April 28, 2025 • 42 mins
According to the Ohio Domestic Violence Network, the economic impact of domestic violence in Ohio is formidable, costing the state $1.2 billion annually. Yet only $20 million is allocated to combat this crisis. This discrepancy affects thousands: while nearly 10,000 Ohioans found shelter last year, over 8,000 were turned away due to capacity issues. Annually, around 188,000 experience intimate partner violence, resulting in more than 100 fatalities.
We explore the complex web connecting domestic violence with brain injuries, substance use disorders, and suicide risk. Furthermore, evolving technologies offer new methods for abuse. Nonetheless, there remains hope, as one survivor said, "After trauma, it is possible to live a life you love."
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Welcome everyone to our April episode of Voices for
Suicide Prevention.
As we like to say, ourconversations here are real talk
, real honest, real life.
Speaker 2 (00:14):
I'm Scott Light and I'm Rachel Tilson.
We are going to begin with astatistic that is underreported
by the media and, overall, justdoesn't get the attention it
deserves.
$1.2 billion is that figure,and that's the economic impact
of domestic violence every yearin Ohio.
This comes from the most recentstudy commissioned by the Ohio
(00:35):
Domestic Violence Network, andwe have two guests from ODVN
joining us to talk about it, anda lot more Rachel Ramirez and
Cheryl Stahl.
Welcome to the podcast.
Thank you so much for beinghereahl.
Welcome to the podcast.
Thank you so much for beinghere.
Very excited to be here.
Well, we have so much to talkabout with both of you.
So let's begin with theeconomic study, because you just
released that in late February.
Speaker 3 (00:55):
Well, this is the first time that we had ever done
any kind of economic impactstudy in the state, and one of
the things we were trying tohighlight was to think about how
, when we invest in domesticviolence services, how that can
help save the state money.
As we know that budgets are abig deal.
Everybody is talking about thebudget now.
There are years when there'sfunding, there are years when
(01:16):
there aren't funding.
But really to estimate, thinkabout how much does it cost us?
How much does domestic violencecost our state?
Is it cost us, how much doesdomestic violence cost our state
?
And in the part of this firststudy, what we learned is the
largest factors.
When we think about physicalhealth care for victims, that
cost approximately $264.8million annually, loss of life,
(01:37):
loss of worker productivity, andthen thinking about how all of
those different costs can kindof ripple through the system.
When we think about lostproductivity and people who
don't show up to work, we thinkabout the impact of law
enforcement and the lawenforcement response.
How much do local policedepartments spend on domestic
violence response?
How much do court systems spendon domestic violence response?
(01:59):
And then, of course, the impactto the victims of domestic
violence, including thosedirectly impacted by domestic
violence, including thosedirectly impacted by domestic
violence and their familymembers.
So maybe this is something Ican see if Cheryl could talk a
little bit about.
We see some of those costsrelated to mental health, to
other health costs and substanceuse and how all of those things
connect.
Speaker 4 (02:19):
A study put out by the CDC in 2017 and looked at
the cost of, of course, theoverdose epidemic across the
United States and that,including the combined cost of
opioid use disorders and fataloverdoses, that equaled about
(02:42):
$72.5 million.
Economic cost to Ohio and overthe United States was over $550
billion.
So that's just substance useand if you're looking at mental
health, you're looking at costto the United States.
I really couldn't find anythingspecific to Ohio with that cost
(03:04):
States.
I really couldn't find anythingspecific to Ohio with that cost
.
But for the United States, theeconomic costs for mental health
alone, and I'm not sure if theylooked at substance use as part
of mental health or behavioralhealth or not.
I didn't see that distinguishedin the study, but that was at
$282 billion and with projectedcosts into like 2040, into the
(03:28):
trillions of dollars if itcontinues at the trends.
It is now, you know, but in thenext less than 20 years you're
looking at trillions of dollars.
Speaker 1 (03:39):
Cheryl and Rachel on that note.
There's, you know, there's thatold business axiom of you can't
manage what you don't measure.
And I want to come back to whatyou mentioned about this.
Is the first time you did thisexhaustive of a study.
Why do you think you need it?
Obviously we need it, but wereour neighboring states?
Did they have these data setsand it was just time for us to
(04:00):
get them?
Speaker 3 (04:01):
Well, I think that we actually worked with an
economist at the University ofSouth Carolina who has done some
similar work in a couple ofdifferent states.
This is very kind of newer worktrying to figure out when we
look at the total cost ofdomestic violence, because
there's so many different waysand so many different places
where that can show up.
But, you know, one of thedrivers behind this was really
(04:25):
thinking about what we do knowis that here in the state of
Ohio, on a per capita income,the state invests much less
money in domestic violence thanour neighboring states, than
Kentucky, than Michigan.
And being able to show we havea $20 million line item for
domestic violence services forthe whole state of Ohio, which
(04:45):
we're very, very grateful for.
We know it's very, very toughbudget times but we have 76
member programs in Ohio andspend much less per capita on
domestic violence services andto be able to come to our
legislature and come to ourstate lawmakers and again very
appreciative of the funding thatthey have provided, but also to
(05:06):
think about, you know, the $20million that we have allocated
to divide between our 76 memberprograms when we think of the
enormous cost of domesticviolence.
I think that that puts thatinto context and in a state
where we're very, you know,budget conscious, here we have a
balanced budget that needs tobe released every year and,
(05:27):
knowing with so much, ohioactually did not have any state
money for domestic violenceuntil around 2019, 2020.
It wasn't ever written into thestate budget.
So that left all of ourprograms very, very dependent on
federal funding and when we seethe federal government, things
can change radically from yearto year and it really left
(05:49):
programs very, very vulnerableand the survivors in their
community vulnerable and able todo that.
So when we think you know, a lotof people might think, oh, you
know, we know that everybodyknows somebody impacted by
domestic violence, just like I'msure that's something you all
say a lot.
Everybody knows somebody who'simpacted by suicide.
But you kind of think, oh,that's something over there that
(06:09):
doesn't have to do with me, Idon't know about.
You know what I mean, thatdoesn't really relate to me.
But when you think about thecosts that are being borne by
your community, the costs thatare being borne in workplaces
and among services and publicservice response, I think that
that was the and we honestly Ithink one of the other things is
we really didn't know and wedidn't know how much it really
(06:30):
cost us, cost the state of Ohio,how much domestic violence and
where those areas were.
So it was able to help usprovide better data and really
thinking about you know, I know,cheryl, you talked about that
the CDC study about some ofthose mental health costs.
But one of the things that wefound and we have more
information about the economicimpact study on our website but
(06:52):
that the professor who did thisestimated that mental health
care in the state of Ohio costs$122 million just mental health
care related to domesticviolence.
So when we see that that's onetiny, tiny piece of this we're
talking about child welfarecosts, loss of property costs,
how much do our shelters cost?
How much do you know policingcosts?
(07:12):
How much do courts costs?
How much does incarcerationcosts?
It's just a very, very smallsliver.
So to be able to make the casethat investing in domestic
violence services really is notonly I mean, we all know, just
like you know with your work itmight be the right thing to do,
but it also makes economic sense.
Speaker 2 (07:30):
Yes, exactly yeah.
So there's another layer inthere about the children who
witness or are themselvesvictims.
What are the long-termchallenges that they face?
Speaker 4 (07:42):
You know, for kids who witness trauma or are
impacted directly by trauma, sothey're the ones that are being
abused or the target of abuse bythe person in the home who is
causing harm you see, of course,increased risk of suicide,
increased risk of substance use,increased risk of mental health
(08:02):
issues later on.
You also see an increased riskthat and this is I haven't read
a recent study about this, but Iknow from past studies I've
read if you are a young girl whois in a home where there is
violence, you are more likely topartner with an abusive person.
(08:22):
If you are a young boy wholives in an abusive home, you
may be more likely to partnerwith an abusive person.
If you are a young boy wholives in an abusive home, you
may be more likely to adopt someof the abuser characteristics.
If that is how the violence isshowing up in the home, meaning
if dad is the abuser and mom isthe victim of the abuse, you may
see that more often.
(08:43):
Where the boy aligns with dad'sbehavior, girl aligns with
what's happening with mom, orsees if she's going to partner
with men later on in life, seesthat that is valid, it's
normalized.
This is what happens.
This is what relationships looklike.
So you tend to see.
(09:03):
You know that those patternsmoving generationally through,
where if mom was abused and youhave a chance that the kids
later on may be abused as wellor be involved in abusive
relationships.
And I know in my work I'm anLPCCS licensed professional
clinical counselor in Ohio Allof my 18-year career was with
(09:24):
substance, using independentpopulation.
