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'violence against women' Options
srkdr68
Posted: Friday, August 12, 2011 12:36:39 PM
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August 10, 2011 — Women who experience gender-based violence (GBV), such as rape, sexual assault, intimate partner violence, and stalking, have a higher prevalence of mental health disorders, dysfunction, and disability, according to new research published in the August 3 issue of the Journal of the American Medical Association

Violence against women is a major public health concern.
In the United States 17% of women report rape or attempted rape, and more than one-fifth say they have been the victims of intimate partner violence, stalking, or both, the study authors, led by Susan Rees, PhD, of the University of New South Wales, Sydney, Australia.

From Medscape Medical News
Violence Against Women a 'Public Health Disaster'
Fran Lowry

Jyrkkä Jätkä
Posted: Friday, August 12, 2011 1:29:33 PM

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How is it in India?
Any studies, srkdr?
intelfam
Posted: Friday, August 12, 2011 2:34:18 PM
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The article was about research in Australia, and quotes the figures that srkdr68gives.

The article gives the results for Australia as::

"They found that over their lifetimes, 1218 women (27.4%) experienced at least 1 type of GBV, the prevalence of each type being as follows: sexual assault, 14.7%; stalking, 10.0%; rape, 8.1%; and intimate partner violence, 7.8%.

The median age of the first occurrence of rape was 13 years; of sexual assault, 12 years; of intimate partner violence, 22 years; and of stalking, 22 years."

For some reason, I can't table it as a comparison, but it still adds up to a big issue. It would be interesting to have some figures from other areas of the world. I'd like to see if the issue is a feature of all societies.
Geeman
Posted: Friday, August 12, 2011 3:41:50 PM

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srkdr68 wrote:

In the United States 17% of women report rape or attempted rape, and more than one-fifth say they have been the victims of intimate partner violence, stalking, or both, the study authors, led by Susan Rees, PhD, of the University of New South Wales, Sydney, Australia.

I don't mean to trivialize the issue, but I don't think "attempted rape" and "stalking" should really count as healthcare concerns in a particularly serious way. There's no "attempted cancer" or being followed home by germs.

I can see the health effects of actual violence as legit to an extent. Victims of sexual violence are hospitalized or can (hopefully) get medical treatment, but I think they are being over-emphasized as medical health issues, and putting them in that light is a rather broad recasting. Shouldn't the thousands killed and injured in traffic accidents, and the stress of rush hour qualify as health care concerns if we're making sexual assault a health care concern? Folks involved in such accidents also visit the hospital.... Aren't the stresses caused by tax audits, the debt crisis, bullying, etc. all similar in actual health care costs and effects if put into this context?

Making sexual violence a health care issue is like equating the Holocaust with an epidemic, or the Vietnam War with alcoholism. Yes, there's a crossover between the concepts in the broad terms of human suffering and loss of life, but changing the perspective so drastically fundamentally misses the point.

Sexual violence is certainly a problem, but I don't think the issue is particularly well addressed by calling it a health care issue.
jmacann
Posted: Saturday, August 13, 2011 4:54:45 AM
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Let's say it is -in the sense that it deals with a main mental health care issue, indeed.
tootsie
Posted: Saturday, August 13, 2011 10:59:04 AM

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Geeman wrote:
srkdr68 wrote:

In the United States 17% of women report rape or attempted rape, and more than one-fifth say they have been the victims of intimate partner violence, stalking, or both, the study authors, led by Susan Rees, PhD, of the University of New South Wales, Sydney, Australia.

[quote]"I don't mean to trivialize the issue, but I don't think "attempted rape" and "stalking" should really count as healthcare concerns in a particularly serious way. There's no "attempted cancer" or being followed home by germs."

you have done just that. The healthcare of the victim first and the perpetrator second should both be looked at as a health issue and a criminal issue as well.
Jyrkkä Jätkä
Posted: Saturday, August 13, 2011 5:31:54 PM

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May I bet srkdr will never get back to this thread again to give any opinion.
Geeman
Posted: Saturday, August 13, 2011 7:58:39 PM

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tootsie wrote:
Geeman wrote:
srkdr68 wrote:

In the United States 17% of women report rape or attempted rape, and more than one-fifth say they have been the victims of intimate partner violence, stalking, or both, the study authors, led by Susan Rees, PhD, of the University of New South Wales, Sydney, Australia.

[quote]"I don't mean to trivialize the issue, but I don't think "attempted rape" and "stalking" should really count as healthcare concerns in a particularly serious way. There's no "attempted cancer" or being followed home by germs."

you have done just that. The healthcare of the victim first and the perpetrator second should both be looked at as a health issue and a criminal issue as well.

Well, OK. First off, you don't get to say it's both health care AND criminal in order to refute my argument that it's not really just a health care issue. If it's a criminal issue then casting it as a health care issue doesn't add up in the first place.

