Sharp uptick in domestic violence during COVID shutdown created ongoing 'shadow pandemic'
Dr. Jay-Sheree Allen is a family medicine physician practicing in central Minnesota and the host of the Millennial Health podcast.
Courtesy of Dr. Jay-Sheree Allen.
At this point, we all know that there are countless effects of the pandemic that started in 2020.
Have you heard of what experts are calling the “shadow pandemic”? It’s the sharp rise in domestic violence that’s taken place all over the country the past few years. And it’s a real safety concern.
Mayo Clinic Family Medicine physician Dr. Jay Sheree-Allen spoke with MPR News host Cathy Wurzer about how she talks to patients who may be dealing with violence at home, red flags, and when to seek help.
Use the audio player above to listen to the full conversation.
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Audio transcript
CATHY WURZER: At this point, we all know that there are countless effects of the pandemic that started in 2020. Have you heard of what experts are calling the shadow pandemic? It's the sharp rise in domestic violence that has taken place all over the country in the past few years. And it's a very real safety concern.
We have Mayo Clinic family physician Dr. Jay-Sheree Allen back with us to talk about how she talks with patients who may be dealing with domestic abuse. So nice to hear your voice. It's been a while. How have you been?
JAY-SHEREE ALLEN: It has been a while. It's so great to be here with you again, Cathy.
CATHY WURZER: Thank you. Thanks for finding the time here. Well, let's begin with the problem. How much has domestic abuse cases gone up since the pandemic started? Do we know?
JAY-SHEREE ALLEN: Yes, we do. We have some numbers. So I think the first thing to understand when we're putting this in context is that domestic violence is often underreported. So as alarming as the numbers are, the magnitude of the problem may actually be even more. But according to the National Commission on COVID-19 and criminal justice, they've seen an increase in up to 8.1% following some of the lockdown orders in 2020.
But there was actually an article in the American Journal of Emergency Medicine showing some global numbers upwards of 25% to 33% increase in domestic violence cases.
CATHY WURZER: Is it because of the lockdowns that people had to-- they were stuck together in a sense?
JAY-SHEREE ALLEN: So we can't say because of the lockdowns, right? I think it had its place. It certainly was needed for public health interventions, but I think there were some unintended consequences. Things like increased financial stressors due to the lockdown, increased childcare burdens which we've spoken about. And this has been very well documented too, child care burdens.
Also thinking of loss of space with the people you are most at risk with. Leaving and going to work or going to school creates some of that distance and puts you in contact with other people where you're able to ask more readily for help. But now, if you're kind of all stuck at home, you're in a different situation. So it's multifactorial.
CATHY WURZER: Are those numbers as high even though the pandemic isn't forcing everyone to stay home anymore?
JAY-SHEREE ALLEN: So data lags. And so now that we're kind of coming down from that, I'm curious to see what the numbers look like at this point, but data lags quite a bit. So we're still looking more at the 2020, '21, and early '22 data.
CATHY WURZER: What worries you the most about this rise in physical abuse?
JAY-SHEREE ALLEN: I think I'm most concerned about victims being able to ask for help asking for the help that they need. And fearing what they are at risk of losing if they do ask for help. Because again, with the increased financial stressors, economic stressors, job security has changed for a lot of people. I think there's a lot more at stake. And so I worry that victims may think twice about reaching out.
CATHY WURZER: Now, you, as a physician, you are you must report abuse when you see it. I'm curious about what signs do you look for in your patients?
JAY-SHEREE ALLEN: So from the physician side of things, when I have the opportunity to have patients in front of me, I ensure that I have a conversation directly with that patient. So even if it means we need to call in an interpreter service, we need to excuse a guest or a family member or friend who's accompanied them to the visit and just have a private conversation, I think it's important to hear directly from a patient.
If someone's always speaking up for them, answering questions for them, they're not making good eye contact. Even if you're doing your physical exam, and you're like, oh, how did you get this bruise here? I think those are the subtle signs that lead us to having a deeper conversation.
CATHY WURZER: But of course, not all abuse is physical, as you know. And I'm wondering then how do you suss out emotional abuse? Can you do that as a physician in just such a short time that you have the patient with you?
