Unplugged: Domestic Violence and Social Inclusion

October 2009

Unplugged: Domestic Violence and Social Inclusion
The Gripping Impact on the Social Determinants of Health

By Helga Luest

President & CEO, Witness Justice

At age 35, "Ellen" couldn't quite explain what was happening, but the isolation of her abusive relationship was magnified by how she felt in the bigger context of her community. Ellen left her marriage and focused on building a new and better life for her and her children. The change was prompted by a traumatic violent incident which Ellen described as the "ultimate betrayal." While believing that the steps were going to eventually be very positive for her and her children, Ellen found that some changes would make her feel even more "unplugged" and isolated than before.

The rural community in which she lived was filled with families; many of which were quite religious. So when Ellen moved toward divorce, there was instant judgment and she experienced "social exclusion." Ellen found things more difficult - it was harder to connect with friends, more difficult to focus at work, whispering behind her when she would go to church, attitude and inflexibility from the school that her children attended, and a family court system that disbelieved and ignored her pleas for protection and safety for her children when visiting their father. While Ellen felt disconnected, judged, misunderstood, and discriminated against, there were important people who helped her to stay grounded.

A local domestic violence shelter would be her first place of sanctuary. Once safety issues were addressed, there was therapeutic counseling. Legal fees and managing expenses as a single mom led to total financial ruin for Ellen, but the shelter didn't let this become a barrier to supporting her and her children - they provided free services. More than counseling and shelter, Ellen found that just having a place to call when she was overcome with emotion and overwhelmed with the struggle was enormously helpful. These people became rays of light and a foundation for her - the healing relationships that would guide her back to feeling "plugged in" to life or social inclusion.

As providers, it's our responsibility to constantly look for strategies that build social inclusion, and those healthy connections that bring about healing and understanding play an essential role. As we consider the social determinants of health - the conditions in which we are born, grow, live, work and age - we can begin to see how social exclusion has a direct impact on our everyday lives. If we are disconnected from the aspects of life that empower and support resiliency, then are we more likely to cope in ways that compromise our overall health and quality of life? And do these coping strategies, while serving as meaningful survival skills, contribute to social exclusion in some ways? If so, it will be essential to demystify coping strategies as such, rather than behaviors or symptoms. Working with survivors to keep them "plugged in" to life should be a primary goal and focus for those working in human services.

The social determinants of health are often lacking for those who struggle economically. They are influenced by policy and are established by the distribution of money, power and resources at the national and local levels. Since policy decisions drive our agencies and the programs and services that are publicly funded in our communities, understanding how trauma impacts social inclusion is extremely important. Trauma affects the social determinants of health - conditions of living, learning, growing, working and aging. For Ellen, she benefitted from policy that afforded funding which trickled down to a helpful shelter that offered free services. What lacked were policies, funding, and programs that supported the other social determinants of health - work, life, education, and community. What that policy looks like and the programs and services that stem from it depend a lot on the population being served, the nature of the traumatic experience(s), and cultural considerations.

Without considering trauma's impact on mental health in the landscape of policy and subsequent programs, social inclusion and wellness in life is much more difficult to achieve. While it was helpful for Ellen to have housing and counseling, a community response to domestic violence that builds to social inclusion and wellness will consider services for her children, healing relationships and peer support, strategies for working around access barriers, supportive school programs for children and families, workplace education and support, and mental/emotional/physical fitness. Long-term support throughout life and its cycles will also be essential in maintaining social inclusion and wellness. Survivors, providers, families, community leaders, and policymakers all play a role in making sure those social determinants of health look positive for every person. Trauma education, awareness, and implementing trauma-informed change are essential steps in the effort to improve the social determinants of health.

Witness Justice is a national nonprofit organization whose mission is to provide support and advocacy for victims of violence and trauma. For more information, please visit www.witnessjustice.org