I know with the clients that Iworked with in therapeutic work,
the vast majority of them hadnot one instance of violence or
trauma but multiple instances ofviolence or trauma, starting in
childhood, through adolescenceand into adulthood.
(09:46):
So their ability to identifyhealthy relationships or healthy
behaviors was never modeled orshown to them.
They didn't know and again I'mspeaking of clients I worked
with but they didn't really knowwhat that meant.
Speaker 1 (10:02):
Rachel, you mentioned that Ohio has been funded with
domestic violence services at$20 million in the past.
When you dive into that, though, we spent about $0.85 per
capita on those services, andthat's low compared to our
Midwest neighbors.
Indiana does about $1.31.
Kentucky three times that.
(10:22):
Why are we being outspent, andwhat could we learn from our
neighbors who are spending moreon these programs?
Speaker 3 (10:31):
Well, you know, I think it is often a question of
priorities and that is, and Iknow it is very, very difficult
to put together a state budgetand there are lots and lots of
needs and our needs are oftenvery complex and very
complicated.
But we're excited for until2019, that was zero dollars.
(10:52):
Oh, the state contributed zerodollars.
I think, again, this is a partof why we commissioned things
like this economic study to beable to make the case that, well
, this funding is important andis very, very much appreciated
and with us being a larger state, with larger, I mean we have
population centers, we have lotsof large cities, we have lots
(11:14):
of rural counties, we have lotsof Appalachia and just the
differing needs of the people inthat state being able to help.
Lawmakers are particularlylawmakers in a state like this
that have a very, very strongfocus on fiscal responsibility,
that investing in domesticviolence services is being
(11:34):
fiscally responsible.
So I think that that issomething and we have made great
strides in the last few years,but we know that our programs,
the money that we get from thestate, it just is life-saving
because of the flexibility ofthat money, because of the ways
we know that there are differentprograms in different areas,
that need different things, thathave different resources, and
(11:56):
that ability to be able to youknow what is missing in Pike
County and how survivors need tobe supported in Pike County is
very, very could be very, verydifferent than what people need
in Cleveland or Akron.
I think the other thing that wasinteresting as I was listening
to Cheryl's conversation abouther clinical experience and
working with substance usingsurvivors there's a lot of
(12:20):
people who wouldn't even connect.
Those are not people who aregoing for domestic violence
services.
They get that like oh, when youcome through the substance use
store, that often getsidentified like, well, that's my
problem.
And somebody who goes to atherapist thinks, well, mental
health is my problem.
And somebody who maybe goes tothe hospital well, my physical
health is the problem.
(12:40):
Or somebody who calls thepolice, that's a criminal
justice problem.
But thinking about kind of thedrivers behind where that
substance use came from, whatare the kind of the roots of
that I think that that's justanother piece is.
I think a lot of times in ourservices and I'm sure you all
know that working in suicideprevention.
(13:02):
You might be the suicideprevention people, but there's a
lot of how does domesticviolence play a role in suicidal
ideation?
How does substance use, how doall of those things, even though
you're not the substance usepeople, you're the suicide
people.
Those really aren't separatethings, and I think that that
was one of the things we werealso trying to highlight that a
(13:24):
lot of people might just say, ohwell, domestic violence, the
only cost associated withdomestic violence, is, like
domestic violence, shelters,right?
No, there's all of these othercosts that are contributed to
that, and that's something thatthose of us who work in domestic
violence, we can't simply say,and that's a part of, you know,
the work Cheryl does is oh, I'msorry, we're the domestic
(13:44):
violence program.
You know, we don't do suicidehere, because that's what the
suicide people do, you know.
Or we don't do substance usehere, because that's what the
substance use people do, youknow.
To have that understanding thatwe have to have a much more
holistic and much morecomprehensive understanding of
this if we're gonna be able tohelp survivors and help
(14:05):
individuals live their best lifepossible, which is what we all
want.
Speaker 2 (14:08):
Yeah, absolutely.
You mentioned shelters.
Are there Ohioans being turnedaway from shelters because of
inadequate funding?
Absolutely.
Speaker 3 (14:18):
What we knew.
We collect data every, sothere's a couple of things that
I think are really important forindividuals to know about
domestic violence programs,particularly people who might
not work in domestic violence ordon't have a lot of information
or knowledge kind of I don'tknow insider view.
I think first of all, we wantto acknowledge that there are.
So we have 76 member domesticviolence programs serve all
(14:41):
survivors people of all races,of all genders, of all.
We serve everybody of allsocioeconomic status.
All of our programs are free.
There aren't any charges,there's not any cost associated
with our domestic violenceservices.
But a lot of people think thatdomestic violence programs are
only shelters and might say well, I'm not in a situation where I
(15:02):
need a shelter.
I could be in a situation whereI have my own housing and kind
of what that is.
From our data that we collectedlast year, our network of
programs housed around 9,700survivors.
Oh wow, but served almost100,000 individuals Wow.
So when we think about—.
Speaker 1 (15:22):
Ten times the number yeah, ten times the number yeah,
ten times the number.
Speaker 3 (15:25):
But we also turned away 8,200 survivors because
shelters are full and we didn'thave the capacity to.
There just isn't enough.
There literally isn't enoughspace.
So I think that that's a coupleof things I just want people
listening to this to betterunderstand about domestic
violence services is that theycan also look very different in
(15:45):
different communities.
It's not like a statewidenetwork where you have your BMV,
which kind of does the samething in every county if that
makes sense, your Bureau ofMotor Vehicles.
Each county has its own kind oflocally funded domestic violence
program and sometimes, when wetalk even about services related
to children, I think thatthat's one of the things that
(16:07):
often, when times get tight andbudgets get tight and we have to
, you know, or federal grantsdon't come through, so we often
see services to children or whenwe get down to like the bare
bones of services, sometimesthose services get cut or other
types of services get cut.
So that is one of the things wewant people to really kind of
understand.
Is that domestic violence?
(16:28):
Yes, we do not have enoughspace for everybody.
We don't have enough funding tobe able to support everybody
who needs shelters, but alsodomestic violence programs have
24-hour hotlines that anybodycan call that are anonymous.
Many of them have some kind ofweb chat or text availability.
Through that, we haveinformation on our website.
(16:49):
We have like a little find yourprogram locator and a map where
you can put your zip code inand get information on your
local program, and we wantpeople to know that that's a
resource that is available toeveryone 24 hours a day,
confidential.
You don't have to share yourname or any information about
yourself if you don't want to.
But we just want people.
But yes, we do have and I meanI think that that was another
(17:12):
being able to have some of thedata in terms of how much this
costs, what that smallinvestment can really have big
returns.
And just acknowledge that,because that's the question we
ask our programs and they trackevery year how many people were
turned away.
And we had again sheltered9,707 survivors and turned away
nearly 8,200.
Speaker 1 (17:32):
Wow, there's another data point in there.
While we're on it, let's justkeep jumping into this and just
go deeper and deeper.
Ohio has an estimated 188,000victims of intimate partner
violence each year and more thana hundred deaths.
Does the greater public knowthis?
Speaker 3 (17:52):
Well, they'll hopefully know it a little bit
more because they have listenedto this podcast, and that's one
of the reasons why we are soexcited.
We were so excited to beinvited to be on this podcast
and some of the evolvingpartnerships between the
domestic violence work and thesuicide prevention work, which
are just two areas that need tobe talking to each other more.
(18:13):
And, yeah, I think that that'ssomething that anytime we have
the opportunity for people whoyou know are in these different
places or in these differentspaces to hear some of those
numbers, it allows people toreally think about this in ways
that maybe they haven'tconsidered before.
Speaker 4 (18:31):
I think, probably like most things, your average
person on the street, if youwere to stop them and ask them,
do you know what the economiccost of domestic violence is?
Do you know how many domesticviolence survivors there are in
the state of Ohio?
Probably wouldn't know thatinformation.
They may know it's an issue.
(18:55):
They may know some things aboutdomestic violence.
But I think, overall, bringingall things together, the
economic impact, the sheernumber of survivors and you know
of course those are justsurvivors that we can track.
There's certainly more out therethat we may not have any
reference for exactly the numberwe have of people who are
(19:17):
experiencing this, but I thinkyour average citizen probably
knows some things, but probablynot all things.
So, yeah, that's what's greatabout podcasts.
And of course, we release ourstudies and all the things that
we do at ODVN.
(19:37):
We release those on listservsand out in our newsletters and
things like that, so hopefullypeople are looking at it and
reading it and educatingthemselves more on just how big
a situation and problem we havewith DV and our culture.
