Domestic violence and intimate partner violence occur in many forms, and unfortunately, can often escalate from emotional and verbal abuse to physical and sexual abuse. The National Domestic Violence Hotline has added cyber abuse to the types of controlling behavior used to isolate and persecute people experiencing domestic violence. They include a thorough description of what constitutes cyber abuse in the “ Abuse Defined ” section of their website. All forms of intimate partner violence and domestic violence involve one partner dominating and controlling another.
Citing statistics gathered in the CDC’s 2010 report, this section of “ The National Intimate Partner and Sexual Violence Survey ” from the National Coalition Against Domestic Violence identifies the scope of the problem:
· On average, nearly 20 people per minute are physically abused by an intimate partner in the United States. During one year, this equates to more than 10 million women and men.
· 1 in 3 women and 1 in 4 men have been the victim of some form of physical violence by an intimate partner within their lifetime.
· 1 in 5 women and 1 in 7 men have been the victim of severe physical violence by an intimate partner in their lifetime.
· 1 in 7 women and 1 in 18 men have been stalked by an intimate partner during their lifetime to the point they felt very fearful or believed that they or someone close to them would be harmed or killed. 1
With so many people affected by this national health crisis, most people reading this article most likely know someone who has been affected by this type of violence, whether they have chosen to reveal it or not.
In 2015 the National Network to End Domestic Violence conducted a 24-hour survey of services provided in each state. In Pennsylvania, in that single day, “1,332 domestic violence victims (697 children and 635 adults) found refuge in emergency shelters or transitional housing provided by local domestic violence programs.” Additionally, “1,268 adults and children received non-residential assistance and services, including counseling, legal advocacy, and children’s support groups.” The survey also revealed 748 hotline calls were answered in a single 24-hour period.
Here in Mercer County, Aware , the local domestic violence agency and rape crisis center, provides a hotline (888-981-1457) for “information, referrals and a sympathetic ear.” Sexual assault response teams are available 24/7, as are emergency response advocates who “can transport women and children to emergency housing throughout Mercer County” when called to “local emergency rooms, police stations, or other safe spaces.” Devoted to providing “a structured program of advocacy, support groups, education, and support” to help “victims develop skills to break the bonds with violence,” Aware’s services also include individual and legal advocacy, youth services, support groups, elder victim advocacy, and the PAWS program, which provides shelter for the pets of those leaving abusive situations. For a complete list of their programs visit their website at www.merceraware.org .
The magnitude of domestic violence extends far beyond what happens in any single moment. Short and long term health consequences for those experiencing abuse, living in abusive households, and surviving abuse are complex and often difficult to identify. In her October 17, 2016 blog post for the US Dept. of Health and Human Services , Mary Smith, Principal Deputy Director, Indian Health Service, notes that, in general, intimate partner violence has been:
…correlated with an increased risk of heart disease, asthma, chronic pain syndromes, gastrointestinal disorders, sexually transmitted infections, gynecological and pregnancy complications. There are emotional and psychological consequences such as depression, anxiety, eating disorders and post-traumatic stress disorder. Adverse health behaviors associated with IPV [intimate partner violence] include high-risk sexual activity, alcohol and substance use and an increased risk for suicide.
The highest rates of IPV occur in women of childbearing age, but early screening and detection of IPV along with appropriate intervention may increase the safety of these women. The impact on children exposed to IPV has wide implications including increased risk for physical, sexual, emotional neglect, harm and death.
With so many physical, emotional, and behavioral consequences facing individuals and their family members when dealing with intimate partner violence, it can be difficult to identify a potentially abusive relationship. The National Domestic Violence Hotline (NDVH) notes that “many abusive partners may seem absolutely perfect in the early stages of a relationship. Possessive and controlling behaviors don’t always appear overnight, but rather emerge and intensify as the relationship grows.” They also caution that “Domestic violence doesn’t look the same in every relationship because every relationship is different. But one thing most abusive relationships have in common is that the abusive partner does many different kinds of things to have more power and control over their partners.”
The NDVH highlights the following categories of abusive and controlling behavior:
· Physical abuse
· Emotional abuse (including verbal abuse)
· Sexual abuse and coercion
· Reproductive coercion
· Financial abuse
· Digital abuse
Abusive behavior escalates over time, or as the controlling partner feels more secure in the relationship. Markers of security can include increased intimacy while dating, sharing living space, marriage, or the birth of a child, with each marker making it more difficult for the person being abused to complain or leave the relationship. Yet, each case is different, and people experiencing abuse may never be able to pinpoint when or how it started. Additionally, the emotional and verbal abuse which often start such a cycle are designed to confuse and isolate, decreasing people’s self-confidence, their contacts with others, and their ability to recognize the verbal and emotional tactics being used against them.
