools, doctor’s offices, grocery stores). They should also provide tip cards identifying local resources or national hotlines.
  • Access to Services: Women need insurance coverage; transportation to and from the doctor’s appointments. Childcare services should be made available and/or the availability of child-friendly offices and doctor’s appointments.   
  • Flexibility: Women need flexibility when making appointments. The choice to go to the doctor may mean not going to work, and vice versa, going to work may mean missing an appointment. Women need flexibility among health care providers, as well as sick leave benefits to allow time off for appointments.
  • Community-based Support Services: Providers should develop partnerships to establish local community-based services and/or peer-support groups in community centers, churches, and schools to increase awareness and dispel the myths and stigma about mental illness.

While it is critical that we advocate for screening for postpartum depression to identify women who are at risk, that is only half the battle. It is equally imperative that providers break down these barriers so that low-income women of color can successfully seek the treatment that they need.

In addition to supporting family friendly legislation, policymakers should recognize racial and ethnic disparities in access to care and incentivize programs that train women and men of color to become medical and mental health providers.

“The essays I found online by women with postpartum mood disorders were either by celebrities or white women. And while I truly appreciated these new parents shedding light on these issues, I never found a mirror to my experience.” – Pooja Makhijani

Postpartum depression knows no color, it can affect any woman regardless of age, race, ethnicity, or economic status. Primary care providers, social services agencies and mental health professionals must work together to educate, communicate and provide services that enable and empower ALL women. The time is now!

 

Resources:

APA Help Center – or call 1-800-964-2000

APA Postpartum Depression Resource (available in English, Spanish, French, and Simplified Chinese)

Black Women Birthing Justice

Black Women’s Health Imperative

National Institute of Child Health and Development – Info for Moms and Moms-to-Be

Postpartum Support International

Postpartum Progress

Postpartum Depression Facts

National Suicide Prevention Lifeline

SISTERSONG, Women of Color Reproductive Justice Collective

 

References included:

Breland-Noble, A. (2014, May 13). When our sisters are hurting… [Blog post]. Retrieved from https://psychologybenefits.org/2014/05/13/when-our-sisters-are-hurting/

Coleman, T. (2015, October 21). What it’s like having PPD as a Black woman. [Blog post]. Retrieved from https://www.buzzfeed.com/tyresecoleman/what-its-like-having-post-partum-depression-when-youre-black?utm_term=.hrRJ3BnZp#.rreWpJZA1.

Corby-Edwards, A. (2016, February 11). Depression screening works and now it can work for pregnant and postpartum women. [Blog post]. Retrieved from https://psychologybenefits.org/2016/02/11/depression-screening-works-and-now-it-can-work-for-pregnant-and-postpartum-women/

Dolbier, C.L., Rush, T.E., Sahadeo, L.S., Shaffer, M.L., Thorp, J., and the Community Child Health Network Investigators. (2013).Relationships of race and socioeconomic status to postpartum depressive symptoms in rural African American and Non-Hispanic White women. Maternal Child Health Journal, 17(7), 1277-1287.

Howell, E.A., Balbierz, A, Wang, J., Parides, M., Zlotnick, C., % Leventah, H. (2012). Reducing postpartum depressive symptoms among Black and Latina mothers: A randomized controlled trial. Obstetrics & Gynecology, 119(5), 942-949.

Keefe, R.H., Brownstein-Evans, C. & Rouland Polmanteer, R.S. (2015). Having our say: African-American and Latina mothers provide recommendations to health and mental health providers working with new mothers living with postpartum depression. Social Work in Mental Health, 1 -11.

Kozhimannil, K.B., Trinacty, C.M., Busch, A.B., Huskamp, H.A, & Adams, A.S. (2011). Racial and ethnic disparities in postpartum depression care among low-income women. Psychiatric Services, 62(6), 619-625.

Makhijani, P. (2015, December 7). We can save one another’s lives: A conversation with women of color about postpartum mood disorders. [Blog post]. Retrieved from https://www.buzzfeed.com/poojamakhijani/we-can-save-one-anothers-lives?utm_term=.eber1PGqX#.vu4pZPNXV.

