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The Hidden Cost: Domestic Violence's $1.2 Billion Impact on Ohio · Voices For Suicide Prevention

• 0:05
  Speaker 1: Welcome everyone to our April episode of Voices for Suicide Prevention.
• 0:09
  Speaker 1: As we like to say, our conversations here are real talk, real honest, real life.
• 0:14
  Speaker 2: I'm Scott Light and I'm Rachel Tilson.
• 0:16
  Speaker 2: We are going to begin with a statistic that is underreported by the media and, overall, just doesn't get the attention it deserves.
• 0:24
  Speaker 2: $1.2 billion is that figure, and that's the economic impact of domestic violence every year in Ohio.
• 0:32
  Speaker 2: This comes from the most recent study commissioned by the Ohio Domestic Violence Network, and we have two guests from ODVN joining us to talk about it, and a lot more Rachel Ramirez and Cheryl Stahl.
• 0:43
  Speaker 2: Welcome to the podcast.
• 0:45
  Speaker 2: Thank you so much for being hereahl.
• 0:47
  Speaker 2: Welcome to the podcast.
• 0:47
  Speaker 2: Thank you so much for being here.
• 0:49
  Speaker 2: Very excited to be here.
• 0:49
  Speaker 2: Well, we have so much to talk about with both of you.
• 0:53
  Speaker 2: So let's begin with the economic study, because you just released that in late February.
• 0:55
  Speaker 3: Well, this is the first time that we had ever done any kind of economic impact study in the state, and one of the things we were trying to highlight was to think about how, when we invest in domestic violence services, how that can help save the state money.
• 1:09
  Speaker 3: As we know that budgets are a big deal.
• 1:12
  Speaker 3: Everybody is talking about the budget now.
• 1:14
  Speaker 3: There are years when there's funding, there are years when there aren't funding.
• 1:17
  Speaker 3: But really to estimate, think about how much does it cost us?
• 1:20
  Speaker 3: How much does domestic violence cost our state?
• 1:22
  Speaker 3: Is it cost us, how much does domestic violence cost our state?
• 1:26
  Speaker 3: And in the part of this first study, what we learned is the largest factors.
• 1:27
  Speaker 3: When we think about physical health care for victims, that cost approximately $264.8 million annually, loss of life, loss of worker productivity, and then thinking about how all of those different costs can kind of ripple through the system.
• 1:42
  Speaker 3: When we think about lost productivity and people who don't show up to work, we think about the impact of law enforcement and the law enforcement response.
• 1:50
  Speaker 3: How much do local police departments spend on domestic violence response?
• 1:56
  Speaker 3: How much do court systems spend on domestic violence response?
• 1:59
  Speaker 3: And then, of course, the impact to the victims of domestic violence, including those directly impacted by domestic violence, including those directly impacted by domestic violence and their family members.
• 2:07
  Speaker 3: So maybe this is something I can see if Cheryl could talk a little bit about.
• 2:11
  Speaker 3: We see some of those costs related to mental health, to other health costs and substance use and how all of those things connect.
• 2:19
  Speaker 4: A study put out by the CDC in 2017 and looked at the cost of, of course, the overdose epidemic across the United States and that, including the combined cost of opioid use disorders and fatal overdoses, that equaled about $72.5 million.
• 2:44
  Speaker 4: Economic cost to Ohio and over the United States was over $550 billion.
• 2:52
  Speaker 4: So that's just substance use and if you're looking at mental health, you're looking at cost to the United States.
• 3:00
  Speaker 4: I really couldn't find anything specific to Ohio with that cost States.
• 3:05
  Speaker 4: I really couldn't find anything specific to Ohio with that cost.
• 3:08
  Speaker 4: But for the United States, the economic costs for mental health alone, and I'm not sure if they looked at substance use as part of mental health or behavioral health or not.
• 3:16
  Speaker 4: I didn't see that distinguished in the study, but that was at $282 billion and with projected costs into like 2040, into the trillions of dollars if it continues at the trends.
• 3:31
  Speaker 4: It is now, you know, but in the next less than 20 years you're looking at trillions of dollars.
• 3:39
  Speaker 1: Cheryl and Rachel on that note.
• 3:41
  Speaker 1: There's, you know, there's that old business axiom of you can't manage what you don't measure.
• 3:47
  Speaker 1: And I want to come back to what you mentioned about this.
• 3:50
  Speaker 1: Is the first time you did this exhaustive of a study.
• 3:53
  Speaker 1: Why do you think you need it?
• 3:54
  Speaker 1: Obviously we need it, but were our neighboring states?
