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In challenging times like these, access to mental health care is very important.
While we isolate at home to prevent the spread of COVID-19 and protect our health and wellness, people at risk for intimate partner violence might find these social distancing precautions can put them in danger. Stay-at-home orders are leaving them isolated with their abusers, who may be feeling greater levels of stress and more likely to act out than ever before.
"As humans, we are social creatures and, by nature, need to interact with one another," says Dr. Christina Huang, PhD, a licensed clinical health psychologist with Sharp Mesa Vista Hospital. "Difficulty tolerating distress and emotions can easily flare when you add the extra stress of the pandemic. This includes being in isolation, financial strain and the possibility of getting sick, paired with the feeling of having no control over it and no way to blow off steam."
According to the National Domestic Violence Hotline, there are a variety of ways an abuser's need to gain control may manifest in isolation. Abusive partners may:
Withhold necessary items, such as hand sanitizer or disinfectants.
Share misinformation about the pandemic to control or frighten victims, or to prevent them from seeking appropriate medical attention if they have symptoms.
Withhold insurance cards, threaten to cancel insurance or prevent victims from seeking medical attention if they need it.
Feel more justified and escalate their isolation tactics.
Furthermore, the pandemic can affect access to the support that people who live with an abusive partner need. Shelters may be full or closed, and counselors may have closed offices and be operating remotely, requiring access to communication tools, such as a phone or computer, which could be removed by an abuser. Means of transport may have been reduced or eliminated. And if a person at risk has physical health problems, the fear of being exposed to the virus outside their home could further deter them from leaving.
How to avoid escalation and make a plan
While the responsibility to not harm lies solely with a perpetrator — never the victim of violence — Dr. Huang says that there are steps someone who is concerned about violence can take to feel a little bit safer during the pandemic and related stay-at-home orders.
"There is no real way to guarantee safety if a victim is isolated with their perpetrator," she says. "However, it might be possible to set physical and emotional boundaries to minimize conflictual interactions that could lead to violence. Keeping busy and maintaining structure is essential."
She offers the following tips to all members of the same household:
Go to bed and get up around the same times each day.
Make sure to get plenty of exercise — if you can go outside to walk, go outside. If you live in a dense area and going outside makes the practice of social distancing difficult, there are many free exercise videos online.
Spend time learning a new skill — maybe that hobby that you've always wanted to do, but have never made time for.
Start household projects or engage in spring cleaning.
Connect as frequently as you can with friends and family through phone calls, texts, social media and video chat platforms.
Eat nutritious foods and avoid mood-altering substances (such as alcohol) as much as possible.
Stay connected to or connect with a therapist through telehealth.
The National Domestic Violence Hotline also recommends creating a safety plan — a personalized, practical plan that includes ways to remain safe while in a relationship, planning to leave or after you leave. The plan should be updated to reflect the new challenges caused by the COVID-19 pandemic, including alternatives to where you might be able to stay if shelters are not an option, such as staying with family or friends or in hotels.
Those at risk should also keep the contact information for the national hotline with them. The hotline is available 24 hours a day at 1-800-799-7233. If you are unable to speak safely, you can log on to thehotline.org or text "LOVEIS" to 22522. In San Diego, free local services and resources are available through the San Diego District Attorney's office.
How to help a loved one
If you are concerned about a friend or loved one being the victim of domestic violence, Dr. Huang recommends that you watch for signs of abuse, but take care in how you address your concerns.
"Signs in a survivor are low self-esteem, low self-worth, low self-efficacy and the tendency to blame oneself or accept too much responsibility," she says. "Don't be a bystander. Often, domestic violence happens openly and it can challenge us to be silent, either out of self-preservation or the belief that it is none of our business. If you see or hear something that bothers you, reach out to your loved one to offer support, help them develop a safety plan and encourage them to seek out resources that can offer further help and guidance."
Talk to your doctor if you or a loved one are experiencing excessive sadness, anxiety or anger for an extended period. Learn more about mental health services at Sharp Mesa Vista Hospital and read important COVID-19 information from Sharp.
The Sharp Health News Team are content authors who write and produce stories about Sharp HealthCare and its hospitals, clinics, medical groups and health plan.
Dr. Christina Huang is a clinical health psychologist at Sharp Mesa Vista Hospital in COG-IOP, a program that specializes in treating severe mood and personality disorders. She is also a Sharp Health News contributor.
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