Nieves, A. (2015, January 6) Women of color and maternal mental health: Why are we so underserved? [Blog post]. Retrieved from http://www.postpartumprogress.com/women-color-maternal-mental-health-underserved.

Wisner, K.L., Sit, D.K., McShea, M.C., Rizzo, D.M., Zoretich, R.A., Hughes, …, & Hanusa, B.H. (2013). Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry, 70(5):490-498.


Filed under: Culture, Ethnicity and Race, Women and Girls Tagged: access to treatment, depression, equal access, health disparities, health equity, postpartum depression, racial disparities, women of color

Why Does HIV Impact African American Women Harder Than Everyone Else and What Can You Do to Help?

Professional black woman under cherry blossoms

By Leo Rennie, MPA (Senior Legislative & Federal Affairs Officer, APA Public Interest)

 

February 7th marked the annual observance of National Black HIV/AIDS Awareness Day. The day is an opportunity to raise awareness about HIV and AIDS and to promote HIV testing in the Black community.  Sadly, 35 years into the HIV epidemic the need for education and community mobilization remains significant.  Nearly half of the 50,000 people who become newly infected with HIV in the United States each year are Black. HIV-related disparities among Black women are even more striking. In 2014, the rate of HIV diagnosis of Black women was 18 times the rate of white women and 5 times that of Hispanic women.  

 

What puts Black women at higher risk for HIV infection? 

 

Black women make up the majority of women living with HIV in the United States. Most become infected through heterosexual sex. Sometimes they may be unaware of their male partner’s HIV-positive status and/or his risk factors for HIV infections (such as injection drug use or having sex with other men). Lack of access to preventive health screenings, quality mental and physical health care, including reproductive health and substance use services, and other health related factors such as untreated sexually transmitted infections play a role. Intimate partner violence (IPV) is another major risk factor for HIV transmission. It impedes women from seeking, accessing and staying in care or taking their medications. A White House interagency task force studied this problem and issued recommendations that resulted in new grant programs and federal initiatives to address the challenge of sexual violence.

 

What can be done about prevention and treatment?

 

Few female-controlled HIV prevention options are available. That is why organizations dedicated to promoting Black women’s health are raising awareness about pre-exposure prophylaxis or PrEP. PrEP is the daily use of anti-retroviral HIV drugs to prevent HIV transmission. While PrEP can be up to 99 percent effective when taken as prescribed, in clinical research women have encountered challenges to taking the drug every day as required. Community perceptions about PrEP and stigma impacted women’s adherence to PrEP in studies.  As health care providers and advocates promote PrEP to women, messages must emphasize that adherence is critical.  Women must receive supports, if needed, once they make the decision to start PrEP. This may mean providing them with regular counseling or mental health treatment, or even day care and transportation services so that they can get to doctors’ appointments.

 

When people living with HIV reach viral suppression, they have very low levels of HIV in their bodies. They can live normal life spans and are less likely to transmit HIV to others. But only 28 percent of HIV-positive Black Americans are virally suppressed. Effective medical intervention to prevent and treat HIV depends on behavioral, social, economic, and political factors. Integrated mental and physical health care tailored for Black women, coupled with essential social services and support, not only are necessary for biomedical tools like PrEP to be effective, but are also required if women are to learn their HIV status through HIV testing, seek and stay in medical treatment, and adhere to antiretroviral treatment (ART).

 

What can you do to help?

 

  • Learn more by visiting the APA Office on AIDS . The office provides useful information you can share with friends, relatives, and loved ones.
  • Sign-up for our Federal Action Network to receive updates on APA’s important public policy advocacy efforts in Congress and with federal agencies to expand HIV prevention and care options for women.  Psychologists and other mental health professions are well suited to destigmatize  HIV infection at individual, community, and societal levels, thereby making prevention and treatment of HIV safe and  routine.
  • But most importantly get tested for HIV. Knowing your status is the first step to keeping you and your partner healthy. To find a testing site near you, visit Get Tested, text your ZIP code to KNOWIT (566948), or call 1-800-CDC-INFO (232-4636).