Secondly, since you see this as a health care issue, let me ask this: How are you going to use the health care system to address the issue? What medicine are you going to proscribe to eliminate stalking? How are you going to treat incidents of attempted rape? In short, what is the benefit of casting the situation as a health care issue?

Casting this issue as a health care problem does more to obscure the situation than it does to enlighten anyone. Might it be that people react as emotionally and illogically as you have done that allows that to occur? Might that reaction be one of the contributing factors to the continuation of the problem in its current form? Might your response be part of the problem? Might you be as guilty of misleading people as those who are trying to cash in on the victims by casting the situation as a health care problem? Might you be, in fact, tacitly aiding them in their efforts?
abcxyz
Posted: Saturday, August 13, 2011 10:28:16 PM
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I think by health issue tootsie means 'mental health issue' and not 'healthcare issue'?

Quote:
Women who experience gender-based violence (GBV), such as rape, sexual assault, intimate partner violence, and stalking, have a higher prevalence of mental health disorders, dysfunction, and disability, according to new research published in the August 3 issue of the Journal of the American Medical Association


So, if violence against women is prevalent, that raises concerns about the mental health of the victims (and the abusers) who are a considerable statistical percentage.
Romany
Posted: Sunday, August 14, 2011 3:57:05 AM
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Geeman -

GBH (Grievous Bodily Harm) is both a health and crime issue:- trauma centres in public hospitals on a Saturday night attest to this!

I wonder if you are not taking rather a dismissive view of what, exactly, is entailed in both attempted rape and stalking?

I know we have quite a few people on the forum who are in the medical profession who could perhaps go into more detail but attempted rape often happens after adminstration of the so-called "date rape" drugs; upon people who have been rendered unconscious due to blows to the head; and to under-age people;. In all cases - especially where such occasions are the first introduction to sexuality, the mental health repucussions last a life-time.

While "attempted" rape means no actual penetration of the vagina/anus took place, lesions, bruising and serious injury often occurs to the genital area, upper thighs, hands, mouth and breasts. Rape - whether "successful" or not, by its very nature, involves coersion. Physical violence is used as a means of subdual. Instruments and weapons, not just bare hands, are often employed.

In marital or familial situations coersion often takes the form of threats of bodily harm not just to the recipient, but to their children, parents or other loved ones.

In either situation health care is most definitely a factor to consider with regard to the cost to the community of this form of violence as much as any other. The mental health of those who have experienced such violations is often seriously affected not just in the short term but also in the long term. This is also a health care issue.

Stalking is frightening. Indeed the terror experienced by having unseen eyes watching you; phone calls in the small hours of the morning; your every move being tracked, no matter how often you try to vary routines, time-tables, work-schedules, is enough to destroy all feelings of having control over oneself or life; losing all power; feeling threatened 24/7 - even in sleep. If one can sleep. Coupled with the hollow-legged fear of what the outcome could be this stress is enough to send anyone round the bend. Another health care issue.

Mental health and physical health are two sides of the same coin: they do not exist in isolation. Mental health concerns can, and often do, result in self-harming, suicide, violence towards others, random and/or premeditated acts of violence. A person who has been attacked, villified, battered and injured (though not technically penetrated)and who then attempts to take their own life, or lashes out at someone else. Can we possibly wrap that up in a little package labelled mental health and seperate it from "Healthcare?"

The person who got drunk because they are mentally unstable and who then went out and wiped out 6 pedestrians. Mental Health? Physical health?

The family in which the parent batters their own children because of unresolved issues in their own life. Mental Health? Physical health?

The hypochrondiac whose high cost of care is attributable to the fact that they were attacked and molested, perhaps as a college student. Mental Health? Physical health?

Other issues e.g. traffic accidents - are ceaselessly being monitored, resulting in the implementation of more education, introduction of different safety factors; the imposition of new rules; and consumer awareness.

However, other forms of violence such as those in the OP have not been taken into account by many and, historically, their cost has not been counted. I expect the article in the OP was written to bring this fact to the attention of those who were not aware of it.

kitten
Posted: Sunday, August 14, 2011 4:38:41 AM
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It took me all day to decide to post on this thread and then I decided it was to personal.

So I shall say that I do strongly believe that it is important for anyone who has experienced any of the above to seek medical attention.

The mind is very powerful and it chooses at times to bury things in order for a person to function but what is buried does eventually come out in different ways.


peace out, >^,,^<
Geeman
Posted: Sunday, August 14, 2011 3:23:42 PM

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OK, let me explain the problem with casting things like sexual assualt and stalking as health care concerns, and why the folks responding on a gut, emotional level are, in fact, part of the problem.

