(Published 2024 April)
Fairfax County’s Health Department Partners with Domestic and Sexual Violence Services to Help Heal Those Impacted by Interpersonal Violence
As part of Fairfax County’s Health and Human Services system, the Health Department strives to keep all county residents living in thriving communities where everyone has the opportunity to be healthy, safe, and realize their potential. But too many might not be aware that this mandate also includes working hand in hand with the Domestic and Sexual Violence Services division of the Department of Family Services. So, Volunteer Voices recently sat down with Joanna Hemmat, assistant director in the Health Services Division, to talk about how these two entities team up to eliminate the public health scourge of interpersonal violence.
This is an excerpt from that discussion.
Volunteer Voices: What is Fairfax County’s Health Department’s mission? What do y’all do?
Joanna Hemmat: The mission of the Health Department is to protect, promote, and improve health for the well-being of the entire community. We protect residents against health and environmental risks. We make sure the community has access to quality health resources. We also respond to emergencies—such as the covid pandemic—as well as disasters, whether natural or manmade. Communicable disease is also a big focus, so providing vaccines, screening for STDs, and tuberculosis—all of those are areas of focus. We strive to foster thriving communities where every person can be safe, healthy, and live to their potential.
So much of the work we do to keep the community healthy and safe and prevent the spread of illness is silent. When the job is done well, you don’t hear about us. Covid was a whole different landscape. But in general, we are constantly working on keeping everyone well and safe.
You are correct: When people think Health Department, they think vaccines and maybe maternal health, but not interpersonal violence, even though that’s a natural fit. How does the Health Department support DSVS’ mission of providing compassionate programming for people impacted by domestic and sexual violence, human trafficking, and stalking?
Intimate partner violence is a major public health problem. It’s associated with many illnesses and concerns that are escalated by violence. For those who are pregnant—my specific area of focus is maternal and child health—and who are impacted by IPV, there are lots of risks: pre-term births, low birth weight births, complications in the pregnancy (like, hemorrhage or placental abruption), and then chronic disease such as diabetes that are poorly managed. Mental health concerns—depression, anxiety, substance misuse—worsening or not being managed further complicate the pregnancy, delivery, and the health of the infant.
What we also know is IPV can escalate during pregnancy. There’s an increased risk of severe injury and also homicide, usually related to gun violence. We know also health care settings are really good at being able to identify if there are concerns related to violence in the home. It’s a confidential environment with hopefully a trusted relationship between the patient and the health care provider. If we do routine screening for domestic violence and other forms of IPV, it can help us identify problems so we can intervene early and improve health outcomes.
Back in 2013 or ‘14 a team of public health nurses, social workers, and intimate partner violence staff founded a group with a mission to equip health care professionals with resources to better screen for IPV in their patients. We used a national tool and incorporated physical, sexual, and emotional abuse and power and control issues that weren’t included in that national tool. We now use this across the Health Department. All pregnant individuals seeking assistance through the Health Department are screened using this tool.
We assist with safety planning and provide home visiting services. And we refer to DSVS when necessary. Maternal child field services continue over time with pregnant individuals, including through postpartum, so can have an eye on things and do more screening and referral for services as indicated.
What’s great about collaborating with DSVS?
I don’t know if this collaboration is unique to Fairfax. I hope not. I would hope there’s a collaboration everywhere between people working in health, public health, and those working in the field of IPV. We love our partners. The people are great. We all have a similar mission and vision that coordinates well to serve the population. And other county partners work together to address this complex issue—and it is a complex issue--with many disciplines coming together.
All our public health nurses are trained by DSVS. This includes new staff across the county—in our clinics, in schools, in community settings—as well as existing staff. We collaborate with DSVS on trainings to increase awareness for the community.
Any challenges to the partnership?
A lot of the challenges are somewhat related to the pandemic. We’re trying to get back to full capacity. The pandemic exposed disparities across various populations in our county. We have been working hard to fill staffing vacancies. We have a large workforce of public health nurses and we have been experiencing a lot of challenges to hire staff because of a national nursing shortage.
Maintaining good communication in collaborative relationships is somewhat challenging because of new people. How do you make sure the continuity is there where there’s a lack of historical knowledge? We have to continually maintain communication.
It also can be difficult to disseminate IPV screenings across the continuum, though we are finding more and more health care providers are doing IPV screenings, so that’s a good thing.
The need for this collaborative work has not gone away. One other area that is a challenge for both [Health Department and DSVS] is collecting info. How do we really know the magnitude in the area of IPV? It’s very difficult to identify. That’s a big challenge for all of us—to see how we can make screening more universal across health systems, how we can increase awareness in the community, how we can increase awareness at a younger age because dating violence often starts at a young age.
But we keep pushing forward because it’s very important in terms of addressing IPV in the community.
What else should we know about the ways the Health Department supports victims of IPV?
We have staff that participate in the community groups and coalitions—such as Step Up 4 Kids and the Council to End Domestic Violence. In addition, our maternal and child health nurses collaborate with shelters to provide IPV support. That’s IPV screenings, postpartum assistance, we facilitate connections to resources, we do developmental screenings and refer to early intervention services if that’s needed, WIC, food banks--whatever resources might be needed when we identify gaps. We help people with primary health care if they need help gaining access to health care and get them connected to a medical home.
This article posting is part of the Domestic and Sexual Violence Services' Volunteer Voices monthly newsletter for current and potential volunteers. If you're not already a volunteer, learn how to get involved. Find out about upcoming trainings, volunteer trainings, happenings around the DSVS office and information about articles, books, media recommendations and more.
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