Imagine that it's midnight and you're hiding in a bathroom, terrified. You didn't want to call 911, but you were desperate. When the paramedics arrive, you feel momentarily relieved. Then they start to ask you questions—Have you had anything to drink tonight? Was there an argument? What did you say that triggered the violence?
Suddenly, you're flooded with guilt and shame. You start to feel like it was all your fault. They ask if you want to go to the hospital, but you decline. No more questions. No more talking. You just want to go to bed and forget the incident ever happened.
For millions of victims of domestic violence in this country, this scenario is sickeningly familiar, as new research suggests the very people sent to help them may make them feel more trapped. According to a new study published in the Journal of Forensic and Legal Medicine, too many EMTs and paramedics buy into the same myths about domestic violence as the public—namely, that the victim is somehow responsible for the abuse.
For the study, researchers specializing in mental health and social work at Florida State University and Canada's University of Windsor recruited 403 emergency medical professionals in Florida to anonymously answer questions about their attitudes toward domestic violence victims. Given that many abuse victims are reluctant to go to a hospital or get police involved, first responders are often the only medical help victims encounter—and their support can be pivotal.
The study participants were surveyed directly after completing a training course on domestic violence cases. Nearly three-quarters of them reported that they had dealt with victims of domestic violence as part of their job, and their attitudes toward victims were disturbing:
- 33% were neutral or agreed with the statement that domestic violence is a "normal reaction" to day-to-day stress and frustration.
- 46% were neutral or agreed that if a victim doesn't disclose abuse there is little they can do to help.
- 35% were neutral or agreed that if the victim stays in the relationship then they themselves are responsible for the abuse.
- 30% reported being dissatisfied with the victim.
- 21% were neutral or agreed that "battered women secretly want to be abused."
Overall, the study found that 32% to 43% of first responders reported attitudes that suggest victims are responsible for the abuse. The findings are even more unsettling given that respondents answered the survey directly after completing the training course, which was based on the National Prevention Toolkit on Domestic Violence for Medical Professionals.
But the researchers weren't shocked. "The endorsement of these stereotypes by participants in our study is not unique to EMS personnel," said Elizabeth Donnelly, one of the study's authors and a professor in the School of Social Work at the University of Windsor, "these views are widespread."
Indeed, study after study has shown that not only does the public buy into these myths, but many medical and law enforcement professionals do, too. And perhaps not shockingly, when victims feel judged, they are much less likely to pursue help, out of fear for their safety.
As the authors point out, there are myriad reasons why a victim of domestic violence might feel like he or she cannot leave a relationship, from financial instability to fear for their children to fear of the police. In 2014, after a video surfaced of professional football player Ray Rice assaulting his now-wife in an elevator, survivor Beverly Gooden launched the #WhyIStayed campaign, in which thousands of victims came forward with their reasons for not leaving abusive relationships, attempting to cultivate understanding and spread awareness.
But even first responders don't always understand the complex nature of domestic violence, focusing more on the victim's actions than those of an abusive partner. "The more people who understand the dynamics of domestic violence, the more victims will benefit," Donnelly told me.
According to Michael Szczygiel, a representative from the National Association of Emergency Medical Technicials (NAEMT), first responders don't currently receive mandatory training specific to domestic violence on a national scale. The study "clearly indicates a gap in knowledge," Szczygiel told me over email. “However, that misjudgment should in no way diminish the efficacy of EMS providers in fulfilling their patient care responsibilities.”
To learn more about first responders' role in domestic violence calls, I spoke with first responders in California, where I live. More than one told me that they more or less outsource the emotional help to the Trauma Intervention Program (TIP), a national program that enlists volunteers trained in domestic violence situations, who travel to the scene of the crime to offer support, guidance, and resources.
In cities where this program, or a similar program, is not available, however, it's up to the first responder to offer emotional support, as well as point victims to additional resources. But handing over a phone number can only do so much—especially if a first responder doesn't show the empathy to help the victim feel truly supported.
This is why the authors believe first responders need to receive more training and education in domestic violence cases—which account for 21% of all violent crime, according to the U.S. Department of Justice.
"Given that EMS personnel endorsed these misconceptions after completing a training on domestic violence means further education may be warranted to debunk these myths and build understanding," write the authors in the study.
The Los Angeles Fire Department put me in touch with a veteran EMT and firefighter for this story, who asked not to be named so that he could speak more openly, and he explained most domestic violence training is "on the job"—and most first responders don't have a ton of time to spend with victims.
"It's difficult to assist a victim since we are very busy [responding to calls]," he told me, pointing out that the department responds to 1,200 incidents per day. "We engage the patient, we try to assess what is actually happening, but our interaction with people is very minimal."
In the roughly 20 minutes they spend with the victim, he said, first responders mainly focus on treating physical injuries and assessing if the patient needs hospital care—then they turn the case over to law enforcement, which can be a dead end. "You'll be surprised how few people want help," he said. "It's like beating your head into a wall."
While it's standard practice for law enforcement to be present "whenever any sort of violence has occurred," according to Szczygiel, "When law enforcement is not present and the victim refuses transport, there should be reporting mechanisms in place that request follow-up by law enforcement."
The authors of the study concluded that agencies need to better equip first responders with training and knowledge of domestic violence in order to help victims take the next step and seek out longer term help.
"Victims already feel shame and guilt and pain—it’s essential for EMS personnel to understand that," Donnelly told me. "Given the unique opportunity that EMS providers have to intervene with victims of domestic violence, the endorsement of negative stereotypes and the current lack of required training represents a missed opportunity to strengthen the safety net for victims."
A missed opportunity indeed.
Taryn Hillin is Fusion's love and sex writer, with a large focus on the science of relationships. She also loves dogs, Bourbon barrel-aged beers and popcorn — not necessarily in that order.