 

For  more information visit:

 

AIDS.gov

CDC – National Black HIV/AIDS Awareness Day

 

 


Filed under: AIDS, Health Disparities, Women and Girls Tagged: african american, african american women, aids, Black, Black women, HIV, intimate partner violence, National Black HIV/AIDS Awareness Day, NBHAAD, PrEP, public health, public policy

Depression Screening Works and Now It Can Work for Pregnant and Postpartum Women

uspstf depression

By Amalia Corby-Edwards, MS (Senior Legislative and Federal Affairs Officer, APA Public Interest Directorate)

You may not have heard much about this, but something just happened that could positively impact millions of women and their families. The U.S. Preventive Services Task Force (USPSTF) just included pregnant and postpartum women in the new depression screening guidelines. 

Psychologists know that depression is common during pregnancy and after birth. Approximately one in seven women experience depression in the year after their child is born, and many of the symptoms begin during pregnancy. In addition to its psychological harms, perinatal depression is linked with pregnancy risks such as preeclampsia, preterm birth, and low birth weight. It is also linked to outcomes which can negatively affect children, including stopping of breastfeeding, family discord, and child abuse and neglect (AAP 2010).

Depression screening works. While health care providers may not always be able to prevent the onset of depressive symptoms, they can reduce the risks of perinatal depression by screening pregnant and postpartum women and referring them to an appropriate treatment provider. Thanks to the new guidelines issued in January 2016, screening for these women will begin to be incorporated into routine medical care.

The USPSTF is an independent panel of national experts in prevention and evidence-based medicine. The Task Force makes evidence-based recommendations on clinical preventive services, including screenings. Surprisingly, previous 2002 and 2009 USPSTF depression screening guidelines applied to all adults with the exception of pregnant women, citing a lack of evidence for this population.

The Task Force chose to revisit the body of evidence again in 2014, and made their research plan available for public comment. APA weighed in, emphasizing the need for a fresh look at the balance of the harms and benefits of screening pregnant and postpartum women. APA and other supporters of women’s reproductive health enthusiastically welcomed the inclusion of pregnant and postpartum women in the revised 2016 USPSTF depression screening guidelines.

Yet, much work remains. Meeting the mental health needs of parents is essential, because it is so closely linked to the well-being of their children.  Congress and the federal government should take a leading role. For example, the Melanie Blocker Stokes MOTHERS Act, which authorized support and education on postpartum depression and psychosis, was included in the 2010 health reform law (PL 111-148), but it has never been funded. Again in 2015, Congress introduced a number of bills focused on maternal mental health and substance use disorders, and even passed the Protecting our Infants Act of 2015 (PL 114-91), which addresses prenatal opioid exposure. Yet there has been no additional funding allocated for these issues, rendering the laws toothless.

APA’s Public Interest Directorate continues to educate congressional and federal agency staff on the importance of these issues. You can help us! Contact your Senators and Representatives to advocate for funding for these and other programs that address maternal mental health through APA’s Federal Action Network.

 

References

American Academy of Pediatrics (AAP). (2010). Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics, 126(5), 1032-1039.

 

Image courtesy of Flickr user Frank de Kleine via Creative Commons


Filed under: Health and Wellness, Public Policy, Women and Girls Tagged: depression, depression prevention, depression screening, perinatal depression, postpartum, postpartum depression, pregnancy, pregnant women, public policy, U.S. Preventive Services Task Force

Shackling Pregnant Women Poses Risks to Mother and Fetus

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Image source: Flickr user Crawford Learmonth on Flickr, under Creative Commons

By Danielle Dallaire, PhD (Associate Professor in the Department of Psychology at the College of William and Mary) and Rebecca Shlafer, PhD (Assistant Professor in the Department of Pediatrics (Division of General Pediatrics and Adolescent Health) at the University of Minnesota)

Since 1990, the number of women incarcerated in the United States has more than doubled. Although much has been written about the overall poor health of incarcerated individuals, most of this work has focused on incarcerated men, perhaps understandably, since the overwhelming majority of incarcerated adults are male. Far less is known about the health of incarcerated women, despite high rates of mental health problems, substance abuse, and trauma histories documented in this population.  Furthermore, many women involved with the criminal justice system are of reproductive age.