JAY-SHEREE ALLEN: It's hard. It's possible, but it is hard. I think it's best, and shameless plug here for Family Medicine, but when you have the opportunity to develop a rapport with your patients and build that longitudinal relationship, they know you. They trust you. You've seen them in good times. And so you're kind of able to pick up on when something's off, whether it may be an issue of domestic violence or not. You can say, you're not quite yourself today. What's going on? Can we talk a little more? So you can, but it's very hard. And it requires you asking the tough questions even in an uncomfortable situation.
CATHY WURZER: I'm sure you have advice for folks who are currently in an abusive relationship and maybe they might be listening here today. What steps should they take?
JAY-SHEREE ALLEN: So I think it's a few things are important. If your life is in danger-- in the state of Minnesota, on average, the past few years, around 20 individuals are killed each year by intimate partner violence in this state. So this is a situation where you do need to speak up. So if your life is in imminent danger, you call 911. You call for help immediately.
But there are also other really good resources in this state. Specifically, the Minnesota Day One crisis line and their number is 866-223-1111. So giving them a call, they can help you to access some of the resources. So not necessarily an emergency, but you do need help with a plan, they can help you in that regard if you're in Minnesota.
CATHY WURZER: We've all been in relationships where there are certain uncomfortable flags. Something doesn't feel right. What are some of the warning signs that people can look out for early on in a relationship to keep themselves safe?
JAY-SHEREE ALLEN: Yes there are some of those signs, as you've mentioned. There's a good website to the hotline.org that I think does a wonderful job talking about a lot of this. But some of those like always criticizing, always telling you that you're never doing anything right, extreme jealousy when you're spending time either with friends or away from that individual, and discouraging you actively from spending time with others.
And some of the insults the shaming, the demeaning, especially in front of other people. I think, some of those big, big signs. And then another big one, controlling finances too in the home without any sort of discussion or taking into account your needs. I think some those are some of those early signs to look out for.
CATHY WURZER: Kind of a personal question here, but how often do you deal with patients who are physically abused? Do you see it a lot?
JAY-SHEREE ALLEN: It varies. It varies. Some of these cases, as I mentioned, I'm in the clinic in Family Medicine. Many of these cases end up in the emergency rooms often times. And so my exposure there is quite limited on that end. But helping patients to regain traction in their lives as they start to re-establish their lives away from abusers, we see more of that in the Clinic.
CATHY WURZER: And Thank you for your work, too and thanks for the information.
JAY-SHEREE ALLEN: Yes, absolutely, absolutely, so again, please keep that number recorded. Share it with a friend, or simply the website the hotline.org, I think, does a great job outlining a lot of this.
CATHY WURZER: All right, appreciate it. Thank you so much, doctor.
JAY-SHEREE ALLEN: Thanks for having me, Cathy. Dr. Jay-Sheree Allen is a Family Medicine physician at Mayo Clinic and host of the podcast Millennial Health. You can check it out wherever you get your podcasts.
We have Mayo Clinic family physician Dr. Jay-Sheree Allen back with us to talk about how she talks with patients who may be dealing with domestic abuse. So nice to hear your voice. It's been a while. How have you been?
JAY-SHEREE ALLEN: It has been a while. It's so great to be here with you again, Cathy.
CATHY WURZER: Thank you. Thanks for finding the time here. Well, let's begin with the problem. How much has domestic abuse cases gone up since the pandemic started? Do we know?
JAY-SHEREE ALLEN: Yes, we do. We have some numbers. So I think the first thing to understand when we're putting this in context is that domestic violence is often underreported. So as alarming as the numbers are, the magnitude of the problem may actually be even more. But according to the National Commission on COVID-19 and criminal justice, they've seen an increase in up to 8.1% following some of the lockdown orders in 2020.
But there was actually an article in the American Journal of Emergency Medicine showing some global numbers upwards of 25% to 33% increase in domestic violence cases.
CATHY WURZER: Is it because of the lockdowns that people had to-- they were stuck together in a sense?
JAY-SHEREE ALLEN: So we can't say because of the lockdowns, right? I think it had its place. It certainly was needed for public health interventions, but I think there were some unintended consequences. Things like increased financial stressors due to the lockdown, increased childcare burdens which we've spoken about. And this has been very well documented too, child care burdens.
Also thinking of loss of space with the people you are most at risk with. Leaving and going to work or going to school creates some of that distance and puts you in contact with other people where you're able to ask more readily for help. But now, if you're kind of all stuck at home, you're in a different situation. So it's multifactorial.
CATHY WURZER: Are those numbers as high even though the pandemic isn't forcing everyone to stay home anymore?