People in doubt about their relationships can consider safely reaching out in confidence to a doctor, counselor, or hotline to discuss their situations. See the list of resources below for local and national hotlines.
Community Counseling Center of Mercer County provides assistance to people to help manage exposure to domestic or intimate partner violence. These services include counseling, mental health management, support groups, youth services, alcohol and addiction recovery services, and referrals to Aware for legal advocacy or to other local support agencies and groups.
People concerned that they may be engaging in abusive behaviors and who are looking to begin a journey toward non-abusive interactions with the people in their lives can also contact CCC for assistance.
LOCAL AND NATIONAL HOTLINES (anonymous and confidential assistance)
Aware: serving Mercer Co., PA sexual assault and domestic violence hotline 1-888-981-1457
The National Domestic Violence Hotline: assistance in over 170 languages 1-800-799-7233 or 1-800-787-3224 (TTY)
RAINN: national hotline for sexual assault 1-800-656-4673
Abuse defined (n.d.) Found in The national domestic violence hotline. Retrieved from
Aware. [pamphlet]. (n.d.)
Aware. (n.d.) Retrieved from www.merceraware.org
Domestic violence counts: A 24-Hour census of domestic violence shelters and
services, pennsylvania. (2015) Found in National network to end domestic violence. Retrieved from http://nnedv.org/downloads/Census/DVCounts2015/Pennsylvania.pdf
National statistics. (n.d.) Found in The national coalition against domestic violence.
Retrieved from http://ncadv.org/learn-more/statistics
Smith, Mary. (2016, October 17) October is domestic violence awareness month.Retrieved from https://www.hhs.gov/blog/2016/10/17/october-is-domestic-violence-awareness-month.html
Any recovery journey is one of learning – not only about facts, appropriate medications and their management, and therapeutic methods, but also about a person’s own needs and strengths. A key element in recovery is support, whether from peers or from trained observers.
According to Pennsylvania Recovery and Resiliency , “Peer Support Services (PSS) are . . . conducted by self-identified current or former consumers of behavioral health services who are trained and certified to offer support and assistance in helping others in their recovery and community-integration process. Peer support is intended to inspire hope in individuals that recovery is not only possible, but probable.”
At Community Counseling Center (CCC), Peer Support Services are open to those who have a qualifying serious mental illness diagnosis that is severe and persistent, and who are referred to the program by a qualified doctor, nurse practitioner, physician’s assistant or psychologist.
Building strong ties to the community is a fundamental part of a recovery journey, and yet obtaining clinical assistance and acquiring a clear plan of treatment – including an accurate diagnosis – can also cause a person to feel separated and different from those around them. This is true even of their own family members, who may or may not be a part of a person’s recovery journey. Each person’s experiences and life histories create both strengths that can be used in recovery, and barriers to be overcome or managed. Each person must find their time to combat the stigmas regarding mental health that exist in our society.
Yet any steps to engage in stamping out stigma and moving toward advocacy must be made in a way that supports the recovery journey, without threatening it during vulnerable moments. Peer support specialists can provide safe discussions about ways to disclose, when to disclose, and how to determine which people to offer the chance to share a recovery journey, while encouraging a peer to discuss such issues with their mental health provider. They can provide information and perspectives on good and bad experiences, and act as a sounding board for processing the feedback a person receives. One peer support specialist at CCC noted that her role involves “going out and embracing other peers with non-judgment, and helping them be in the community and function in the community.”
Trying to maintain or regain ties to the community without access to others who have or are making a recovery journey can increase isolation, worsen symptoms, or stall progress in various stages. Working through a long period without change can be as difficult as managing periods of ups and downs in progress. Being able to work with someone who can help you set wellness goals, and even meet you out in the community to accompany you as a companion, friend, and advocate as you try to accomplish those goals, can help maintain hope, resiliency, and the recognition of forward progress on the path to recovery.
According to an article in Mental Health America , “Peer specialists model recovery, teach skills and offer supports to help people experiencing mental health challenges lead meaningful lives in the community. Peer specialists promote recovery; enhance hope and social networking through role modeling and activation; and supplement existing treatment with education, empowerment, and aid in system navigation.” This is not limited to navigating the health care system. Several peer support specialists from CCC said they provide support and assistance to clients by putting them in contact with other agencies that may help with housing or household needs, by working with them as they complete forms for food stamps, energy assistance programs, and employment services. One noted that many people don’t know what may be available to them, and that “you can’t recover if your basic needs aren’t being met.”
The needs of those accessing peer support services reach into the full range of the choices for wellness. Activities for meeting wellness goals have included things as wide ranging as helping a peer bathe a dog, helping put up or take down a Christmas tree, meeting peers at libraries or at a community event to meet social wellness goals, meeting at the park to help with fitness goals, and accompanying peers to meetings with doctors or medical care givers as an emotional support, as well as having discussions prior to such meetings to help peers outline goals, questions, and needs for the meeting. Peer support specialists can also assist those learning to manage public transportation if needed.