Speaker 3 (19:58):
I think I would like to just add one thing to that is
that people might not know, asCheryl said, kind of like these
numbers and these statistics andthe scope of this.
They're all said kind of likethese numbers and these
statistics and the scope of this, but you would be hard pressed
to find somebody who doesn'tknow, somebody who has been
personally impacted by domesticviolence, that, whether they
(20:18):
have a friend or a family memberor grew up in a home where they
were unsafe or you know aroommate or a colleague or a
co-worker Significant enoughthat that is our annual Domestic
Violence Awareness Month, whichis in October.
Our national theme for the pastcouple of years have been
everybody knows somebody.
So I think that that is alwaysone of the things that's
interesting and I know Cherylmight have some of the same
(20:40):
experience when I don't know ifyou've ever been on an airplane
and you're sitting next tosomebody and they're like what
do you do?
And it's always this weird.
Speaker 2 (20:50):
I don't know if you kind of get that like oh yeah,
yeah, I work in suicideprevention.
Um, yes, and it's like ithappens at target.
And then you talk to thecashier and the cashier had a
brother who died by suicide 30years ago.
It's like you give somebodylike an opening to share their
story.
Hopefully it's a, it's a ablessing and a curse, and it is,
and sometimes I know you'rethinking.
Speaker 3 (21:09):
Should I just say I work at the bank Like?
I work at a bank like something.
It's not very interesting,there's not any questions about
it, but I think it is one ofthose things where we think
about how many times there arepeople who you know you say, oh,
I work in domestic violence.
How they will talk about, howthey have had a personal, just a
(21:30):
personal.
We look at this and this isthat one person you know.
There are, you know, hundredsof thousands of people who don't
(21:53):
have the same experience, butyou know that you're not alone
and that person is not alone andthat we do have a network of
people to help you, that careabout you and that care about
your safety.
I think that that's somethingthat's super powerful.
Speaker 2 (22:06):
I was going to say if you guys had, you know, any
recommendations, I guess, of howthe public awareness can grow
to where our neighbors andfriends and family members know,
uh, widespread, how urgent of amatter this is.
Um, I think sometimes insuicide prevention, you know, we
talk about breaking the stigmaand sometimes it's OK to talk
(22:29):
about maybe struggling withmental health, but there are
cases in which maybe it's notsafe to talk about a domestic
violence situation.
So, you know, I didn't know ifyou had any thoughts on that.
It's, how do we start talkingin the general public about how
urgent this is?
Speaker 4 (22:46):
Well, I think that's what's.
You know, one of the reallygood things about social media
is you reach a lot of people ina very short amount of time.
You don't even have to put outthat much information from
people to, and you shouldn't.
You know, you tend to stop onthe things that have short but
impactful information on mostsocial media platforms, and ODVN
(23:07):
is on Facebook, we're onInstagram, we're on X I believe
we're still on X or formerly,twitter.
I might be missing one, but wedo put out during Domestic
Violence Awareness Month, duringBrain Injury Awareness Month,
which Rachel talked a bit abouther work in brain injury, and
(23:29):
you know, we put out these kindof short little blurbs, these
eye-catching things, hopefullyeye-catching things out on
social media, like results fromthis study that we'll put out,
and you know, over the course oftime on social media, so that
hopefully people are seeing itand at least stopping and saying
(23:50):
whoa, that's a whole lot morethan I thought or that's a whole
lot bigger problem than Ianticipated it was, or you know,
and I put things out forsubstance use awareness and
mental health awareness andthings like that.
So I think social media is agreat way to do that, because
(24:11):
you get millions of people witheyes on what you're putting out
there.
Speaker 3 (24:17):
I think the other thing is, you know, when we
think about talking about I waslistening to Cheryl talking
about some of her clinicalexperience and there is, you
know, legislation that thereneeds to be information about
healthy relationships in schooland just really thinking about,
particularly in the technologyage that we're in, just thinking
about what are relationshipssupposed to look like?
(24:39):
What should they be?
I think that there are.
I have three kids and twoteenagers, so there was a recent
movie that came out that wascalled it Ends With Us.
That was off of a book.
I mean I think that there arealso opportunities.
Yes, I went to see the moviewith my kids, but I think it is
sometimes when we think aboutthere are sometimes news stories
(25:00):
of a person gets arrested andkind of what that is.
I think that there areopportunities there, kind of
what that is.
I think that there areopportunities there.
But I also think you know oneof the things that often has us
concerned about from thedomestic violence space when we
look at you know, what dorelationships look like in
today's age, in the digital age,where you know I go to the mall
and my daughter pulls out herphone and sees she knows who's
(25:24):
at the mall, she knows whereeverybody is and she's always
like mom.
Like mom, because I always thatstuff always freaks me out,
because back in the day, likeit's weird when people follow
you and track you but you knowhow how many snaps is too many
snaps and what do relationshipslook like when there's so much?
It's just a.
It's a very, very differenttime, um, than when we were um.
(25:44):
As somebody who's been marriedfor almost 21 years like like
this is like I mean, I mean itwas like finding somebody on the
internet was creepy, you know,and really thinking about how
are we talking about wherepeople learn a lot about what
relationships are and what theyshould be and what they
shouldn't be, and they'relearning, you know, I think you
know, as Cheryl was talkingabout earlier, you know we know
that the home is a very, verypowerful place to teach people
(26:06):
things, whether it's violence.
We know that most people, whenwe think about if people come
from homes where parents havecollege degrees, they're much
more likely to have collegedegrees.
I mean it kind of goes and youknow there's a lot of ways in
which home shapes us, butthere's also a lot of ways in
which other places shape us andthere are many of us who are in
the domestic violence field whoyou know.
(26:28):
For some of you remember, youknow, fifty Shades of Grey and
that came out and there were alot of real concerns about the
dynamics in that relationshipfrom a domestic violence
perspective.
But how it is shown as likethis is exciting and this is
sexy and this is, you know kindof really thinking about that.
Speaker 1 (26:45):
Yeah, there were segments on, you know, good
morning American, the today show.
Like it got like a ton ofpositivity and like that
excitement around.
Speaker 3 (26:55):
So I think it's a stalker, just like if you and
there were actually, of course,the journal articles that nobody
reads, but like if you our youknow our domestic violence stuff
and the power and control wheeland the surveillance and the
degradation and the emotionalabuse and all that kind of stuff
that we talk about, and thenit's like put on this movie,
almost kind of like glamorizedand yeah, you know, when we
(27:18):
think also about young peopleand I again have two teenagers
at home like they haven't hadrelationships before and you're
learning how to do this stuff soI think it is also really being
able to have conversations andfigure out you know where all of
that stuff plays a role.
There was just a few weeks ago Iwas listening to a you know, it
(27:38):
was actually a podcast on allof the smart cars that people
have now and just about howthat's become a tool of tracking
people.
When we think about that, Iactually had my sister, who was
on some like mom's Facebookgroup, who she texted me a
question because there wassomebody.
This was not so again, I wantyou to remember, this was not
somebody who called our program.
(27:59):
This is not some of our hundredthousand people who reached out
to us.
She had a sleep number bed andyou have an app with the sleep
number bed and her abusivepartner.
She had kicked her abusivepartner out and he kept messing
with her bed when she wassleeping and she was trying to
figure out like.
I tried to call, like the sleepnumber customer service and
(28:19):
would use that as a.
I mean, it's just the kind ofstuff that you don't even and,
like I said, that was like mysister's little neighborhood
mom's Facebook group.
That wasn't our everybody who,everyone knows someone and she
was just like and I go into thestore but hearing things about
people who have cars that areall connected and all of that
kind of stuff, really thinkingabout it just is a very, very
(28:42):
different world.
And thinking about how torespond and how to think about
how much social media contact isacceptable, when does it get to
be too much?
It's just a very differentcharacterization of what that
looks like with technology.
That didn't exist for many ofus.
Speaker 2 (29:01):
Okay, so you mentioned, Cheryl, something
about Brain Injury Month.
Tell us more about that, Rachel.
The association between braininjury and domestic violence.
Yeah, you know a littlesomething about it.
Speaker 3 (29:15):
We're gonna have to come have a whole nother podcast
.
Cheryl and I have so manythings that we could talk about
related to this, but I thinkthat that's another as we talk
about, as we know more and as welearn more.
