In an era of heightened mental-health awareness, authorities and youth advocates in South Dakota say it is key not to lose sight of signs of child abuse, and experts say some crisis signals cross paths.

April is recognized in the U.S. as National Child Abuse Prevention Month.

Wendy Kloeppner, state's attorney for Lake County, said educators help by serving as "mandatory reporters" when they see bruises or other unexplained marks. During the pandemic, schools also have expressed more mental-health needs for students, citing changes in behavior.

Kloeppner pointed out all can be symptoms of abuse.

"Children who have mood changes or behavior disruptions, that would be something that we would look for," Kloeppner explained. "We would maybe want to inquire with the child about what is happening at home."

Kloeppner, also a board member with the Center for the Prevention of Child Maltreatment, said law enforcement looks for some of the same signs in cases tied to trauma.

The Center is encouraging South Dakotans to spread awareness this month by signing up to be a "Blue Ambassador." Enrollees can receive content to share within community and social media networks.

At the onset of the pandemic, the American Academy of Pediatrics urged parents to practice self-care, and not let COVID stress manifest into child abuse, including verbal attacks.

Kloeppner noted situations involving actions like excessive screaming are something law enforcement can follow up on.

"If a report comes to my office, for example, that a child is continuously emotionally abused, that could turn into what we call an abuse and neglect case, where we asked the Department of Social Services to step in and monitor the family," Kloeppner outlined.

And like other cases involving suspected abuse, social services can determine if a child should be removed from the home. Kloeppner hopes this month's awareness creates more places for kids to feel safe and talk with adults if they're experiencing trauma. Beyond schools, she said it can include after-school activities, such as sports.

Sexual assault survivors in rural Ohio may have to travel hours to get a forensic exam.

During National Forensic Nurses Week, Ohio advocates say they're working to expand access to these trained professionals who can offer trauma-informed care.

Tammy Robertson, statewide director of forensic nursing for the Ohio Alliance to End Sexual Violence, said beyond a medical exam, forensic nurses can provide courtroom testimony, and assist patients in ways other health care professionals typically do not. She wants survivors of sexual assault, elder abuse, domestic violence, child abuse or human trafficking to know some hospitals have forensic nurses on staff.

"And, at least if the hospitals are unaware of that program, or doesn't have a program, they can potentially reach out to a surrounding hospital and get that patient services," Robertson advised.

Robertson added advocates are working to educate community partners, including law enforcement, prosecutors, child protective services and others about the resources forensic nurses provide.

If you or someone you know is experiencing a crisis or needs help, call the Ohio Sexual Violence Helpline at 844-644-6435, 24 hours a day, seven days week.

Robertson pointed out the holistic approach to care and support forensic nurses offer has been shown to improve survivor outcomes.

"There is, statistically, shown that there is a better healing outcome for those patients who receive care from a forensic nurse," Robertson noted.

Nationwide, between 17% and 20% of hospitals have a sexual assault examiner or forensic nurse available, according to the Rape, Abuse and Incest National Network and the International Association of Forensic Nurses.

Domestic Violence Awareness Month might be coming to an end, but a recent panel discussion was aimed at educating Nevadans about policy changes as well as dispelling misconceptions surrounding domestic violence.

Serena Evans, policy director for the Nevada Coalition to End Domestic and Sexual Violence, said as a state, Nevada tends to be what she calls "reactive instead of proactive," relating to policy implementation. She adds Nevada is one of a few states that does not fund prevention and intervention through its general budget- making it more difficult to get victim survivors the help they need.

"So many other states fund domestic and sexual violence in their general budget. We do not. So a lot of our programs struggle to make ends meet, and we do not have enough funding in the state to meet the needs of victim survivors," she explained.

For 23 out of the last 25 years, Nevada has ranked among the top 10 states with the highest rates of women being killed by men, according to the Violence Policy Center. It also ranks 21st in the nation in terms of household firearm ownership rates. Domestic violence experts call the combination a dangerous mix. Evans said Nevada policymakers can vote to better support housing and education initiatives to decrease the rate of domestic violence.

One of the laws that was passed during Nevada's latest legislative session was Assembly Bill 51. It expands the window for when people can be arrested in domestic-violence cases from 24 hours to seven days. Before AB 51's passage, law enforcement officers only had 24 hours to make an arrest before they had to obtain a warrant. Advocates say it should help reduce survivor's vulnerability.

Kristen Kennedy, executive director of the Domestic Violence Resource Center in Reno, said they not only provide emergency services for those fleeing domestic-violence situations, but also work with victim survivors to get them back on their feet.

"We assist in helping individuals rebuild their lives. We have a transitional housing program so individuals can be in our program and live in our housing for up to two years," she explained. "And during that time, we do some very intensive financial coaching with our clients and trauma counseling."

Kennedy added many have the misconception that one needs to find themselves in what she calls a crisis situation to seek help. She said that isn't the case at all, and encourages those who want to learn more or simply get advice to reach out to organizations like hers, as they are there to help and provide resources.

For some people experiencing domestic violence, concern about the safety of their household pet can prevent them from leaving. In a survey of 2,500 domestic-violence survivors
, about half reported they feared the perpetrator would harm their pet. Nearly a third reported their pet had been harmed or killed.

Pat Carraher, managing attorney with Legal Aid of Nebraska, said as of September 1st, Nebraska law allows pets to be included in domestic-violence protection orders, and added the law should deter perpetrators from using pets as leverage, since violating a protection order is a crime.

"It's a Class I misdemeanor, and if you violate it twice, it gets bumped up to a felony. Up until now, a perpetrator of domestic violence could make a lot of threats about a household pet without really worrying about much criminal liability," Carraher explained.

Carraher said when an individual fills out the paperwork for a domestic-abuse protection order, they can check one box asking for possession of the household pet, and/or another requesting that the other party "be enjoined from harming" it. He says Legal Aid of Nebraska
puts "high priority" on representing victims of domestic violence, including in protection-order cases.

The Nebraska Humane Society's Project Pet Safe
will temporarily shelter domestic pets for people working with a caseworker in domestic-abuse situations. Pam Wiese with the Humane Society says they will help in other ways, too.

"While they're with us, we try to provide anything that we can, so if they need spaying and neutering, microchipping; if they need some type of medical (care) done, we work to try to get that pet into the best shape that it can be so that they can kind of start their new life on a good footing, " Wiese explained.

Wiese added some pet owners will realize they can't reunite with their pet, but Project Pet Safe provides them valuable time.

"Even if they feel that they can't take care of the pet moving forward, they are able to make that decision for themselves, and it's not forced upon them," Wiese said.

Some victims of domestic violence find they have to leave their pet behind, and Carraher said the new law is designed to help in those situations, too.

"If for some reason they can't take the pet with them, they might check that second box, knowing that they are going to leave the pet but that the perpetrator of domestic violence will be ordered not to harm the pet," Carraher continued.

As of 2022, 38 states had some provisions for adding pets to domestic-violence protection orders.