In her article “ Peer Specialists are Not Clinicians ,” Patricia Deegan notes that the relationship between peers and peer support specialists includes a focus on “learning together rather than assessing or prescribing help.” The whole interaction is guided by the goals of the peer. Asking good questions, actively listening to the peer, and reinforcing the ideas a client has about those goals are all part of a peer specialist’s role. Knowing when to advise a peer to ask a clinician or a doctor a specific question, or for help in determining positive, realistic goals is also part of the job.
Pennsylvania Recovery and Resiliency notes that peer support services are “designed to promote empowerment, self-determination, understanding, coping skills, and resiliency through mentoring and service coordination supports that allow individuals with severe and persistent mental illness and co-occurring disorders to achieve personal wellness and cope with the stressors and barriers encountered when recovering.” Additionally, “Peer support is designed on the principles of consumer choice and the active involvement of persons in their own recovery process. Peer support practice is guided by the belief that people . . . need opportunities to identify and choose for themselves their desired roles with regard to living, learning, working and social interaction in the community.”
While the scope of a peer support specialist’s role can be far reaching, it is guided by goals set out by the peer and is designed to help support the peer’s growing independence. CCC’s peer support specialists complete 75 hours of training prior to certification, and are responsible for meeting continuing education goals throughout the year. One noted that setting and modeling appropriate boundaries is challenging because their goal is to encourage the patient, not to do things or to speak for them.
Specialists provide support, encouragement, shared experiences, and true compassion and empathy. One specialist at CCC noted that with a peer support specialist “you have someone who can say they really get it. But you [the peer] have to be in the place when you’re ready to work.” Another noted, “We’ve been where you are.”
Peer support services differ from traditional mental health services in some basic ways. It is a self-referring program focused on equality among participants (both peers and peer support specialists). The program provides a non-judgmental atmosphere, and the informality of the interaction between peers and peer support specialists avoids the artificial barriers such as those between “consumers” and “professionals.” Some of the program goals include individual choice in recovery, personal wellness or being as healthy as a person can be, self-advocacy, making friends that can be counted on, dealing with the stressors of finding and keeping a job, increasing self-esteem, and contacting community resources.
If you are interested in joining the community of peers, have your mental or behavioral healthcare provider or other doctor or qualifying medical provider refer you to the Community Counseling Center’s Peer Support Services program.
If you are interested in become a peer support specialist as you continue on your recovery journey, contact Susan Pozner at Community Counseling Center of Mercer County at 724-981-7141 or toll free at 866-853-7758 and TTY: at 724-981-4327. For more information about Community Counseling Center of Mercer County visit our website or our Facebook page .
“Defining Peer Support.” (n.d.) Pennsylvania Recovery and Resiliency. Retrieved from http://184.108.40.206/parecovery/services_peer.shtml#psi
Deegan, Patricia E., Ph.D. (21 June, 2017) “Peer Specialists are Not Clinicians.” PDA Blog. Retrieved from https://www.patdeegan.com/blog/posts/peer-specialists-are-not-clinicians
Interviews with Peer Support Specialists. (2 October, 2017) Community Counseling Center.
“Peer Specialists.” (n.d.) Mental Health America. Retrieved from http://www.mentalhealthamerica.net/peer-services
The Light Beneath Their Feet
This film may not necessarily be known by many, but it is perhaps one of the most realistic movies produced in almost documentary genre while it is also quite moving in its flow.
The mental health related flicks may be viewed through four items within the line of their realistic silver screen presentations:
1) Mental health concept and illness
2) Patients with mental health
3) Behavioral Health workers and
4) Behavioral Health settings
This film is successful in achieving realistic presentation of all these four items.
The story is simple enough that it may remind the patients and therapists of their own lives related to taking care of a person who has a mentally illness.
The leading characters consist of a mother and her daughter.
The mother is a patient with bipolar disorder. Provided she takes her medication regularly and visits her psychiatrist frequently, she appears to be maintaining the non-psychotic status, even productive when employed by the settings that would not be expecting her to engage in complex tasks.
Unfortunately, like some if not many patients with bipolar disorder, she does not want to continue taking her medication regularly. She chooses to stop taking it and then becomes psychotic which leads to her hospitalization.
Her daughter is a high school senior and a very good student who had been making plans to apply for her dream university. It would be a higher educational setting far away as long as her desired outcomes would be workable. She would need to be accepted by the university and find someone to take care of her mother in her absence. They do not have other family members and friends are reluctant to get involved in her mother’s prospective care as they do not know how to handle an individual with behavioral disturbances.
