People with no formal health training may be able to spot signs of brain injury in domestic-violence survivors, using a set of tools called CARE, which stands for Connect, Acknowledge, Respond and Evaluate. Severe intimate-partner violence is often targeted at the head and neck, and in the airways.

Julianna Nemeth, assistant professor, college of public health, The Ohio State University explained since these injuries often are invisible, staff at domestic-violence service organizations and medical providers may not be aware of how best to meet a survivor's needs, and added brain injuries impact a person's cognitive function, decision-making skills and planning ability.

"The other impact of brain injury can be things like seizures, constant headaches, balance problems, anger and rage, ability to control emotions," she said. "Those are all things that impact survivors' daily function."

Nemeth recently co-authored a paper on the effectiveness of the CARE model. She said its four cornerstones include connecting with survivors; acknowledging that head trauma, strangulation and related challenges are common; responding by collaborating with survivors to develop accommodations for challenges related to suspected brain injury caused by violence; and evaluating services by establishing a strong feedback loop with survivors to ensure their needs are being met.

Nemeth added that memory problems, depression and suicidal thoughts can also be affected by trauma to the brain.

"Emerging literature really is suggesting to us that brain injury from domestic violence is not only prevalent, but it's really having neurologic psychologic cognitive and behavioral impacts," she continued.

Ohio's domestic-violence shelters provided emergency housing to nearly 10,000 people last year.




Brain injury from domestic violence is an unrecognized public health challenge, and new research shows how a set of tools called "CARE" can help staff at domestic-violence service organizations recognize signs of traumatic brain injury. Comments from Julianna Nemeth (nuh-em-ith), assistant professor, college of public health, The Ohio State University.

People with no formal health training may be able to spot signs of brain injury in domestic-violence survivors, using a set of tools called "CARE," which stands for Connect, Acknowledge, Respond and Evaluate. More from Nadia Ramlagan (ROM-la-gone).

I'm Nadia Ramlagan.

Reach Nemeth at 614-247-7142. CARE research: https://bit.ly/43DO8c5. Ten thousand (in caption): https://bit.ly/3KLog5g.

Across the state, Ohio's domestic violence prevention programs are improving their services for human trafficking survivors.

A $1.8 million grant from the Ohio Department of Public Safety will help 32 shelters provide human trafficking training and expand case managers.

Shelley Marsh, deputy director of the Ohio Domestic Violence Network, said it will better serve the needs of individuals who may not realize what has happened to them.

"A lot of human trafficking survivors either may not know or understand that they've been trafficked," Marsh explained. "And/or don't maybe have the language to explain to someone when they are seeking services that they are a victim or survivor of human trafficking."

Marsh pointed out the grooming tactics used by traffickers normalize abuse and exploitation to the point many survivors report believing their experiences are just "how the world operates." A study by the Polaris Project of 457 trafficking survivors found 37% were trafficked by a close family member or guardian.

Marsh added the funding will also help shelters meet the needs of individuals coping with high levels of trauma.

"We also know that mental health and substance use is also not only a component of domestic and intimate partner violence and sexual violence," Marsh noted. "But certainly a significant component of human trafficking as well."

Marsh added advocates are working to increase awareness about how all interpersonal and gender-based violence is connected.

"These victimizations, while all have distinct, unique qualities, they also have a lot of intersectional issues that really need sort of holistic approaches and holistic service delivery," Marsh emphasized.

According to the Ohio Attorney General's Office, signs of possible human trafficking include a person not having their own identification documents or money, being in the presence of an overtly controlling male or female friend, and showing signs of mental, emotional or physical abuse.

To report suspected trafficking, call the National Human Trafficking Hotline at 833-373-7888.

Domestic-violence prevention organizations in Minnesota continue to express relief over a U.S. Supreme Court ruling dealing with abusers having access to firearms.

In an 8-to-1 decision released Friday, the court upheld a federal law barring people subject to a domestic-violence restraining order from owning guns. Violence Free Minnesota reported from 1989 to 2018, guns were used in nearly half of cases around the state in which adult women were killed by an intimate partner.

Connie Moore is executive director of Alexandra House, a service organization for survivors in the Twin Cities. She noted weapons are also used to intimidate a partner who is planning to escape a dangerous situation.

"Many victim/survivors have reported about a gun being pointed at them and threatening, 'I'll kill you if you leave me,'" Moore observed.

Moore noted there are still challenges in ensuring a gun's removal, even when a restraining order has been issued. Minnesota does have a law covering the removal process but support groups said there is uneven enforcement around the country. This decision comes two years after the Supreme Court greatly expanded gun rights.

Moore pointed out the federal law not only protects survivors and their children, but also first responders in 911 calls stemming from domestic violence.

"We know that domestic calls for law enforcement are one of the most dangerous calls that they go on," Moore emphasized.

She pointed to the three first responders killed earlier this year in a call in the suburb of Burnsville. The tragedy led to a change in state law concerning straw purchases of guns.

Meanwhile, survivor groups also press for reforms when it comes to obtaining a protection order, noting there are a range of barriers just getting that step taken care of.


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Ohio advocates said the Biden administration's new Title IX regulations better protect victims of sexual assault, even as a group of states temporarily blocked the new rules, following controversy over expanded protections for transgender and LGBTQ+ students.

The federal civil rights legislation has continually morphed since it was created in the 1970s to ban discrimination in education programs and student activities receiving federal funding.

Emily Gemar, director of public policy for the Ohio Alliance to End Violence, said Ohioans should feel encouraged the latest batch of rules helps create a safer and more supportive environment for students who've experienced sexual assault.

"One of the changes that the Department of Education has included in its final regulations: They've reinstated that investigations have to be prompt, which was something that the Trump administration had removed," Gemar pointed out.

The final rules clarify the steps a school must take to protect students and employees from discrimination based on pregnancy, sexual orientation, gender identity and sex characteristics. It also protects against retaliation for people who exercise their Title IX rights. The new rules go into effect on August 1.

Gemar added communities can play a role in creating a violence-free environment for young people.

"We should all want at the end of the day is to send not only just our young schoolchildren, but our young adults into environments that have these protective measures in place," Gemar asserted. "To appropriately address sex-based harassment and other forms of sex-based discrimination."

Studies have found approximately 26% of all female undergraduate students and nearly 7% of all male undergraduate students have experienced sexual assault, according to the American Association of University Women.


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