Addressing the Shadow Pandemic: COVID-19 Related Impacts, Barriers, Needs, and Priorities to Healthcare and Support for Women Survivors of Intimate Partner Violence and Brain Injury

ABSTRACT

Background: One in three women experience intimate partner violence (IPV) in their lifetime and both the rates and severity of IPV have increased during the COVID-19 pandemic. The majority of injuries to women experiencing IPV are to the head, face, and neck, leaving survivors at high risk for traumatic brain injury (TBI);however, the intersection of IPV and TBI (IPV/TBI) remains largely unrecognized. Here we report on the COVID-19 related impacts, barriers, needs, and priorities to healthcare and support services for women survivors of IPV/TBI. Methods: A pan-Canadian group of 30 stakeholders was engaged in a two-day virtual summit using a participatory research model. Stakeholders were drawn from an IPV/TBI knowledge-to-practice (K2P) Network comprising women survivors, service providers, researchers, and decision makers. Semi-structured discussion guides were used by the research team to facilitate small group break-out sessions which were recorded and transcribed verbatim. Thematic analysis techniques were used to analyze transcripts and develop themes. Stakeholders were given the opportunity to contribute to the analysis and KT through member checking activities. Ethics approval was obtained through the University of Toronto. Results: COVID-19 has increased rates and severity of IPV and resulted in barriers to help-seeking and accessing services. The impacts of the pandemic have been exacerbated by pre-existing infrastructure and resource limitations in rural and remote areas, including limited access to services. Stakeholders called for increased awareness across a number of groups. Survivors and the public need greater awareness of the resources available for survivors of IPV/TBI, particularly how access to or availability of resources and services have changed during the pandemic. Healthcare providers ranging from emergency departments to rehabilitation professionals need greater awareness of the intersection of IPV/TBI and how to appropriately manage these survivors' unique needs, particularly considering the impact of COVID on the accessibility of that care. Requests from survivors for peer support have increased significantly during the pandemic, highlighting the need for more formalized and better supported peer roles for IPV/TBI survivors. Stakeholders also noted the implications of virtual care, for example, safety, privacy, and usability, require careful consideration. Conclusions: The COVID-19 pandemic has intensified IPV/ TBI, increased challenges for women survivors, and accentuated the continued lack of IPV/TBI awareness. Key recommendations for healthcare and rehabilitation and a national strategy to address this priority are discussed.