• 3:57
  Speaker 1: Did they have these data sets and it was just time for us to get them?
• 4:01
  Speaker 3: Well, I think that we actually worked with an economist at the University of South Carolina who has done some similar work in a couple of different states.
• 4:10
  Speaker 3: This is very kind of newer work trying to figure out when we look at the total cost of domestic violence, because there's so many different ways and so many different places where that can show up.
• 4:20
  Speaker 3: But, you know, one of the drivers behind this was really thinking about what we do know is that here in the state of Ohio, on a per capita income, the state invests much less money in domestic violence than our neighboring states, than Kentucky, than Michigan.
• 4:37
  Speaker 3: And being able to show we have a $20 million line item for domestic violence services for the whole state of Ohio, which we're very, very grateful for.
• 4:46
  Speaker 3: We know it's very, very tough budget times but we have 76 member programs in Ohio and spend much less per capita on domestic violence services and to be able to come to our legislature and come to our state lawmakers and again very appreciative of the funding that they have provided, but also to think about, you know, the $20 million that we have allocated to divide between our 76 member programs when we think of the enormous cost of domestic violence.
• 5:16
  Speaker 3: I think that that puts that into context and in a state where we're very, you know, budget conscious, here we have a balanced budget that needs to be released every year and, knowing with so much, ohio actually did not have any state money for domestic violence until around 2019, 2020.
• 5:36
  Speaker 3: It wasn't ever written into the state budget.
• 5:38
  Speaker 3: So that left all of our programs very, very dependent on federal funding and when we see the federal government, things can change radically from year to year and it really left programs very, very vulnerable and the survivors in their community vulnerable and able to do that.
• 5:54
  Speaker 3: So when we think you know, a lot of people might think, oh, you know, we know that everybody knows somebody impacted by domestic violence, just like I'm sure that's something you all say a lot.
• 6:03
  Speaker 3: Everybody knows somebody who's impacted by suicide.
• 6:06
  Speaker 3: But you kind of think, oh, that's something over there that doesn't have to do with me, I don't know about.
• 6:12
  Speaker 3: You know what I mean, that doesn't really relate to me.
• 6:13
  Speaker 3: But when you think about the costs that are being borne by your community, the costs that are being borne in workplaces and among services and public service response, I think that that was the and we honestly I think one of the other things is we really didn't know and we didn't know how much it really cost us, cost the state of Ohio, how much domestic violence and where those areas were.
• 6:35
  Speaker 3: So it was able to help us provide better data and really thinking about you know, I know, cheryl, you talked about that the CDC study about some of those mental health costs.
• 6:44
  Speaker 3: But one of the things that we found and we have more information about the economic impact study on our website but that the professor who did this estimated that mental health care in the state of Ohio costs $122 million just mental health care related to domestic violence.
• 7:01
  Speaker 3: So when we see that that's one tiny, tiny piece of this we're talking about child welfare costs, loss of property costs, how much do our shelters cost?
• 7:09
  Speaker 3: How much do you know policing costs?
• 7:12
  Speaker 3: How much do courts costs?
• 7:14
  Speaker 3: How much does incarceration costs?
• 7:15
  Speaker 3: It's just a very, very small sliver.
• 7:18
  Speaker 3: So to be able to make the case that investing in domestic violence services really is not only I mean, we all know, just like you know with your work it might be the right thing to do, but it also makes economic sense.
• 7:30
  Speaker 2: Yes, exactly yeah.
• 7:31
  Speaker 2: So there's another layer in there about the children who witness or are themselves victims.
• 7:37
  Speaker 2: What are the long-term challenges that they face?
• 7:42
  Speaker 4: You know, for kids who witness trauma or are impacted directly by trauma, so they're the ones that are being abused or the target of abuse by the 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 issues later on.
• 8:03
  Speaker 4: You also see an increased risk that and this is I haven't read a recent study about this, but I know from past studies I've read if you are a young girl who is in a home where there is violence, you are more likely to partner with an abusive person.
• 8:22
  Speaker 4: If you are a young boy who lives in an abusive home, you may be more likely to partner with an abusive person.
• 8:24
  Speaker 4: If you are a young boy who lives in an abusive home, you may be more likely to adopt some of the abuser characteristics.
• 8:31
  Speaker 4: If that is how the violence is showing up in the home, meaning if dad is the abuser and mom is the victim of the abuse, you may see that more often.
• 8:43
  Speaker 4: Where the boy aligns with dad's behavior, girl aligns with what's happening with mom, or sees if she's going to partner with men later on in life, sees that that is valid, it's normalized.