Our organization got a grantabout eight years ago to start
looking at the intersection ofdomestic violence and brain
injuries or concussions, whichis something that many of us
(29:37):
hear concussions and most of us,the vast majority of people
when you hear concussions, youthink football, as most of us do
, but anybody and I think evenyou know anybody who's ever
worked in domestic violence knowthat a lot of times, if people
are physically abused, they'rephysically abused their heads,
necks or faces, like they'rephysically abused in the head,
or another very, very kind ofterrifying and traumatic tactic
(30:01):
of abuse is strangulation, whichis a new felony which was
recently passed felonylegislation in 2023.
The state of Ohio was the laststate to make strangulation a
felony, but that is again veryproblematic in a ton of
different ways.
But it also deprives the brainof oxygen and when we think
(30:22):
about some of the protocols thathave been developed to address
concussions in other places inmilitary spaces or in sports
spaces.
Thinking about that being one ofthe health consequences of
domestic violence is somethingthat both Cheryl and I, who have
been doing this work for a very, very long time, had never even
really considered.
(30:42):
So that's another piece ofawareness raising that we're
really thinking about.
What does that mean and whatare some of the long-term
consequences of that,particularly when we have brain
injuries that hardly ever getidentified because there's also
we think about how much I don'tknow.
If any of you have kids, havethem play sports, get a little
(31:03):
concussion fact sheet from theOhio Department of Health,
because you're there watchingright Like people don't get beat
up in front of other people.
You know that doesn't happen.
There's not that I caught kindof like the bystander
intervention piece.
That's not like really a thing,because you don't do these
kinds of things to people and wethink about that being one of
(31:23):
the potential very long-termconsequences.
We know that most domesticviolence survivors, if they have
been hit or hurt in the head,it's been repeated, it's often
been over a long period of timeand then have people who could
have longer-term consequencesbecause of that.
So Ohio is really doing someleading work around that.
And then once I got startedtalking about that.
(31:45):
Then, cheryl, talk a little bitabout your background and how
this brain injury stuff plays arole in again mental health, not
brain injury.
We're not talking about braininjury, substance use, that's
not brain injury stuff, that'ssubstance use stuff.
Maybe you can share a littlebit about kind of that piece,
because we are co-captaining thebrain injury ship over here at
ODVN.
I'm the skipper.
Speaker 4 (32:07):
So, yeah, so you know , as I mentioned, 18 years of
clinical work with both anoutpatient, residential, with
substance use.
That's my background.
And when I came to ODVN in 2022and started working with Rachel
, you know, of course, learninga lot about partner inflicted
(32:29):
brain injury, which is notsomething I knew about, nor
thought about, I should say, andso I started learning about
that.
And then, you know, almost in amoment and I couldn't pinpoint
when that moment was, but almostin a moment of like holy cow,
wait a minute.
What about overdose-relatedbrain injury?
(32:52):
And with the number of nonfataloverdoses you're looking at
about roughly half a millionpeople that visit the ER every
year for non-fatal overdoses.
So these are people that youknow obviously live through
their overdose and haveabsolutely no care, treatment
(33:15):
questions, nobody asking them.
You know, about anythingrelated to brain injury.
So that got me thinking aboutall of my years of working and
the clients that I had who wereshowing what now I know to be
potential symptoms of cognitiveimpairment, and clients that I
(33:35):
knew had overdosed not once, notfive times, but 10 times, 12
times.
And I really started thinkingback like, wow, how many of
those people because they wereshowing, let's say, they weren't
participating in group or theyweren't showing up to their
sessions or they weren't able tomaintain their sobriety did I
(34:00):
write letters to their POs,probation officers that said,
hey, they're not participating,they're keeping their sunglasses
on in group and their hoodiesover their head and they're not
engaged.
They're not all these things.
And never once did I have aconversation with somebody about
well, we know this person'soverdosed a bunch of times.
Maybe they have a cognitiveimpairment and the lights are
(34:24):
bothering them, or having 11other people in the room is
impacting their ability to besuccessful in group or
participate.
So that just led me down therabbit hole of.
I really want other cliniciansto understand that.
You know, with overdose you areguaranteed a lack of oxygen to
(34:50):
the brain.
It's just part of what it is.
It's a certainty, and this isin no way to take away from what
domestic violence survivorsexperience or victims experience
.
But you don't always havephysical violence in a
relationship.
You may not with that physicalviolence.
You may not always have a hit,a person who's hit or hurt in
the head, although that's likelywhere you're going to get
(35:13):
injured.
But with overdose you areguaranteed a lack of oxygen to
the brain period as a certainty.
So that's where I came into thebrain injury space was really
becoming very passionate abouteducating other clinicians,
emergency room doctors, firstresponders to please just ask a
(35:35):
few questions if you have anoverdose person who's overdosed,
just asking a few questions andgiving some information that
you know.
We're in the process of creatingsome overdose-specific brain
injury-related tools andresources and you know please
just hand them out to people sothat they're aware that some of
(35:55):
the symptoms they may be seeingin themselves could very well be
the result of a brain injury,because of an anoxic or hypoxic
brain injury resulting fromtheir overdose and with that
they're more prone to overdosein the future, with an injured
brain less likely to be able tomonitor their intake of drugs
(36:16):
with an injured brain.
So you're also looking atsituations where recovery
becomes exponentially moredifficult when your impulse
control is affected by a braininjury and you're more likely to
overuse substances, even ifyou're trying not to, because of
(36:37):
an injured brain.
So lots of components that gowith that that are similar to,
and some that are very differentthan what people who are in
abusive relationships experiencewith brain injury that's such
important work.
Speaker 1 (36:52):
Let's do this, let's make a pivot, as we start to
wrap up our conversation, tothings that are hopeful.
Of course, we're OSPF, the OhioSuicide Prevention Foundation.
We talk about and we tacklesome tough subjects.
We've done that in this veryepisode as well.
But in doing this work, we alsosee how mental health changes
and saves lives every single day.
(37:14):
So, rachel to you, cheryl toyou, what gives each of you hope
?
Speaker 3 (37:20):
Well, I think one of the things that gives me hope
first of all, is the fact thatwe're here doing this podcast
and to be able to think abouthaving a deeper relationship and
better understanding.
How can maybe our deepenedunderstanding of suicide help us
better support domesticviolence survivors?
How can deepened understandingof domestic violence help us
(37:42):
better support survivors ofsuicide and kind of what it is
that that looks like are workinghard to support survivors and
just being able to helpsurvivors know that they're not
alone?
And there is this amazingnetwork of 76 programs that's
(38:17):
around, that's available for youand that really cares about you
and wants to help you,available for you and that
really cares about you and wantsto help you.
So I'm really and also assomebody I actually did lose my
older sister to suicide in 2011.
So I'm also very personallyimpacted by this.
Speaker 4 (38:31):
Yeah, I don't know that I have much to add other
than what Rachel said.
I just know that you know frommy personal experience and
seeing people go from the, youknow the depths of their
addiction to recovery has beenone of the great joys of my
career is, despite everything,all the seemingly insurmountable
(38:57):
odds they have to face to getto a place where they can
rebuild their lives and have alife that they find to be
rewarding for them.
You know it's easy to get lostin these kinds of statistics and
the dark side of the statisticsand all of the things that are
(39:19):
not going well.
But you see, millions of peoplego into recovery from substance
use and mental health all thetime and I think a spotlight
needs to be shown on the peoplewho have been there and made it
through it and came out theother side of it.
Speaker 3 (39:41):
I remember seeing a brain injury survivor at a
conference and one of her shewas a X Games athlete and
actually had a terrible braininjury like during a competition
almost died, and you know wasat the height of her.
That was what she was.
She was a skier and you knowshe couldn't walk and she
couldn't talk.
But she does a presentationtalking about how I think after
not only after brain injury butafter trauma, it is possible to
(40:03):
live a life you love.
That's what she talks about.
It might not be the same lifeand we know trauma can change
people.
We know, when we even work withpeople who have been in really
really you all work with peoplewho have been in really really
dark places and sometimes wehave things that happen to us.
They do change us and we aredifferent people, but that you
can live a life you love andthat life that you love might be
(40:26):
different than it was beforeWhatever happened to you it is
but that recovery is possibleand that being able to have a
life that you wake up in, thatyou're excited to be in, just is
something that humans aredesigned to survive and designed
to overcome incredible odds.
So it has just been such aprivilege, I think, for Cheryl
(40:47):
and I both to also be able towalk with people who are in
really, really difficultsituations and just be able to
support them and being able tosee themselves through some
really dark times.
Speaker 2 (40:58):
It has been so inspiring to talk to both of you
.
I can't thank you enough forwhat you do for the community.
I have no doubt that you guysare saving people's lives.
I just I commend you.
