A National Plan to End Interpersonal Violence across the Lifespan Executive Summary

The National Partnership to End Interpersonal Violence across the Lifespan (NPEIV) is an overarching group of practitioners, academics, organizations, agencies, and coalitions that embrace a national, multi-disciplinary and multicultural commitment to the elimination of all forms of interpersonal violence. We believe it is a basic human right to be safe at home, at school, in our communities, and in our interactions with the institutions of our society. Additionally, all people should have equal access to effective systems of protection, justice, health and education. Accordingly, it is our mission to work towards eliminating all forms of interpersonal violence, for all people, in all communities, at all stages of life. To this end, NPEIV has developed and is endorsing a set of recommendations based on research, best practice and common sense which, if fully implemented, would dramatically advance the goal of ending interpersonal violence. That document is a fully referenced treatise which provides the bases and justifications for the recommendations set forth. The present document is an executive summary of those recommendations. The reader is directed to the parent document for a more detailed explanation, citations, and supportive documentation.

The scope of the problem
There is no disputing the fact that interpersonal violence is the pre-eminent problem facing society. Gun violence is an everyday occurrence. Child physical and sexual abuse, intimate partner violence (IPV), elder abuse, bullying, human trafficking, gang violence, rape and sexual assault are among the exemplars of interpersonal violence that have reached epidemic proportions. The price tag in terms of medical expenses, police and legal costs, incarceration, time lost from the work force, and the immediate and long-term psychological costs are inestimable. As a nation, we spend hundreds of billions of dollars dealing with the aftermath of all forms of interpersonal violence and abuse.

Violence begets trauma and there is a large body of research documenting significant levels of trauma in childhood, college, the military, intimate partner relationships, and in the elderly. Violence at one level often leads to violence at multiple levels. Abuse victims are often abused in multiple ways, some may become perpetrators, and this pattern of victimization and perpetration can extend throughout the life cycle. Violence has a profound impact on our physical, emotional, and spiritual health.

It is well documented that exposure to all forms of interpersonal violence and abuse occurs across all socio-economic levels, and especially among impoverished families and communities. Children and adults with a disability and those who are GLBTQ are also at higher risk of violence victimization. Thus, it is essential that, in every section of this National Plan, consideration must be given to the implications of culture in aspects of services delivery, professional development, research, and policy formulation.

This National Plan recognizes the challenge of conducting prevention and intervention programs and services to diverse racial and ethnic communities and linguistic groups, each with its own distinct cultural beliefs, traits and historical challenges. It is for this reason we include cultural tailoring to this National Plan to encourage appropriate interventions for all racial, ethnic, and cultural groups.

A National Plan

I. Unequal Access & Other Barriers to Systems of Protection
To address the needs of victims of interpersonal violence, it is integral that we recognize the underlying belief systems, values, and attitudes of oppression that impact our understanding, recognition, prevention and intervention responses. For example, many of those experiencing violence are the marginalized populations within each community lacking access to systems of justice, health, social services, education and other institutional protections. Adequately responding to these barriers must be a part of developing a holistic, trauma-informed, and systemic approach to addressing interpersonal violence.

a) Through a focus on collaborations with criminal justice, medical, public health, social services, mental health, education, community and faith-based organizations and allies, we must bridge gaps to improve current systems of care on local, regional, and national levels.
b) Our goal must be to build, expand, and sustain organizational and community capacity to make trauma-informed, culturally relevant services available to all.

II. Improving the Development & Delivery of Prevention Initiatives Within a Coordinated Community Public Health Model

Violence is multi-determined. It is embedded within the social and cultural fabric of our communities. It is also a significant public health issue and needs to be addressed as such. Ultimately, ending interpersonal violence will require cultural changes, as well as changes in the way we socialize our children. We will have to reconsider how we raise both our sons and our daughters such that aggression is no longer part of our definition of masculinity and violence by women is equally unacceptable. In developing prevention strategies, it is critical to expand prevention within and across all communities with an emphasis not just on taking actions, but also on changing social norms that promote, or at least permit the use of violence.

The hallmark of one well known approach for addressing intimate partner violence (IPV), the program usually referred to as the Duluth Model, was the coordinated community response, which recognized the importance of cooperation and communication between all of the agencies involved in IPV cases. These included the police, courts, probation departments, shelters, and batterer intervention programs. Similarly, ending interpersonal violence will require the coordinated efforts of law and policy makers, criminal justice, education, mental health, social services, and healthcare systems, religious and spiritual groups, and the media.

Given the heterogeneity of the communities in this country, it will be important to recognize the importance of partnering with leadership at the local level in designing intervention and prevention programs that are sensitive to the dynamics unique to each community. An evaluation of the history of child abuse prevention in America found six factors contributing to the shortcomings of these efforts. These factors were taken into consideration in the formulation of the current National Plan. Importantly, the evaluation suggested that the field failed to establish the public will and the political clout to change the policies and institute the programmatic reforms needed to prevent child abuse. That criticism is equally applicable to all forms of interpersonal violence and was, in part, the impetus for the formation of NPEIV. There are many commonalities among the various forms of violence and abuse, and yet the organizations concerned with each have functioned independently of each other rather than joining their considerable talents to achieve a common goal. The NPEIV plan offers such an opportunity. The recommendations are aimed at eliminating violence and abuse, not one specific form of violence. The proposed framework is a starting point. Something has to be done to stop the violence, and it will take the efforts of all of us to accomplish that urgent imperative.