First, yes, there are medical and mental health aspects of the problem. I AM NOT saying that people should not seek help once they have experienced some sort of criminal violence or threatening behavior, nor am I saying that kind of treatment should be unavailable.

I'm going to say that again, because I think a lot of people are missing that fundamental reality here and are responding on an emotional level: We absolutely must have a system of medical care in place to deal with this situation. No system of prevention is perfect, and we should be prepared to deal with the issue.

However, consider for a moment what the source of this discussion is. The problem from a medical standpoint, the source of the facts would indicate, is that we are spending so enough money on the health care side of issue that some folks are now attempting to recast the problem itself as a health care issue. Health care services are available to people who have been victimized. People aren't turned away from emergency rooms if they've been assaulted.

One could argue that there is more money needed in particular areas. Perhaps there should be more spent on the psychological aspects of the problem. Maybe the forensic evidence gathering in one place or another isn't sufficient. Perhaps there are new techniques or medicines that could be employed. Specific concerns that could be used in the medical aspect of the situation are perfectly legitimate.

None of those arguments are being made here. Instead, what's being suggested is that the issue is itself not a criminal one, but a medical one. Why would someone emphasize that aspect rather than the one that is obvious and standard? What is the function of turning attention away from prevention and into treatment when there already is a lot of effort put into treatment? The reason is so that people will react emotionally and put MORE attention into treatment than prevention. So, instead of doing something like educating people about how to avoid areas where assaults are taking place by spending some money publicizing crime watch statistics, the emotionally inspired reaction leads them to spend that same money on awareness of treatment options. The result? People who could have avoided a sexual assault in the first place become victims of sexual assault... but at least they know where to go for treatment.

Wouldn't it be more intelligent to put some effort into preventing assaults in the first place? If health care is already available then the answer isn't health care. Recasting the issue as a health care concern leads people to thinking they should spend MORE money on health care instead of more money on things like police officers. Instead of funding a new counsellor, what if one hired a new DA dedicated to prosecuting stalkers, or spent money on legislation that better addressed stalking to begin with?

Fundamentally recasting the situation as a health care concern rather than a criminal one leads to the kind of thinking that prevents not one sexual assault. Rather than spend time, money and effort doing things like lighting areas where safety is a concern, the argument that sex crimes are a health care concern leads to spending money on post-crime treatment. (I'm getting a little repititious here, but I really think the point needs to be hammered home since some folks are so emotionally invested.)

Emphasizing treatment over prevention does not make sense. Isn't it more reasonable to prevent the sexual assault in the first place than to treat it after the fact? Well, that's exactly the opposite of what recasting sexual assault as a health care issue does.

Let me continue the traffic accidents as health care issue analogy. If we were to cast traffic accidents as health care then we'd do things like spend more money on rehabilitation for those who are involved in traffic accidents. So, instead of spending a few thousand dollars putting a traffic light on a dangerous corner, those who look at the people injured there would rather spend money on their medical costs. What's more the traffic issue that led to the problem to begin with is still there. But the next person who crashes there will, at least, be covered by the additional money spent on rehab.
kitten
Posted: Sunday, August 14, 2011 4:10:36 PM
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Silenced Still watching and keeping mouth shut. Brick wall


>^,,^<
GeorgeV
Posted: Sunday, August 14, 2011 5:46:27 PM
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Geeman - I think stopping potential perpetrators is more problematic, than installing traffic lights at dangerous intersections. Two days ago I wanted to post the following in the P&R section as "Is he a Christian, when did he cease to be one, will he be one again?" (having remembered the turn of discussion on the formerly nice Norwegian). I find this the opportunity to post, even thought it does not concern women.
I just doubt that putting more lighting in dark alleys would have prevented this unlikely perpetrator from going about his business. Perhaps going from house to house and testing every individual for latent perversion would do the trick, but at what cost? (Not to mention the public outcry.)
http://www.torontosun.com/2011/08/04/torture-photos-on-ex-bishops-computer-court-hears
Romany
Posted: Sunday, August 14, 2011 11:41:01 PM
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Geeman - ok. I understand the point you are making better now, but I still differ in my opinion.

I know nothing about health care systems overall in any country other than Australia - as it was there I became involved. Funding is tight. (Well, that's putting it mildly.) Certain amounts are earmarked directly to certain areas. "Women's health", in Australia at least, has attracted more funding since campaigns against breast (and ovarian) cancer were put in place.

With Maternity being a seperate sector however, "Women's Health" (and believe me, I've had many discussions on the distinctions - both fiscal and community-wise - contained is "Men's" and "Women's" seperate appropriation!) is a very neglected segment. Currently, things like vaginal and anal reconstruction for women - whether it is cosmetic or necessary as a result of trauma or not (And this is where 'attempted' and not just 'successful' rape come into it.) are all lumped together under 'elective surgery'. Most health care plans won't pay out. And woe-betide those thousands of women who have NO health care plan.