I have the utmost respect forboth of you.
Thank you both so much forjoining us today, and to our
listeners, thank you as well.
When you listen to our episodes, you break stigmas, break
barriers and you care aboutmental health and saving lives.
(41:20):
This is Voices for SuicidePrevention, brought to you by
the Ohio Suicide PreventionFoundation.
Thank, you.
Welcome everyone to our April episode of Voices for
Suicide Prevention.
As we like to say, ourconversations here are real talk
, real honest, real life.
Speaker 2 (00:14):
I'm Scott Light and I'm Rachel Tilson.
We are going to begin with astatistic that is underreported
by the media and, overall, justdoesn't get the attention it
deserves.
$1.2 billion is that figure,and that's the economic impact
of domestic violence every yearin Ohio.
This comes from the most recentstudy commissioned by the Ohio
(00:35):
Domestic Violence Network, andwe have two guests from ODVN
joining us to talk about it, anda lot more Rachel Ramirez and
Cheryl Stahl.
Welcome to the podcast.
Thank you so much for beinghereahl.
Welcome to the podcast.
Thank you so much for beinghere.
Very excited to be here.
Well, we have so much to talkabout with both of you.
So let's begin with theeconomic study, because you just
released that in late February.
Speaker 3 (00:55):
Well, this is the first time that we had ever done
any kind of economic impactstudy in the state, and one of
the things we were trying tohighlight was to think about how
, when we invest in domesticviolence services, how that can
help save the state money.
As we know that budgets are abig deal.
Everybody is talking about thebudget now.
There are years when there'sfunding, there are years when
(01:16):
there aren't funding.
But really to estimate, thinkabout how much does it cost us?
How much does domestic violencecost our state?
Is it cost us, how much doesdomestic violence cost our state
?
And in the part of this firststudy, what we learned is the
largest factors.
When we think about physicalhealth care for victims, that
cost approximately $264.8million annually, loss of life,
(01:37):
loss of worker productivity, andthen thinking about how all of
those different costs can kindof ripple through the system.
When we think about lostproductivity and people who
don't show up to work, we thinkabout the impact of law
enforcement and the lawenforcement response.
How much do local policedepartments spend on domestic
violence response?
How much do court systems spendon domestic violence response?
(01:59):
And then, of course, the impactto the victims of domestic
violence, including thosedirectly impacted by domestic
violence, including thosedirectly impacted by domestic
violence and their familymembers.
So maybe this is something Ican see if Cheryl could talk a
little bit about.
We see some of those costsrelated to mental health, to
other health costs and substanceuse and how all of those things
connect.
Speaker 4 (02:19):
A study put out by the CDC in 2017 and looked at
the cost of, of course, theoverdose epidemic across the
United States and that,including the combined cost of
opioid use disorders and fataloverdoses, that equaled about
(02:42):
$72.5 million.
Economic cost to Ohio and overthe United States was over $550
billion.
So that's just substance useand if you're looking at mental
health, you're looking at costto the United States.
I really couldn't find anythingspecific to Ohio with that cost
(03:04):
States.
I really couldn't find anythingspecific to Ohio with that cost
.
But for the United States, theeconomic costs for mental health
alone, and I'm not sure if theylooked at substance use as part
of mental health or behavioralhealth or not.
I didn't see that distinguishedin the study, but that was at
$282 billion and with projectedcosts into like 2040, into the
(03:28):
trillions of dollars if itcontinues at the trends.
It is now, you know, but in thenext less than 20 years you're
looking at trillions of dollars.
Speaker 1 (03:39):
Cheryl and Rachel on that note.
There's, you know, there's thatold business axiom of you can't
manage what you don't measure.
And I want to come back to whatyou mentioned about this.
Is the first time you did thisexhaustive of a study.
Why do you think you need it?
Obviously we need it, but wereour neighboring states?
Did they have these data setsand it was just time for us to
(04:00):
get them?
Speaker 3 (04:01):
Well, I think that we actually worked with an
economist at the University ofSouth Carolina who has done some
similar work in a couple ofdifferent states.
This is very kind of newer worktrying to figure out when we
look at the total cost ofdomestic violence, because
there's so many different waysand so many different places
where that can show up.
But, you know, one of thedrivers behind this was really
(04:25):
thinking about what we do knowis that here in the state of
Ohio, on a per capita income,the state invests much less
money in domestic violence thanour neighboring states, than
Kentucky, than Michigan.
And being able to show we havea $20 million line item for
domestic violence services forthe whole state of Ohio, which
(04:45):
we're very, very grateful for.
We know it's very, very toughbudget times but we have 76
member programs in Ohio andspend much less per capita on
domestic violence services andto be able to come to our
legislature and come to ourstate lawmakers and again very
appreciative of the funding thatthey have provided, but also to
(05:06):
think about, you know, the $20million that we have allocated
to divide between our 76 memberprograms when we think of the
enormous cost of domesticviolence.
I think that that puts thatinto context and in a state
where we're very, you know,budget conscious, here we have a
balanced budget that needs tobe released every year and,
(05:27):
knowing with so much, ohioactually did not have any state
money for domestic violenceuntil around 2019, 2020.
It wasn't ever written into thestate budget.
So that left all of ourprograms very, very dependent on
federal funding and when we seethe federal government, things
can change radically from yearto year and it really left
(05:49):
programs very, very vulnerableand the survivors in their
community vulnerable and able todo that.
So when we think you know, a lotof people might think, oh, you
know, we know that everybodyknows somebody impacted by
domestic violence, just like I'msure that's something you all
say a lot.
Everybody knows somebody who'simpacted by suicide.
But you kind of think, oh,that's something over there that
(06:09):
doesn't have to do with me, Idon't know about.
You know what I mean, thatdoesn't really relate to me.
But when you think about thecosts that are being borne by
your community, the costs thatare being borne in workplaces
and among services and publicservice response, I think that
that was the and we honestly Ithink one of the other things is
we really didn't know and wedidn't know how much it really
(06:30):
cost us, cost the state of Ohio,how much domestic violence and
where those areas were.
So it was able to help usprovide better data and really
thinking about you know, I know,cheryl, you talked about that
the CDC study about some ofthose mental health costs.
But one of the things that wefound and we have more
information about the economicimpact study on our website but
(06:52):
that the professor who did thisestimated that mental health
care in the state of Ohio costs$122 million just mental health
care related to domesticviolence.
So when we see that that's onetiny, tiny piece of this we're
talking about child welfarecosts, loss of property costs,
how much do our shelters cost?
How much do you know policingcosts?
(07:12):
How much do courts costs?
How much does incarcerationcosts?
It's just a very, very smallsliver.
So to be able to make the casethat investing in domestic
violence services really is notonly I mean, we all know, just
like you know with your work itmight be the right thing to do,
but it also makes economic sense.
Speaker 2 (07:30):
Yes, exactly yeah.
So there's another layer inthere about the children who
witness or are themselvesvictims.
What are the long-termchallenges that they face?
Speaker 4 (07:42):
You know, for kids who witness trauma or are
impacted directly by trauma, sothey're the ones that are being
abused or the target of abuse bythe person in the home who is
causing harm you see, of course,increased risk of suicide,
increased risk of substance use,increased risk of mental health
(08:02):
issues later on.
You also see an increased riskthat and this is I haven't read
a recent study about this, but Iknow from past studies I've
read if you are a young girl whois in a home where there is
violence, you are more likely topartner with an abusive person.
(08:22):
If you are a young boy wholives in an abusive home, you
may be more likely to partnerwith an abusive person.
If you are a young boy wholives in an abusive home, you
may be more likely to adopt someof the abuser characteristics.
If that is how the violence isshowing up in the home, meaning
if dad is the abuser and mom isthe victim of the abuse, you may
see that more often.
(08:43):
Where the boy aligns with dad'sbehavior, girl aligns with
what's happening with mom, orsees if she's going to partner
with men later on in life, seesthat that is valid, it's
normalized.
This is what happens.
This is what relationships looklike.
So you tend to see.
(09:03):
You know that those patternsmoving generationally through,
where if mom was abused and youhave a chance that the kids
later on may be abused as wellor be involved in abusive
relationships.
And I know in my work I'm anLPCCS licensed professional
clinical counselor in Ohio Allof my 18-year career was with
(09:24):
substance, using independentpopulation.
I know with the clients that Iworked with in therapeutic work,
the vast majority of them hadnot one instance of violence or
trauma but multiple instances ofviolence or trauma, starting in
childhood, through adolescenceand into adulthood.
(09:46):
So their ability to identifyhealthy relationships or healthy
behaviors was never modeled orshown to them.