III. RECOMMENDATIONS
1) Federal, state and local governments should be encouraged to provide funds for the development and implementation of evidence-based prevention efforts encompassing all forms of violence.

2) Communities should be incentivized to establish multi-disciplinary teams to develop, maintain, and evaluate violence prevention programs encompassing the best practices for the particular problems faced by their community.

3) Research funds specifically earmarked for the development and validation of violence prevention programs should be made available.

4) The government should fund a clearinghouse for the collection and dissemination of empirically supported prevention and intervention programs and program materials. Funds should be provided to enable dissemination via the internet and other technology-based mechanisms.

5) Implementing successful programming should be a primary goal and focus. For example, within 5 years, there should be seven or more evidence-based prevention programs in every county in the United States with the sum total of these programs addressing violence across the lifespan. This could decrease violence across the lifespan within each state, and make community members feeling safe in their communities a real priority.

6) Implementing more prevention programs through expanding prevention training to more disciplines with the goal of having at least one pilot program per state. Training for education, social service, criminal justice, drug and alcohol, medical and mental health professionals could be expanded to include prevention skills.

7) Implementing more prevention programs using technology to maximize the impact for lowest possible cost. Prevention should be made practical and personal through the creation of apps and other technology that can aid children, youth, adults, and older adults in asking the right questions, and making the best decisions about personal safety and awareness.

8) Undergraduate and graduate programs should address violence across the lifespan and provide students with the practical skills necessary to be effective in responding to instances of trauma. Professional training programs should be encouraged to include training specific to trauma-informed care and violence prevention. Licensing boards should be encouraged to include violence prevention and trauma-informed care in their licensing and continuing education requirements.

9) It is recommended that academic (grade school through graduate school) curricula include violence awareness, violence remediation, and violence prevention components, as well as support services for those students already victimized. Examples would include bullying prevention programs, bystander intervention, and dating violence programs. Whenever possible, training should include experiential, first-hand laboratory models of learning which has been found to be the most effective for practical learning.

10) It is important to maintain a quality workforce by addressing vicarious trauma that can follow intervening in cases involving violence or abuse.

11) Accreditation standards of health care facilities (e.g., JCAHO) should require all employees to undergo specialized training in violence recognition and response, as well as providing trauma-informed care in all patient care departments. It is suggested that within 5 years, each major medical center routinely incorporates screening for cases of violence and abuse, including male victims of sexual and physical violence, and provides access to needed intervention resources.

12) It is important to strengthen trauma screening by medical and mental health providers, including addressing the spiritual impact of trauma. To accomplish this, it is also important to establish partnerships with faith-based organizations to take the lead in the prevention of violence and abuse in their congregations through trauma-informed educational initiatives.

13) The collection of corroborating evidence in cases of violence, as a national norm, would increase successful prosecution of cases. It is recommended that the National Institutes of Justice, working with state and national organizations as well as front line professionals, develop and disseminate standards for police, prosecutors, and judges regarding the specialized considerations for collection of evidence, administration of restraining orders, and timeliness of response in all cases of IPV, sexual assault, elder and child abuse.

14) Training criminal justice professionals to recognize and screen for poly-victimization would help end the cycle of violence for more perpetrators and victims.

15) Holding trials within six months of charging for a crime could reduce adverse impacts of violence on victims and family members.

16) The impact and utility of restorative justice initiatives should be studied, and then implemented if they are found to be effective.

17) It is suggested that we expand the research paradigm to make connections to human rights, social norms, oppression, differential distribution, and prevalence of violence to research, policy, and practice. It is recommended that all Federal agencies whose mandates include any forms of violence be required to earmark some percentage of their funds each year to supporting research, conferences, and trainings related to adverse childhood experiences, interpersonal violence and abuse, and the traumatic effects they produce. Aiding professionals in applying research to practice by shortening the time it takes for research findings to be translated into frontline application is needed.

18) Developing strategic media partnerships could facilitate nationwide campaigns.

19) Media coverage of candidates for public office must include their positions on issues of interpersonal violence, including (when appropriate) the candidates’ response to this National Plan, and to publicize the answers to the public. Asking candidates their positions and their specific recommendations is important. In order to maximize their impact, organizations must be willing to work with all political parties in addressing interpersonal violence and abuse across the lifespan.

20) It is important to develop partnerships with grass roots organizations of survivors of abuse and violence such that these groups provide input and play a significant role in the efforts to end interpersonal violence and abuse across the lifespan.

21) Universities instructing future professionals working with victims or perpetrators in any setting should include instruction on public policy advocacy. Public policy advocacy instruction should occur in university courses as well as online such that written materials are available to communities who otherwise cannot access them.

22) End all forms of sanctioned violence within institutions, such as corporal punishment in schools.

Conclusion

The National Plan outlined here has the potential to dramatically improve our response to violence and abuse in every community. However, even if fully implemented, this plan is only the beginning. Within these broad parameters, there is a need to determine what undergraduate and graduate reforms, prevention and research may look like for various forms of interpersonal violence and abuse. However, this plan does provide guidance, solutions and a direction toward the movement to end all interpersonal violence and abuse. It should be recognized that violence cuts across all ethnic, racial, cultural, and gender lines and that all of these recommendations should be considered to be gender neutral. We have waited long enough. Policy makers, legislators, and community advocates need to immediately begin channeling funds into an action plan. The people should demand that the Federal government divert some of the funds being spent overseas into programs aimed at eliminating violence in our own country and communities.