Patterns and Predictors of Service Use Among Women Who Have Separated from an Abusive Partner.

Marilyn Ford-Gilboe,Eman Alhalal,Joanne Hammerton,Judith Wuest,Camille Burnett,Marianne Noh,Colleen Varcoe

doi:10.1007/s10896-015-9688-8

Abstract

Using baseline data from a survey of 309 Canadian women recently separated from an abusive partner, we investigated patterns of access to health, social, legal, and violence-specific services and whether abuse history and social and health variables predict service use. We compared rates of service use to population rates, and used logistic regression to identify determinants of use. Service use rates were substantially higher than population estimates in every category, particularly in general and mental health sectors. Although women were confident in their ability to access services, they reported substantial unmet need, difficulty accessing services, and multiple barriers. The strongest unique predictors of use varied across service type. Health variables (high disability chronic pain, symptoms of depression and PTSD), low income, and mothering were the most consistent predictors. Service providers and policy makers must account for social location, abuse history, and health status of Intimate Violence (IPV) survivors. Strategies to enhance access to primary health care services, and to create a system of more integrated, accessible services, are required.

Highlights

Using baseline data from a survey of 309 Canadian women recently separated from an abusive partner, we investigated patterns of access to health, social, legal, and violencespecific services and whether abuse history and social and health variables predict service use
Given differences in Canadian and U.S health and social service systems, patterns of service use, levels of unmet need, and the barriers faced by women may differ across these different system contexts. We address these gaps by presenting a comprehensive analysis of patterns of access to a broad range of services in health, social, violence-specific, and legal sectors among Canadian women who had separated from an abusive partner in order to better understand the context of service use
The use of health and social services is known to be higher among women who have experienced Intimate partner violence (IPV) compared to those who have not (Bonomi et al 2009; Domino et al 2005), our findings extend current knowledge beyond service use by Canadian women who have experienced IPV (Ansara and Hindin 2010; Barrett and Pierre 2011) to those who have separated from an abusive partner and illuminate important areas of unmet need

Summary

Introduction

Using baseline data from a survey of 309 Canadian women recently separated from an abusive partner, we investigated patterns of access to health, social, legal, and violencespecific services and whether abuse history and social and health variables predict service use. In a recent analysis of data from the Canadian General Social Survey (GSS) (Barrett and Pierre 2011), women who had experienced IPV in the past 5 years reported using an average of two services to help them deal with the violence. Using a greater number of services was associated with particular characteristics of women (e.g., higher income, Aboriginal, disabled) and with increased severity of violence, the latter finding being consistent with Ansara and Hindin’s (2010) analysis of the GSS These findings suggest that use of services in general by IPV survivors is a complex process that may be shaped by many factors. While only 11 % of Canadian women who had experienced IPV in the past 5 years reported accessing a domestic violence (DV) shelter and 17 % used a DV crisis line (Barrett and Pierre 2011), less is known about women’s use of a wider range of domestic violence services, after separation

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Conclusion