They didn't know and again I'mspeaking of clients I worked
with but they didn't really knowwhat that meant.
Speaker 1 (10:02):
Rachel, you mentioned that Ohio has been funded with
domestic violence services at$20 million in the past.
When you dive into that, though, we spent about $0.85 per
capita on those services, andthat's low compared to our
Midwest neighbors.
Indiana does about $1.31.
Kentucky three times that.
(10:22):
Why are we being outspent, andwhat could we learn from our
neighbors who are spending moreon these programs?
Speaker 3 (10:31):
Well, you know, I think it is often a question of
priorities and that is, and Iknow it is very, very difficult
to put together a state budgetand there are lots and lots of
needs and our needs are oftenvery complex and very
complicated.
But we're excited for until2019, that was zero dollars.
(10:52):
Oh, the state contributed zerodollars.
I think, again, this is a partof why we commissioned things
like this economic study to beable to make the case that, well
, this funding is important andis very, very much appreciated
and with us being a larger state, with larger, I mean we have
population centers, we have lotsof large cities, we have lots
(11:14):
of rural counties, we have lotsof Appalachia and just the
differing needs of the people inthat state being able to help.
Lawmakers are particularlylawmakers in a state like this
that have a very, very strongfocus on fiscal responsibility,
that investing in domesticviolence services is being
(11:34):
fiscally responsible.
So I think that that issomething and we have made great
strides in the last few years,but we know that our programs,
the money that we get from thestate, it just is life-saving
because of the flexibility ofthat money, because of the ways
we know that there are differentprograms in different areas,
that need different things, thathave different resources, and
(11:56):
that ability to be able to youknow what is missing in Pike
County and how survivors need tobe supported in Pike County is
very, very could be very, verydifferent than what people need
in Cleveland or Akron.
I think the other thing that wasinteresting as I was listening
to Cheryl's conversation abouther clinical experience and
working with substance usingsurvivors there's a lot of
(12:20):
people who wouldn't even connect.
Those are not people who aregoing for domestic violence
services.
They get that like oh, when youcome through the substance use
store, that often getsidentified like, well, that's my
problem.
And somebody who goes to atherapist thinks, well, mental
health is my problem.
And somebody who maybe goes tothe hospital well, my physical
health is the problem.
(12:40):
Or somebody who calls thepolice, that's a criminal
justice problem.
But thinking about kind of thedrivers behind where that
substance use came from, whatare the kind of the roots of
that I think that that's justanother piece is.
I think a lot of times in ourservices and I'm sure you all
know that working in suicideprevention.
(13:02):
You might be the suicideprevention people, but there's a
lot of how does domesticviolence play a role in suicidal
ideation?
How does substance use, how doall of those things, even though
you're not the substance usepeople, you're the suicide
people.
Those really aren't separatethings, and I think that that
was one of the things we werealso trying to highlight that a
(13:24):
lot of people might just say, ohwell, domestic violence, the
only cost associated withdomestic violence, is, like
domestic violence, shelters,right?
No, there's all of these othercosts that are contributed to
that, and that's something thatthose of us who work in domestic
violence, we can't simply say,and that's a part of, you know,
the work Cheryl does is oh, I'msorry, we're the domestic
(13:44):
violence program.
You know, we don't do suicidehere, because that's what the
suicide people do, you know.
Or we don't do substance usehere, because that's what the
substance use people do, youknow.
To have that understanding thatwe have to have a much more
holistic and much morecomprehensive understanding of
this if we're gonna be able tohelp survivors and help
(14:05):
individuals live their best lifepossible, which is what we all
want.
Speaker 2 (14:08):
Yeah, absolutely.
You mentioned shelters.
Are there Ohioans being turnedaway from shelters because of
inadequate funding?
Absolutely.
Speaker 3 (14:18):
What we knew.
We collect data every, sothere's a couple of things that
I think are really important forindividuals to know about
domestic violence programs,particularly people who might
not work in domestic violence ordon't have a lot of information
or knowledge kind of I don'tknow insider view.
I think first of all, we wantto acknowledge that there are.
So we have 76 member domesticviolence programs serve all
(14:41):
survivors people of all races,of all genders, of all.
We serve everybody of allsocioeconomic status.
All of our programs are free.
There aren't any charges,there's not any cost associated
with our domestic violenceservices.
But a lot of people think thatdomestic violence programs are
only shelters and might say well, I'm not in a situation where I
(15:02):
need a shelter.
I could be in a situation whereI have my own housing and kind
of what that is.
From our data that we collectedlast year, our network of
programs housed around 9,700survivors.
Oh wow, but served almost100,000 individuals Wow.
So when we think about—.
Speaker 1 (15:22):
Ten times the number yeah, ten times the number yeah,
ten times the number.
Speaker 3 (15:25):
But we also turned away 8,200 survivors because
shelters are full and we didn'thave the capacity to.
There just isn't enough.
There literally isn't enoughspace.
So I think that that's a coupleof things I just want people
listening to this to betterunderstand about domestic
violence services is that theycan also look very different in
(15:45):
different communities.
It's not like a statewidenetwork where you have your BMV,
which kind of does the samething in every county if that
makes sense, your Bureau ofMotor Vehicles.
Each county has its own kind oflocally funded domestic violence
program and sometimes, when wetalk even about services related
to children, I think thatthat's one of the things that
(16:07):
often, when times get tight andbudgets get tight and we have to
, you know, or federal grantsdon't come through, so we often
see services to children or whenwe get down to like the bare
bones of services, sometimesthose services get cut or other
types of services get cut.
So that is one of the things wewant people to really kind of
understand.
Is that domestic violence?
(16:28):
Yes, we do not have enoughspace for everybody.
We don't have enough funding tobe able to support everybody
who needs shelters, but alsodomestic violence programs have
24-hour hotlines that anybodycan call that are anonymous.
Many of them have some kind ofweb chat or text availability.
Through that, we haveinformation on our website.
(16:49):
We have like a little find yourprogram locator and a map where
you can put your zip code inand get information on your
local program, and we wantpeople to know that that's a
resource that is available toeveryone 24 hours a day,
confidential.
You don't have to share yourname or any information about
yourself if you don't want to.
But we just want people.
But yes, we do have and I meanI think that that was another
(17:12):
being able to have some of thedata in terms of how much this
costs, what that smallinvestment can really have big
returns.
And just acknowledge that,because that's the question we
ask our programs and they trackevery year how many people were
turned away.
And we had again sheltered9,707 survivors and turned away
nearly 8,200.
Speaker 1 (17:32):
Wow, there's another data point in there.
While we're on it, let's justkeep jumping into this and just
go deeper and deeper.
Ohio has an estimated 188,000victims of intimate partner
violence each year and more thana hundred deaths.
Does the greater public knowthis?
Speaker 3 (17:52):
Well, they'll hopefully know it a little bit
more because they have listenedto this podcast, and that's one
of the reasons why we are soexcited.
We were so excited to beinvited to be on this podcast
and some of the evolvingpartnerships between the
domestic violence work and thesuicide prevention work, which
are just two areas that need tobe talking to each other more.
(18:13):
And, yeah, I think that that'ssomething that anytime we have
the opportunity for people whoyou know are in these different
places or in these differentspaces to hear some of those
numbers, it allows people toreally think about this in ways
that maybe they haven'tconsidered before.
Speaker 4 (18:31):
I think, probably like most things, your average
person on the street, if youwere to stop them and ask them,
do you know what the economiccost of domestic violence is?
Do you know how many domesticviolence survivors there are in
the state of Ohio?
Probably wouldn't know thatinformation.
They may know it's an issue.
(18:55):
They may know some things aboutdomestic violence.
But I think, overall, bringingall things together, the
economic impact, the sheernumber of survivors and you know
of course those are justsurvivors that we can track.
There's certainly more out therethat we may not have any
reference for exactly the numberwe have of people who are
(19:17):
experiencing this, but I thinkyour average citizen probably
knows some things, but probablynot all things.
So, yeah, that's what's greatabout podcasts.
And of course, we release ourstudies and all the things that
we do at ODVN.
(19:37):
We release those on listservsand out in our newsletters and
things like that, so hopefullypeople are looking at it and
reading it and educatingthemselves more on just how big
a situation and problem we havewith DV and our culture.
Speaker 3 (19:58):
I think I would like to just add one thing to that is
that people might not know, asCheryl said, kind of like these
numbers and these statistics andthe scope of this.