• 8:57
  Speaker 4: This is what happens.
• 8:58
  Speaker 4: This is what relationships look like.
• 9:00
  Speaker 4: So you tend to see.
• 9:03
  Speaker 4: You know that those patterns moving generationally through, where if mom was abused and you have a chance that the kids later on may be abused as well or be involved in abusive relationships.
• 9:16
  Speaker 4: And I know in my work I'm an LPCCS licensed professional clinical counselor in Ohio All of my 18-year career was with substance, using independent population.
• 9:26
  Speaker 4: I know with the clients that I worked with in therapeutic work, the vast majority of them had not one instance of violence or trauma but multiple instances of violence or trauma, starting in childhood, through adolescence and into adulthood.
• 9:46
  Speaker 4: So their ability to identify healthy relationships or healthy behaviors was never modeled or shown to them.
• 9:54
  Speaker 4: They didn't know and again I'm speaking of clients I worked with but they didn't really know what that meant.
• 10:02
  Speaker 1: Rachel, you mentioned that Ohio has been funded with domestic violence services at $20 million in the past.
• 10:08
  Speaker 1: When you dive into that, though, we spent about $0.85 per capita on those services, and that's low compared to our Midwest neighbors.
• 10:17
  Speaker 1: Indiana does about $1.31.
• 10:19
  Speaker 1: Kentucky three times that.
• 10:22
  Speaker 1: Why are we being outspent, and what could we learn from our neighbors who are spending more on these programs?
• 10:31
  Speaker 3: Well, you know, I think it is often a question of priorities and that is, and I know it is very, very difficult to put together a state budget and there are lots and lots of needs and our needs are often very complex and very complicated.
• 10:46
  Speaker 3: But we're excited for until 2019, that was zero dollars.
• 10:52
  Speaker 3: Oh, the state contributed zero dollars.
• 10:54
  Speaker 3: I think, again, this is a part of why we commissioned things like this economic study to be able to make the case that, well, this funding is important and is very, very much appreciated and with us being a larger state, with larger, I mean we have population centers, we have lots of large cities, we have lots of rural counties, we have lots of Appalachia and just the differing needs of the people in that state being able to help.
• 11:22
  Speaker 3: Lawmakers are particularly lawmakers in a state like this that have a very, very strong focus on fiscal responsibility, that investing in domestic violence services is being fiscally responsible.
• 11:35
  Speaker 3: So I think that that is something and we have made great strides in the last few years, but we know that our programs, the money that we get from the state, it just is life-saving because of the flexibility of that money, because of the ways we know that there are different programs in different areas, that need different things, that have different resources, and that ability to be able to you know what is missing in Pike County and how survivors need to be supported in Pike County is very, very could be very, very different than what people need in Cleveland or Akron.
• 12:10
  Speaker 3: I think the other thing that was interesting as I was listening to Cheryl's conversation about her clinical experience and working with substance using survivors there's a lot of people who wouldn't even connect.
• 12:21
  Speaker 3: Those are not people who are going for domestic violence services.
• 12:25
  Speaker 3: They get that like oh, when you come through the substance use store, that often gets identified like, well, that's my problem.
• 12:32
  Speaker 3: And somebody who goes to a therapist thinks, well, mental health is my problem.
• 12:36
  Speaker 3: And somebody who maybe goes to the hospital well, my physical health is the problem.
• 12:40
  Speaker 3: Or somebody who calls the police, that's a criminal justice problem.
• 12:44
  Speaker 3: But thinking about kind of the drivers behind where that substance use came from, what are the kind of the roots of that I think that that's just another piece is.
• 12:56
  Speaker 3: I think a lot of times in our services and I'm sure you all know that working in suicide prevention.
• 13:02
  Speaker 3: You might be the suicide prevention people, but there's a lot of how does domestic violence play a role in suicidal ideation?
• 13:10
  Speaker 3: How does substance use, how do all of those things, even though you're not the substance use people, you're the suicide people.
• 13:17
  Speaker 3: Those really aren't separate things, and I think that that was one of the things we were also trying to highlight that a lot of people might just say, oh well, domestic violence, the only cost associated with domestic violence, is, like domestic violence, shelters, right?
• 13:31
  Speaker 3: No, there's all of these other costs that are contributed to that, and that's something that those 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'm sorry, we're the domestic violence program.
• 13:45
  Speaker 3: You know, we don't do suicide here, because that's what the suicide people do, you know.
