The Intersecting Roles of Violence, Gender, and Substance Use in the Emergency Department: A Research Agenda

Abstract

The relationship between gender, violence, and substance use in the emergency department (ED) is complex. This paper examines the role of gender in the intersection of substance use and three types of violence: peer violence, intimate partner violence, and firearm violence. Current approaches to treatment of substance abuse and violence are similar across both genders; however, as patterns of violence and substance abuse differ by gender, interventions may be more effective if they are designed with a specific gender focus.

Gender differences in lifetime psychiatric and substance use disorders among people who use substances in Barcelona, Spain

“…Potential explanations for these gender differences have include that women who use substances have often (Afifi et al, 2012;Choo et al, 2014;Verona et al, 2015;Gilchrist et al, 2015) which may contribute to the higher prevalence of mood and anxiety disorders.…”

Gender-specific Research on Mental Illness in the Emergency Department: Current Knowledge and Future Directions

“…93 The majority of adolescent and adult women seeking care after peer violence injuries have psychiatric issues, including substance use and abuse. 94,95 Females’ mental health after violent injuries may differ from that of males. 70,71,96 …”

Relationship of Physical Intimate Partner Violence with Mental Health Diagnoses in the Nationwide Emergency Department Sample

“…45 Despite the JCAHO mandate, less than half of US EDs report having policies and procedures in place for IPV screening, and even fewer EDs regularly ask about mental health problems in women identified as IPV victims. 40,45,78 A bidirectional association 31 has been previously suggested between IPV history and costly mental health problems 45 such as symptoms of depression, 79-81 PTSD, 82,83 suicidality, [84][85][86] and substance abuse. [87][88][89] In a recent study of women enrolled in the Group Health Cooperative, IPV exposure was specifically linked to excessive utilization of mental health services.…”

“…Although both sexes are involved in IPV and experience IPV-related health outcomes, 31,32 researchers have traditionally focused on physical and nonphysical forms of violence perpetrated by a male partner against a female victim. 1,33 In the general population, lifetime prevalence of IPV against women has been estimated at 22%, 3,[34][35][36] with physical violence affecting 17%-34% and nonphysical violence affecting 12%-35% of women.…”

“…40 According to the US Preventive Services Task Force (USPSTF), high-quality evidence supporting IPV screening in primary care and EDs as a safe and effective strategy for the prevention of IPV and its associated health outcomes remains inconclusive 40,49 with recently conducted intervention trials yielding inconsistent findings. While the USPSTF and other organizations have recommended screening of reproductive aged women for IPV in various healthcare settings, 31 the Joint Commission on Accreditation of Healthcare Organizations ( JCAHO) requires all EDs to have policies and procedures in place for IPV screening and patients who disclose IPV can be treated or referred to services, which address healthcare needs associated with IPV. 45 Despite the JCAHO mandate, less than half of US EDs report having policies and procedures in place for IPV screening, and even fewer EDs regularly ask about mental health problems in women identified as IPV victims.…”