Of the more than 200,000 incarcerated women in U.S. prisons and jails, it is estimated that 6%-10% of those women are pregnant. Although there is a dearth of research data on these women, we do know that, when compared to women in the general population, pregnant prisoners are more likely to have risk factors associated with poor perinatal outcomes, including preterm and small-for-gestational-age infants. These outcomes are likely a result of exposure to a combination of risk factors, including lack of access to or failure to attend prenatal care, substance use, toxic stress, domestic violence, poor nutrition, and sexually transmitted infections. In addition, African American, Native American, and Hispanic women – three groups that are also at highest risk for poor birth outcomes – are disproportionally represented in the prison system.

These risks for poor birth outcomes may be exacerbated by the care and treatment pregnant women receive during their incarcerations, including the dangerous practice of restraint. Despite strong evidence of danger to mother and child, 13 U.S. states allow indiscriminate use of restraints on incarcerated women and adolescent girls during pregnancy, labor, and recovery, even though the vast majority are incarcerated for nonviolent offenses.

Shackling has negative physical and mental health effects on mothers and their infants:

  • Shackling women and adolescent girls in transport to prenatal care and during labor and delivery can obstruct necessary medical care and, during labor, lead to extreme physical pain and complications because of the mother’s inability to move freely.
  • Shackling increases the likelihood of falls, inability to break a fall, life-threatening embolic complications, and impediments to epidurals, emergency caesarian section, and other interventions, all of which may also affect the fetus.
  • In one documented case, a woman shackled during labor experienced a hip dislocation that caused permanent deformities and pain, stomach muscle tears, and an umbilical hernia.
  • Mental health problems exist among incarcerated women in higher rates than the general population; pregnancy and the postpartum period bring increased risk of symptoms of mental health problems, such as depression and post-traumatic stress disorder.
  • Women subjected to shackling during childbirth report severe mental distress, depression, anguish, and trauma, and use of shackles during or immediately following childbirth can cause or exacerbate pregnancy-related mental health problems.
  • The presence of shackles after delivery may inhibit or interfere with a mother’s ability to bond with and safely handle her infant, to initiate breastfeeding, and may negatively affect the infant’s health.

These risks clearly compromise women’s health, and also have important implications for the health of their future offspring. We know very little about this population and what happens once they return to their families, making intervention and research with pregnant incarcerated women a priority. This also reflects a pressing need for gender-responsive and trauma-informed policies in the nation’s jails and prisons.

APA anticipates legislative action on this issue in the early part of 2016. Please check back or sign-up for our Federal Action Network, to participate in this important public policy advocacy effort.

Biographies

Danielle Dallaire, PhD is an Associate Professor in the Department of Psychology at the College of William and Mary. She received her PhD in developmental psychology from Temple University. Dr. Dallaire’s research examines children’s social and emotional development in the context of risk, including research on how children cope with the multifaceted risk of parental incarceration.

Rebecca Shlafer, PhD is an Assistant Professor in the Department of Pediatrics (Division of General Pediatrics and Adolescent Health) at the University of Minnesota. She received her PhD in child psychology from the Institute of Child Development at the University of Minnesota. Her research focuses on understanding the developmental outcomes of children and families with multiple risk factors. She is particularly interested in children with parents in prison, as well as the programs and policies that impact families affected by incarceration.  In addition to her academic work, Dr. Shlafer also volunteers as a guardian ad litem.

Image source: Flickr user Crawford Learmonth on Flickr, under Creative Commons

Copyright 2015 American Psychological Association


Filed under: Health and Wellness, Human Rights and Social Justice, Public Policy, Women and Girls Tagged: incarceration, public policy, women's health