JAY-SHEREE ALLEN: So data lags. And so now that we're kind of coming down from that, I'm curious to see what the numbers look like at this point, but data lags quite a bit. So we're still looking more at the 2020, '21, and early '22 data.
CATHY WURZER: What worries you the most about this rise in physical abuse?
JAY-SHEREE ALLEN: I think I'm most concerned about victims being able to ask for help asking for the help that they need. And fearing what they are at risk of losing if they do ask for help. Because again, with the increased financial stressors, economic stressors, job security has changed for a lot of people. I think there's a lot more at stake. And so I worry that victims may think twice about reaching out.
CATHY WURZER: Now, you, as a physician, you are you must report abuse when you see it. I'm curious about what signs do you look for in your patients?
JAY-SHEREE ALLEN: So from the physician side of things, when I have the opportunity to have patients in front of me, I ensure that I have a conversation directly with that patient. So even if it means we need to call in an interpreter service, we need to excuse a guest or a family member or friend who's accompanied them to the visit and just have a private conversation, I think it's important to hear directly from a patient.
If someone's always speaking up for them, answering questions for them, they're not making good eye contact. Even if you're doing your physical exam, and you're like, oh, how did you get this bruise here? I think those are the subtle signs that lead us to having a deeper conversation.
CATHY WURZER: But of course, not all abuse is physical, as you know. And I'm wondering then how do you suss out emotional abuse? Can you do that as a physician in just such a short time that you have the patient with you?
JAY-SHEREE ALLEN: It's hard. It's possible, but it is hard. I think it's best, and shameless plug here for Family Medicine, but when you have the opportunity to develop a rapport with your patients and build that longitudinal relationship, they know you. They trust you. You've seen them in good times. And so you're kind of able to pick up on when something's off, whether it may be an issue of domestic violence or not. You can say, you're not quite yourself today. What's going on? Can we talk a little more? So you can, but it's very hard. And it requires you asking the tough questions even in an uncomfortable situation.
CATHY WURZER: I'm sure you have advice for folks who are currently in an abusive relationship and maybe they might be listening here today. What steps should they take?
JAY-SHEREE ALLEN: So I think it's a few things are important. If your life is in danger-- in the state of Minnesota, on average, the past few years, around 20 individuals are killed each year by intimate partner violence in this state. So this is a situation where you do need to speak up. So if your life is in imminent danger, you call 911. You call for help immediately.
But there are also other really good resources in this state. Specifically, the Minnesota Day One crisis line and their number is 866-223-1111. So giving them a call, they can help you to access some of the resources. So not necessarily an emergency, but you do need help with a plan, they can help you in that regard if you're in Minnesota.
CATHY WURZER: We've all been in relationships where there are certain uncomfortable flags. Something doesn't feel right. What are some of the warning signs that people can look out for early on in a relationship to keep themselves safe?
JAY-SHEREE ALLEN: Yes there are some of those signs, as you've mentioned. There's a good website to the hotline.org that I think does a wonderful job talking about a lot of this. But some of those like always criticizing, always telling you that you're never doing anything right, extreme jealousy when you're spending time either with friends or away from that individual, and discouraging you actively from spending time with others.
And some of the insults the shaming, the demeaning, especially in front of other people. I think, some of those big, big signs. And then another big one, controlling finances too in the home without any sort of discussion or taking into account your needs. I think some those are some of those early signs to look out for.
CATHY WURZER: Kind of a personal question here, but how often do you deal with patients who are physically abused? Do you see it a lot?
JAY-SHEREE ALLEN: It varies. It varies. Some of these cases, as I mentioned, I'm in the clinic in Family Medicine. Many of these cases end up in the emergency rooms often times. And so my exposure there is quite limited on that end. But helping patients to regain traction in their lives as they start to re-establish their lives away from abusers, we see more of that in the Clinic.
CATHY WURZER: And Thank you for your work, too and thanks for the information.
JAY-SHEREE ALLEN: Yes, absolutely, absolutely, so again, please keep that number recorded. Share it with a friend, or simply the website the hotline.org, I think, does a great job outlining a lot of this.
CATHY WURZER: All right, appreciate it. Thank you so much, doctor.
JAY-SHEREE ALLEN: Thanks for having me, Cathy. Dr. Jay-Sheree Allen is a Family Medicine physician at Mayo Clinic and host of the podcast Millennial Health. You can check it out wherever you get your podcasts.
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