According to the Brain Injury Association of America, approximately 67% of women who experience domestic violence also have symptoms of traumatic brain injury. It is important that programs screen for TBI and also encourage law enforcement and healthcare partners to do the same.

Our Senior Program Director, Abeer Monem shares below facts about traumatic brain injury:

TBI as a result of head injury(ies) and/or strangulation, suffered at the hands of the perpetrator, can be mild to severe and cause many detrimental effects that impede the pursuit of safety and economic stability. Examples of the devastating cognitive effects of TBI that would clearly be impediments to obtaining and/or maintaining employment and, thus, economic stability, are as follows:

– Decreased concentration, attention span

– Difficulties with executive functioning (goal setting, self monitoring, planning, ability to solve problems, learn and organizing tasks)

– Memory loss

– Difficulty displaying appropriate emotional/communication responses

– May appear disorganized and impulsive

– Difficulty spelling, writing, and reading

– Difficulty understanding written or spoken communication

– Difficulty feeling initiative, sustaining motivation

– Depression

There are also behavioral and physical effects that include:

– Changes in behavior, personality or temperament

– Increased aggression and/or anxiety

– Decreased or increased inhibitions

– Quickly agitated or saddened

– Changes in emotional expression (flat, non-emotional, inappropriate or overreactions)

– Avoidance of people, family, friends

– Difficulty sleeping

– Increased irritability or impatience

– Hearing loss

– Headaches, neck pain

– Nausea and vomiting

– Changes in vision

– Ringing or buzzing in ears

– Dizziness, difficulty balancing

– Decrease in, or loss of, smell or taste

– Decreased coordination

– Loss of bowel or bladder control

– Increased sensitivity to noise or bright lights

– Seizures

– Weakness or numbness

A woman with a TBI who enters the criminal justice or family law system may face additional challenges. She may appear to be disorganized, aggressive, temperamental or confused. If her behaviors are misunderstood or misdiagnosed as indicating a mental health disability, which often happens, she may have difficulty obtaining custody or being credible as a victim or reliable witness.

Maricopa County, Arizona (Phoenix area) has paved the way for our county to incorporate their innovative approach to Harris county’s law enforcement response to an IPV incident.

· Officers and detectives do not limit testing to strangulation or sexual assault cases but offer ConQVerge Near Point Convergence (NPC) testing to all IPV victims reporting head trauma.

· Social workers and advocates assumed a larger role in testing and guiding victims through the process.

· Concussion information will be given out at the scene by nurses, officers, advocates an social workers as a part of an awareness campaign on the dangers of TBI for IPV survivors.

Why can’t we do something similar in Harris County? What are the possibilities that can be reality and really address the impact of IPV in Harris County?

• Add TBI screen questions Strangulation supplement that officers already complete?

• Establish concussion protocol when law enforcement responds to an IPV incident? Use advocates or forensic nurses to conduct the concussion protocol?

• Develop neurofeedback program – the only evidence-based treatment option – for our survivors to give them a chance to truly recover from the debilitating impact of head trauma?

• Develop a coordinated care system so no matter where the touch point for a survivor is, they receive the care they need after head trauma resulting from IPV?

For more information, please contact Abeer Monem.