• 13:49
  Speaker 3: Or we don't do substance use here, because that's what the substance use people do, you know.
• 13:54
  Speaker 3: To have that understanding that we have to have a much more holistic and much more comprehensive understanding of this if we're gonna be able to help survivors and help individuals live their best life possible, which is what we all want.
• 14:08
  Speaker 2: Yeah, absolutely.
• 14:09
  Speaker 2: You mentioned shelters.
• 14:11
  Speaker 2: Are there Ohioans being turned away from shelters because of inadequate funding?
• 14:17
  Speaker 2: Absolutely.
• 14:18
  Speaker 3: What we knew.
• 14:19
  Speaker 3: We collect data every, so there's a couple of things that I think are really important for individuals to know about domestic violence programs, particularly people who might not work in domestic violence or don't have a lot of information or knowledge kind of I don't know insider view.
• 14:35
  Speaker 3: I think first of all, we want to acknowledge that there are.
• 14:37
  Speaker 3: So we have 76 member domestic violence programs serve all survivors people of all races, of all genders, of all.
• 14:44
  Speaker 3: We serve everybody of all socioeconomic status.
• 14:48
  Speaker 3: All of our programs are free.
• 14:50
  Speaker 3: There aren't any charges, there's not any cost associated with our domestic violence services.
• 14:55
  Speaker 3: But a lot of people think that domestic violence programs are only shelters and might say well, I'm not in a situation where I need a shelter.
• 15:03
  Speaker 3: I could be in a situation where I have my own housing and kind of what that is.
• 15:07
  Speaker 3: From our data that we collected last year, our network of programs housed around 9,700 survivors.
• 15:15
  Speaker 3: Oh wow, but served almost 100,000 individuals Wow.
• 15:21
  Speaker 3: So when we think about—.
• 15:22
  Speaker 1: Ten times the number yeah, ten times the number yeah, ten times the number.
• 15:25
  Speaker 3: But we also turned away 8,200 survivors because shelters are full and we didn't have the capacity to.
• 15:32
  Speaker 3: There just isn't enough.
• 15:33
  Speaker 3: There literally isn't enough space.
• 15:35
  Speaker 3: So I think that that's a couple of things I just want people listening to this to better understand about domestic violence services is that they can also look very different in different communities.
• 15:46
  Speaker 3: It's not like a statewide network where you have your BMV, which kind of does the same thing in every county if that makes sense, your Bureau of Motor Vehicles.
• 15:57
  Speaker 3: Each county has its own kind of locally funded domestic violence program and sometimes, when we talk even about services related to children, I think that that's one of the things that often, when times get tight and budgets get tight and we have to, you know, or federal grants don't come through, so we often see services to children or when we get down to like the bare bones of services, sometimes those services get cut or other types of services get cut.
• 16:22
  Speaker 3: So that is one of the things we want people to really kind of understand.
• 16:27
  Speaker 3: Is that domestic violence?
• 16:28
  Speaker 3: Yes, we do not have enough space for everybody.
• 16:31
  Speaker 3: We don't have enough funding to be able to support everybody who needs shelters, but also domestic violence programs have 24-hour hotlines that anybody can call that are anonymous.
• 16:42
  Speaker 3: Many of them have some kind of web chat or text availability.
• 16:47
  Speaker 3: Through that, we have information on our website.
• 16:49
  Speaker 3: We have like a little find your program locator and a map where you can put your zip code in and get information on your local program, and we want people to know that that's a resource that is available to everyone 24 hours a day, confidential.
• 17:02
  Speaker 3: You don't have to share your name or any information about yourself if you don't want to.
• 17:07
  Speaker 3: But we just want people.
• 17:08
  Speaker 3: But yes, we do have and I mean I think that that was another being able to have some of the data in terms of how much this costs, what that small investment can really have big returns.
• 17:20
  Speaker 3: And just acknowledge that, because that's the question we ask our programs and they track every year how many people were turned away.
• 17:26
  Speaker 3: And we had again sheltered 9,707 survivors and turned away nearly 8,200.
• 17:32
  Speaker 1: Wow, there's another data point in there.
• 17:35
  Speaker 1: While we're on it, let's just keep jumping into this and just go deeper and deeper.
• 17:39
  Speaker 1: Ohio has an estimated 188,000 victims of intimate partner violence each year and more than a hundred deaths.
• 17:49
  Speaker 1: Does the greater public know this?
• 17:52
  Speaker 3: Well, they'll hopefully know it a little bit more because they have listened to this podcast, and that's one of the reasons why we are so excited.