They're all said kind of likethese numbers and these
statistics and the scope of this, but you would be hard pressed
to find somebody who doesn'tknow, somebody who has been
personally impacted by domesticviolence, that, whether they
(20:18):
have a friend or a family memberor grew up in a home where they
were unsafe or you know aroommate or a colleague or a
co-worker Significant enoughthat that is our annual Domestic
Violence Awareness Month, whichis in October.
Our national theme for the pastcouple of years have been
everybody knows somebody.
So I think that that is alwaysone of the things that's
interesting and I know Cherylmight have some of the same
(20:40):
experience when I don't know ifyou've ever been on an airplane
and you're sitting next tosomebody and they're like what
do you do?
And it's always this weird.
Speaker 2 (20:50):
I don't know if you kind of get that like oh yeah,
yeah, I work in suicideprevention.
Um, yes, and it's like ithappens at target.
And then you talk to thecashier and the cashier had a
brother who died by suicide 30years ago.
It's like you give somebodylike an opening to share their
story.
Hopefully it's a, it's a ablessing and a curse, and it is,
and sometimes I know you'rethinking.
Speaker 3 (21:09):
Should I just say I work at the bank Like?
I work at a bank like something.
It's not very interesting,there's not any questions about
it, but I think it is one ofthose things where we think
about how many times there arepeople who you know you say, oh,
I work in domestic violence.
How they will talk about, howthey have had a personal, just a
(21:30):
personal.
We look at this and this isthat one person you know.
There are, you know, hundredsof thousands of people who don't
(21:53):
have the same experience, butyou know that you're not alone
and that person is not alone andthat we do have a network of
people to help you, that careabout you and that care about
your safety.
I think that that's somethingthat's super powerful.
Speaker 2 (22:06):
I was going to say if you guys had, you know, any
recommendations, I guess, of howthe public awareness can grow
to where our neighbors andfriends and family members know,
uh, widespread, how urgent of amatter this is.
Um, I think sometimes insuicide prevention, you know, we
talk about breaking the stigmaand sometimes it's OK to talk
(22:29):
about maybe struggling withmental health, but there are
cases in which maybe it's notsafe to talk about a domestic
violence situation.
So, you know, I didn't know ifyou had any thoughts on that.
It's, how do we start talkingin the general public about how
urgent this is?
Speaker 4 (22:46):
Well, I think that's what's.
You know, one of the reallygood things about social media
is you reach a lot of people ina very short amount of time.
You don't even have to put outthat much information from
people to, and you shouldn't.
You know, you tend to stop onthe things that have short but
impactful information on mostsocial media platforms, and ODVN
(23:07):
is on Facebook, we're onInstagram, we're on X I believe
we're still on X or formerly,twitter.
I might be missing one, but wedo put out during Domestic
Violence Awareness Month, duringBrain Injury Awareness Month,
which Rachel talked a bit abouther work in brain injury, and
(23:29):
you know, we put out these kindof short little blurbs, these
eye-catching things, hopefullyeye-catching things out on
social media, like results fromthis study that we'll put out,
and you know, over the course oftime on social media, so that
hopefully people are seeing itand at least stopping and saying
(23:50):
whoa, that's a whole lot morethan I thought or that's a whole
lot bigger problem than Ianticipated it was, or you know,
and I put things out forsubstance use awareness and
mental health awareness andthings like that.
So I think social media is agreat way to do that, because
(24:11):
you get millions of people witheyes on what you're putting out
there.
Speaker 3 (24:17):
I think the other thing is, you know, when we
think about talking about I waslistening to Cheryl talking
about some of her clinicalexperience and there is, you
know, legislation that thereneeds to be information about
healthy relationships in schooland just really thinking about,
particularly in the technologyage that we're in, just thinking
about what are relationshipssupposed to look like?
(24:39):
What should they be?
I think that there are.
I have three kids and twoteenagers, so there was a recent
movie that came out that wascalled it Ends With Us.
That was off of a book.
I mean I think that there arealso opportunities.
Yes, I went to see the moviewith my kids, but I think it is
sometimes when we think aboutthere are sometimes news stories
(25:00):
of a person gets arrested andkind of what that is.
I think that there areopportunities there, kind of
what that is.
I think that there areopportunities there.
But I also think you know oneof the things that often has us
concerned about from thedomestic violence space when we
look at you know, what dorelationships look like in
today's age, in the digital age,where you know I go to the mall
and my daughter pulls out herphone and sees she knows who's
(25:24):
at the mall, she knows whereeverybody is and she's always
like mom.
Like mom, because I always thatstuff always freaks me out,
because back in the day, likeit's weird when people follow
you and track you but you knowhow how many snaps is too many
snaps and what do relationshipslook like when there's so much?
It's just a.
It's a very, very differenttime, um, than when we were um.
(25:44):
As somebody who's been marriedfor almost 21 years like like
this is like I mean, I mean itwas like finding somebody on the
internet was creepy, you know,and really thinking about how
are we talking about wherepeople learn a lot about what
relationships are and what theyshould be and what they
shouldn't be, and they'relearning, you know, I think you
know, as Cheryl was talkingabout earlier, you know we know
that the home is a very, verypowerful place to teach people
(26:06):
things, whether it's violence.
We know that most people, whenwe think about if people come
from homes where parents havecollege degrees, they're much
more likely to have collegedegrees.
I mean it kind of goes and youknow there's a lot of ways in
which home shapes us, butthere's also a lot of ways in
which other places shape us andthere are many of us who are in
the domestic violence field whoyou know.
(26:28):
For some of you remember, youknow, fifty Shades of Grey and
that came out and there were alot of real concerns about the
dynamics in that relationshipfrom a domestic violence
perspective.
But how it is shown as likethis is exciting and this is
sexy and this is, you know kindof really thinking about that.
Speaker 1 (26:45):
Yeah, there were segments on, you know, good
morning American, the today show.
Like it got like a ton ofpositivity and like that
excitement around.
Speaker 3 (26:55):
So I think it's a stalker, just like if you and
there were actually, of course,the journal articles that nobody
reads, but like if you our youknow our domestic violence stuff
and the power and control wheeland the surveillance and the
degradation and the emotionalabuse and all that kind of stuff
that we talk about, and thenit's like put on this movie,
almost kind of like glamorizedand yeah, you know, when we
(27:18):
think also about young peopleand I again have two teenagers
at home like they haven't hadrelationships before and you're
learning how to do this stuff soI think it is also really being
able to have conversations andfigure out you know where all of
that stuff plays a role.
There was just a few weeks ago Iwas listening to a you know, it
(27:38):
was actually a podcast on allof the smart cars that people
have now and just about howthat's become a tool of tracking
people.
When we think about that, Iactually had my sister, who was
on some like mom's Facebookgroup, who she texted me a
question because there wassomebody.
This was not so again, I wantyou to remember, this was not
somebody who called our program.
(27:59):
This is not some of our hundredthousand people who reached out
to us.
She had a sleep number bed andyou have an app with the sleep
number bed and her abusivepartner.
She had kicked her abusivepartner out and he kept messing
with her bed when she wassleeping and she was trying to
figure out like.
I tried to call, like the sleepnumber customer service and
(28:19):
would use that as a.
I mean, it's just the kind ofstuff that you don't even and,
like I said, that was like mysister's little neighborhood
mom's Facebook group.
That wasn't our everybody who,everyone knows someone and she
was just like and I go into thestore but hearing things about
people who have cars that areall connected and all of that
kind of stuff, really thinkingabout it just is a very, very
(28:42):
different world.
And thinking about how torespond and how to think about
how much social media contact isacceptable, when does it get to
be too much?
It's just a very differentcharacterization of what that
looks like with technology.
That didn't exist for many ofus.
Speaker 2 (29:01):
Okay, so you mentioned, Cheryl, something
about Brain Injury Month.
Tell us more about that, Rachel.
The association between braininjury and domestic violence.
Yeah, you know a littlesomething about it.
Speaker 3 (29:15):
We're gonna have to come have a whole nother podcast
.
Cheryl and I have so manythings that we could talk about
related to this, but I thinkthat that's another as we talk
about, as we know more and as welearn more.
Our organization got a grantabout eight years ago to start
looking at the intersection ofdomestic violence and brain
injuries or concussions, whichis something that many of us
(29:37):
hear concussions and most of us,the vast majority of people
when you hear concussions, youthink football, as most of us do
, but anybody and I think evenyou know anybody who's ever
worked in domestic violence knowthat a lot of times, if people
are physically abused, they'rephysically abused their heads,
necks or faces, like they'rephysically abused in the head,
or another very, very kind ofterrifying and traumatic tactic
(30:01):
of abuse is strangulation, whichis a new felony which was
recently passed felonylegislation in 2023.