Therefore the movie displays two people struggling with their own situations while dearly loving each other. The mom struggled with endless manic and depressive episodes and the daughter struggled with the decision to go for her education or not to go and stay at home and take care of her mother.
I will take liberty to state a few things regarding the ending, since these will not be spoilers as the movie ends with no outcome! The screenplay leaves the outcome to the audience's discretion as the daughter joins her mom in their room in the last scene. The End. We do not know whether she says goodbye or lets her mom know that she is staying to take care of her.
This is an excellent film for sharing with a respective community with regard to anti-stigma efforts and educating the public about mental health.
This is also an excellent movie for educating behavioral health students, interns and residents along with rehabilitative program and patient groups while stopping the film from time to time and asking what is going on. What would the participants do if they were in the shoes of the mother and daughter? This would generate and maintain a good discussion and debate.
It is a behavioral health gem and a bittersweet mother and daughter relationship presentation. It is relevant for many real patients, their families and therapists who have similar clients.
M. F. Ulus, MD
SHARON — According to the National Institute of Mental Health, approximately 15 percent of women who have recently given birth suffer from postpartum depression.
This year’s Stamp Out Stigma (SOS) at Penn State Shenango will feature a presentation on the subject at its fourth annual SOS event to be held from 12:15 to 1:15 p.m. on Wednesday, Oct. 18, in the Great Hall of Sharon Hall located on Vine Avenue in downtown Sharon.
The event is free and open to the public.
The hour-long program will also include a discussion on why health and fitness are vital to a person’s mental well-being led by Penn State Shenango Counselor Tony Paglia, as well as a special message on love and unity in the face of the horrible tragedies that have recently occurred in our country by Jack Luchette, a Penn State alumnus and the lead organizer of the annual event.
“At Penn State Shenango, we approach student health from a holistic perspective, and we seek to serve students with programming and resources that will promote their health in the areas of mind, body, and spirit,” Paglia said. “This semester, we are excited to offer our students on-campus yoga classes with instructor Debbie Harrington. We believe that by reducing stigma and encouraging our students to take better care of their physical and mental health, they will be more successful in meeting their academic and personal goals.”
The presenters at this year’s SOS event, in addition to Paglia and Luchette, include Community Counseling Center of Mercer County Community Outreach and Development Director Fern Torok, and special guest Penn State Shenango Human Development and Family Studies Lecturer and Licensed Clinical Social Worker Kara Mild, who will be speaking about postpartum depression and the stigma associated with the mood disorder.
“The Community Counseling Center has conducted 97 distinct Stamp Out Stigma presentations with over 117,000 people during the past several years,” Torok said. “We are excited to be part of the Shenango campus’ event again this year.”
For more information, call Paglia at 724-983- 2841.
Gossip has been around since the beginning of man and women. However, a lot of people take gossip way too far in life, which can cause terrible events to unroll onto that person. Looking back, I myself was involved in several horrible rumors and lies. Now for me that did nothing to me, I shrugged them off, laughed, and cheered registering their petty lies useless. This is a mechanism that I have created over time. The same cannot be said about other individuals, the lies can emotionally harm someone especially if the rumor isn’t true. The Gossip Effect explains how and what the effect of gossiping can have on someone. For example, in high school a women or a man could be verbally abused by others daily. They might say something like “You are ugly, how could anyone date you!” this inappropriate comment will spread throughout the school like wild fire aka (Gossip). As it goes through one person it will get told slightly different every single time it is told to a new person it is altered. Eventually the comment previous-ly said could be something like this, “Oh, I heard she is pregnant” or “I heard they do drugs almost every day”. From my point of view, I take all these comments and think, “Hmm, how could someone their age be so childish. Ha-ha.” Laughing is the best medicine, my advice to all of you is laugh at those comments, don’t let them get to you. Now I understand you can take it personally or even get angry and lash out at the accused. STOP, think it over and think of the consequences and then calm down and smile and don’t care about those petty comments. Odds are you want to hurt them or make them experience the same pain as yourself. However, if you really want to hurt them, don’t let those insults get to you. Shrug them off and smile, laugh a few times and walk away from the situation. Thank them for their time and continue your beautiful day, don’t let anything get to you. If you are looking to learn how to just shrug it off then practice in your mind and head, play a scenario over and over again practicing. Let me tell you, you are beautiful and you are awesome regardless of what anyone says. Look into the mirror every morning and smile at yourself and say one good thing about your-self, could be your smile, or your personality. Love yourself, once you accept these facts, those petty gossips will mean nothing. Gossip isn’t just insulting someone, gossip is when someone tells everyone else without your knowledge of it. Keep those private conversations to your-self, it should always be confidential. You are awesome and as long as you keep seeing good traits and staying true to one self.