HOW TO DOCUMENT DOMESTIC VIOLENCE IN MENTAL HEALTH RECORDS Washington Behavioral Healthcare Conference June 23, 2016 Alison Iser, MA Project Manager Domestic Violence & Mental Health Collaboration Project Coalition Ending Gender-Based Violence alison@endgv.org 206.568.5454 Susie Winston, LICSW Director of Child and Family Services Sound Mental Health susiew@smh.org 206.302.2340 How do good documentation practices positively impact domestic violence survivors? DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 1
Mental Health Coercion Study Called "crazy" Threatened to report "craziness" to authorities Sought MH support From The National Center on Domestic Violence, Trauma & Mental Health Gaslighting 50% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 53% 74% 86% Legal & Ethical Considerations Do No Harm Agency Policy Funder Requirements Client s Voice Free of Assumptions & Judgment Trauma-Informed Care Protection Orders or Criminal Cases Could be only evidence of DV Saying who perpetrated the DV is crucial Credibility Perception of survivors with MH concerns (trauma response) DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 2
Family Law Credibility Parenting Plan Restrictions Long-term AND interfering with parenting How does DV impact their mental health? Will their mental health improve as their safety improves? Immigration Can provide evidence needed to help survivor stay in the U.S. Need to show they have experienced domestic violence and/or that the DV affected their mental health Red light Green light DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 3
The client was involved in a domestic dispute. Red light or Green light? Red light or Green light? Client stated he needs a refill before he is due for one because his abusive partner, Jack, has been taking his pills. The client alleges she was strangled. Red light or Green light? DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 4
Practice Recommendations Neutral Describe DV and who perpetrated it Show pattern of coercive control Strengths-based Practice Recommendations continued Mindful of safety / consequences Provide context for client actions Link symptoms to trauma/abuse Include client s voice & cultural identity Questions to Consider Do my notes give a clear picture of what the survivor experienced and who caused the harm? Do I describe the impact of the DV on the survivor s mental health? Can my notes be misconstrued or used to harm the survivor? DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 5
Safety & Mental Health Safety Worsens MH Improves Safety Improves MH Worsens DV & Recovery Connection between trauma and healing Treatment compliance in context of coercive control Social Context & Choices Explain context within which survivor is making choices Barriers Opportunities / Access Referrals to culturally-specific services DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 6
Group Exercise Work together to write a treatment note based on the scenario. Aim for a green light! Questions to Consider Do my notes give a clear picture of what the survivor experienced and who caused the harm? Do I describe the impact of the DV on the survivor s mental health? Can my notes be misconstrued or used to harm the survivor? Q&A DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 7
Summary You can make a difference It s worth the challenge Do no harm Respectful depiction of client s voice Connection between trauma & recovery Summary continued Need Context Description of DV Symptoms Cultural identity Barriers Options View through lens of safety DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 8
Family Law Toolkit for Survivors Coping Skills Court Orders Comparison DV Advocacy Resources DV Definitions Comparison DV Protection Order Info Family Court Services Q&A Family Law Evaluations Financial Resources Immigration FAQ s Language & Disability Access Legal Resources MH Treatment Resources Parenting Evaluators Parenting Resources Songs for Surviving the Family Law Process Client experienced domestic violence perpetrated by. Red light or Green light? Client refuses to make a police report. Red light or Green light? DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 9
Red light or Green light? Client reports her spouse,, is trying to use her immigration status to control her. Thank You! Learn more at http://endgv.org/projects/domesticviolence-mental-health-collaborationproject/ This project is supported by Grant No. 2014-FW-AX-K010 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women. DV&MH Collaboration Project DV Documentation Workshop 06-23-16 p. 10