Not being a medical doctor, my experience came from being appointed as liason between patients and staff in the psychiatric ward of a large hospital. During all the time I was involved, there was not one female on those wards who had not undergone trauma as a result of gendered violence. However, many were clawing on desperately to stay there because of funding issues.

My own position I took on as a voluntary one, even though at that time niether my own children nor I were managing to exist above the poverty line. Also as a result of violence towards women. Well, one specific woman, in this case. I could have done with a salary but the money just wasn't there in the system.

So, while casting this as a HealthCare issue might attract all the objective points you put forward, I can only welcome it. It is desperately needed.

Sure. I agree wholeheartedly that the ideal solution is to prevent it altogether. In the best of all possible worlds that would be where all our energies should go. But national pride notwithstanding, I don't think there are many of us that could claim we are residents in the best of all possible worlds. It just isn't working.

The whole question of violence towards women is complex, far-reaching and involves many different disciplines. Money is poured into prevention: in Australia one of the forms that takes is of highly in-yer-face t.v. advertising that costs millions and has raised an entire -and growing - backlash section of disaffected men who are gaining ground in casting any preventative campaign as sexist... and shutting them down.

But women and young girls are still daily - hourly? - in need of treatment. My personal take is that anything - anything at all - that will allow these women to access the care and help they need is desperately needed. If getting funding through this manner will do it, I'm for it. Its unfortunate. It's not right. It seems like tacit agreement, perhaps to some. But it is what it is.
intelfam
Posted: Wednesday, August 17, 2011 5:55:48 AM
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I think Geeman has a point, if one reads the article in the context of TFD, where one might use these statistics as an argument for more health care for victims. But the article was written by health care providers for health care providers and researched for a health care grant and published in a health care journal.

In that context, the reader is reading a journal in order to gain information so that they can do their job better. I read it as a health care professional. What it said to me was that, as I go about my job and meet victims of gender based violence (and there are male victims of violence as well as female), I should be more aware of the potential outcomes of these incidents than maybe I was before. Made a note in my head. "Check out the follow up policies in this casualty ward"; "When I'm in the GP surgery, have a look at the cases of anxiety, depression, and see if they might be better approached, if violence has featured, as cases of PTSD".
No, as Geeman said, this is not just a case of health care - for society at large. But my job is to deal with my little world and change what I can. Note that I say "My job is...." and in that context, the only thing I can change directly, is how victims are treated. Outside of my day job, maybe I should write an article to the wider professional journals pointing up exactly Geeman's point, why are we throwing so much money at treatment, and not spending at least some on the education of kids about violence and empathy. There are some excellent packages produced in the US that have been proven to reduce violence and bullying - which is where sexual crime fits snugly.
In the wider context, there is room for debate and maybe policy changes. And I firmly believe that, in society at large, this is an elephant in the room.

srirr
Posted: Wednesday, August 17, 2011 6:54:06 AM

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Jyrkkä Jätkä wrote:
May I bet srkdr will never get back to this thread again to give any opinion.


You win! Applause

The text in OP's post is taken from Medscape Today's article. For complete article click here.
However the link only directs you to the report by Medscape. The actual and original report by Dr Susan Rees of Australia was published in The Journal of the American Medical Association JAMA August 3, 2011 edition. To read this, you need to subscribe.
Romany
Posted: Friday, August 19, 2011 3:03:50 AM
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Intel - well, as I said, I was referring to Australia and there is, there, recognition that funding for preventative campaigns would be money better spent than money poured into patching up victims.

However, as I briefly mentioned, this has backfired somewhat.

While I agree that victims of gendered violence are not only female, the OP concerned violence against women. All campaigns to address this subject in Australia have resulted in such an outcry from Disaffected Dads et. al., that the entire media campaign has ground to a halt. In fact this particular sector in Australia has been gaining ground rapidly in recent years - the more the subject of violence against women is highlighted, the more the DDs rally against it.

Which is why my post above, in reference to Oz, at least, reflected the idea that if funding were to be chanelled through an alternative source it could only be advantageous. (Softley, softley catchey monkey?)
intelfam
Posted: Friday, August 19, 2011 7:12:42 AM
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Sorry Romany if you thought my post was somehow in response to yours. I was trying, really, only to set the article in context having read Geeman's post - but only skimmed some of the others.

I have no experience of Australia and it's DDs. And my mention of violence against males was an aside as, in my professional role, I saw a large number - but in a very specific "class" of patients, so I wouldn't generalise. There is a bit of a backlash here against some of the service design as well, some folk can't see it as "both" - but that any attempt to put in a service gives rise to a "what about us" response. Unfortunately some of the media coverage has, I think, been seen to demonise all men, somewhat like the child abuse publicity. This is unfortunate.


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