The state of Ohio was the laststate to make strangulation a
felony, but that is again veryproblematic in a ton of
different ways.
But it also deprives the brainof oxygen and when we think
(30:22):
about some of the protocols thathave been developed to address
concussions in other places inmilitary spaces or in sports
spaces.
Thinking about that being one ofthe health consequences of
domestic violence is somethingthat both Cheryl and I, who have
been doing this work for a very, very long time, had never even
really considered.
(30:42):
So that's another piece ofawareness raising that we're
really thinking about.
What does that mean and whatare some of the long-term
consequences of that,particularly when we have brain
injuries that hardly ever getidentified because there's also
we think about how much I don'tknow.
If any of you have kids, havethem play sports, get a little
(31:03):
concussion fact sheet from theOhio Department of Health,
because you're there watchingright Like people don't get beat
up in front of other people.
You know that doesn't happen.
There's not that I caught kindof like the bystander
intervention piece.
That's not like really a thing,because you don't do these
kinds of things to people and wethink about that being one of
(31:23):
the potential very long-termconsequences.
We know that most domesticviolence survivors, if they have
been hit or hurt in the head,it's been repeated, it's often
been over a long period of timeand then have people who could
have longer-term consequencesbecause of that.
So Ohio is really doing someleading work around that.
And then once I got startedtalking about that.
(31:45):
Then, cheryl, talk a little bitabout your background and how
this brain injury stuff plays arole in again mental health, not
brain injury.
We're not talking about braininjury, substance use, that's
not brain injury stuff, that'ssubstance use stuff.
Maybe you can share a littlebit about kind of that piece,
because we are co-captaining thebrain injury ship over here at
ODVN.
I'm the skipper.
Speaker 4 (32:07):
So, yeah, so you know , as I mentioned, 18 years of
clinical work with both anoutpatient, residential, with
substance use.
That's my background.
And when I came to ODVN in 2022and started working with Rachel
, you know, of course, learninga lot about partner inflicted
(32:29):
brain injury, which is notsomething I knew about, nor
thought about, I should say, andso I started learning about
that.
And then, you know, almost in amoment and I couldn't pinpoint
when that moment was, but almostin a moment of like holy cow,
wait a minute.
What about overdose-relatedbrain injury?
(32:52):
And with the number of nonfataloverdoses you're looking at
about roughly half a millionpeople that visit the ER every
year for non-fatal overdoses.
So these are people that youknow obviously live through
their overdose and haveabsolutely no care, treatment
(33:15):
questions, nobody asking them.
You know, about anythingrelated to brain injury.
So that got me thinking aboutall of my years of working and
the clients that I had who wereshowing what now I know to be
potential symptoms of cognitiveimpairment, and clients that I
(33:35):
knew had overdosed not once, notfive times, but 10 times, 12
times.
And I really started thinkingback like, wow, how many of
those people because they wereshowing, let's say, they weren't
participating in group or theyweren't showing up to their
sessions or they weren't able tomaintain their sobriety did I
(34:00):
write letters to their POs,probation officers that said,
hey, they're not participating,they're keeping their sunglasses
on in group and their hoodiesover their head and they're not
engaged.
They're not all these things.
And never once did I have aconversation with somebody about
well, we know this person'soverdosed a bunch of times.
Maybe they have a cognitiveimpairment and the lights are
(34:24):
bothering them, or having 11other people in the room is
impacting their ability to besuccessful in group or
participate.
So that just led me down therabbit hole of.
I really want other cliniciansto understand that.
You know, with overdose you areguaranteed a lack of oxygen to
(34:50):
the brain.
It's just part of what it is.
It's a certainty, and this isin no way to take away from what
domestic violence survivorsexperience or victims experience
.
But you don't always havephysical violence in a
relationship.
You may not with that physicalviolence.
You may not always have a hit,a person who's hit or hurt in
the head, although that's likelywhere you're going to get
(35:13):
injured.
But with overdose you areguaranteed a lack of oxygen to
the brain period as a certainty.
So that's where I came into thebrain injury space was really
becoming very passionate abouteducating other clinicians,
emergency room doctors, firstresponders to please just ask a
(35:35):
few questions if you have anoverdose person who's overdosed,
just asking a few questions andgiving some information that
you know.
We're in the process of creatingsome overdose-specific brain
injury-related tools andresources and you know please
just hand them out to people sothat they're aware that some of
(35:55):
the symptoms they may be seeingin themselves could very well be
the result of a brain injury,because of an anoxic or hypoxic
brain injury resulting fromtheir overdose and with that
they're more prone to overdosein the future, with an injured
brain less likely to be able tomonitor their intake of drugs
(36:16):
with an injured brain.
So you're also looking atsituations where recovery
becomes exponentially moredifficult when your impulse
control is affected by a braininjury and you're more likely to
overuse substances, even ifyou're trying not to, because of
(36:37):
an injured brain.
So lots of components that gowith that that are similar to,
and some that are very differentthan what people who are in
abusive relationships experiencewith brain injury that's such
important work.
Speaker 1 (36:52):
Let's do this, let's make a pivot, as we start to
wrap up our conversation, tothings that are hopeful.
Of course, we're OSPF, the OhioSuicide Prevention Foundation.
We talk about and we tacklesome tough subjects.
We've done that in this veryepisode as well.
But in doing this work, we alsosee how mental health changes
and saves lives every single day.
(37:14):
So, rachel to you, cheryl toyou, what gives each of you hope
?
Speaker 3 (37:20):
Well, I think one of the things that gives me hope
first of all, is the fact thatwe're here doing this podcast
and to be able to think abouthaving a deeper relationship and
better understanding.
How can maybe our deepenedunderstanding of suicide help us
better support domesticviolence survivors?
How can deepened understandingof domestic violence help us
(37:42):
better support survivors ofsuicide and kind of what it is
that that looks like are workinghard to support survivors and
just being able to helpsurvivors know that they're not
alone?
And there is this amazingnetwork of 76 programs that's
(38:17):
around, that's available for youand that really cares about you
and wants to help you,available for you and that
really cares about you and wantsto help you.
So I'm really and also assomebody I actually did lose my
older sister to suicide in 2011.
So I'm also very personallyimpacted by this.
Speaker 4 (38:31):
Yeah, I don't know that I have much to add other
than what Rachel said.
I just know that you know frommy personal experience and
seeing people go from the, youknow the depths of their
addiction to recovery has beenone of the great joys of my
career is, despite everything,all the seemingly insurmountable
(38:57):
odds they have to face to getto a place where they can
rebuild their lives and have alife that they find to be
rewarding for them.
You know it's easy to get lostin these kinds of statistics and
the dark side of the statisticsand all of the things that are
(39:19):
not going well.
But you see, millions of peoplego into recovery from substance
use and mental health all thetime and I think a spotlight
needs to be shown on the peoplewho have been there and made it
through it and came out theother side of it.
Speaker 3 (39:41):
I remember seeing a brain injury survivor at a
conference and one of her shewas a X Games athlete and
actually had a terrible braininjury like during a competition
almost died, and you know wasat the height of her.
That was what she was.
She was a skier and you knowshe couldn't walk and she
couldn't talk.
But she does a presentationtalking about how I think after
not only after brain injury butafter trauma, it is possible to
(40:03):
live a life you love.
That's what she talks about.
It might not be the same lifeand we know trauma can change
people.
We know, when we even work withpeople who have been in really
really you all work with peoplewho have been in really really
dark places and sometimes wehave things that happen to us.
They do change us and we aredifferent people, but that you
can live a life you love andthat life that you love might be
(40:26):
different than it was beforeWhatever happened to you it is
but that recovery is possibleand that being able to have a
life that you wake up in, thatyou're excited to be in, just is
something that humans aredesigned to survive and designed
to overcome incredible odds.
So it has just been such aprivilege, I think, for Cheryl
(40:47):
and I both to also be able towalk with people who are in
really, really difficultsituations and just be able to
support them and being able tosee themselves through some
really dark times.
Speaker 2 (40:58):
It has been so inspiring to talk to both of you
.
I can't thank you enough forwhat you do for the community.
I have no doubt that you guysare saving people's lives.
I just I commend you.
I have the utmost respect forboth of you.
Thank you both so much forjoining us today, and to our
listeners, thank you as well.
When you listen to our episodes, you break stigmas, break
barriers and you care aboutmental health and saving lives.
(41:20):
This is Voices for SuicidePrevention, brought to you by
the Ohio Suicide PreventionFoundation.
Thank, you.
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