• 18:00
  Speaker 3: We were so excited to be invited to be on this podcast and some of the evolving partnerships between the domestic violence work and the suicide prevention work, which are just two areas that need to be talking to each other more.
• 18:13
  Speaker 3: And, yeah, I think that that's something that anytime we have the opportunity for people who you know are in these different places or in these different spaces to hear some of those numbers, it allows people to really think about this in ways that maybe they haven't considered before.
• 18:31
  Speaker 4: I think, probably like most things, your average person on the street, if you were to stop them and ask them, do you know what the economic cost of domestic violence is?
• 18:42
  Speaker 4: Do you know how many domestic violence survivors there are in the state of Ohio?
• 18:45
  Speaker 4: Probably wouldn't know that information.
• 18:47
  Speaker 4: They may know it's an issue.
• 18:55
  Speaker 4: They may know some things about domestic violence.
• 18:56
  Speaker 4: But I think, overall, bringing all things together, the economic impact, the sheer number of survivors and you know of course those are just survivors that we can track.
• 19:06
  Speaker 4: There's certainly more out there that we may not have any reference for exactly the number we have of people who are experiencing this, but I think your average citizen probably knows some things, but probably not all things.
• 19:26
  Speaker 4: So, yeah, that's what's great about podcasts.
• 19:29
  Speaker 4: And of course, we release our studies and all the things that we do at ODVN.
• 19:37
  Speaker 4: We release those on listservs and out in our newsletters and things like that, so hopefully people are looking at it and reading it and educating themselves more on just how big a situation and problem we have with DV and our culture.
• 19:58
  Speaker 3: I think I would like to just add one thing to that is that people might not know, as Cheryl said, kind of like these numbers and these statistics and the scope of this.
• 20:06
  Speaker 3: They're all said kind of like these numbers and these statistics and the scope of this, but you would be hard pressed to find somebody who doesn't know, somebody who has been personally impacted by domestic violence, that, whether they have a friend or a family member or grew up in a home where they were unsafe or you know a roommate or a colleague or a co-worker Significant enough that that is our annual Domestic Violence Awareness Month, which is in October.
• 20:30
  Speaker 3: Our national theme for the past couple of years have been everybody knows somebody.
• 20:34
  Speaker 3: So I think that that is always one of the things that's interesting and I know Cheryl might have some of the same experience when I don't know if you've ever been on an airplane and you're sitting next to somebody and they're like what do you do?
• 20:45
  Speaker 3: And it's always this weird.
• 20:50
  Speaker 2: I don't know if you kind of get that like oh yeah, yeah, I work in suicide prevention.
• 20:52
  Speaker 2: Um, yes, and it's like it happens at target.
• 20:54
  Speaker 2: And then you talk to the cashier and the cashier had a brother who died by suicide 30 years ago.
• 20:59
  Speaker 2: It's like you give somebody like an opening to share their story.
• 21:04
  Speaker 2: Hopefully it's a, it's a a blessing and a curse, and it is, and sometimes I know you're thinking.
• 21:09
  Speaker 3: Should I just say I work at the bank Like?
• 21:12
  Speaker 3: I work at a bank like something.
• 21:14
  Speaker 3: It's not very interesting, there's not any questions about it, but I think it is one of those things where we think about how many times there are people who you know you say, oh, I work in domestic violence.
• 21:26
  Speaker 3: How they will talk about, how they have had a personal, just a personal.
• 21:31
  Speaker 3: We look at this and this is that one person you know.
• 21:49
  Speaker 3: There are, you know, hundreds of thousands of people who don't have the same experience, but you know that you're not alone and that person is not alone and that we do have a network of people to help you, that care about you and that care about your safety.
• 22:03
  Speaker 3: I think that that's something that's super powerful.
• 22:06
  Speaker 2: I was going to say if you guys had, you know, any recommendations, I guess, of how the public awareness can grow to where our neighbors and friends and family members know, uh, widespread, how urgent of a matter this is.
• 22:21
  Speaker 2: Um, I think sometimes in suicide prevention, you know, we talk about breaking the stigma and sometimes it's OK to talk about maybe struggling with mental health, but there are cases in which maybe it's not safe to talk about a domestic violence situation.
• 22:38
  Speaker 2: So, you know, I didn't know if you had any thoughts on that.
• 22:41
  Speaker 2: It's, how do we start talking in the general public about how urgent this is?
• 22:46
  Speaker 4: Well, I think that's what's.
• 22:47
  Speaker 4: You know, one of the really good things about social media is you reach a lot of people in a very short amount of time.
• 22:53
  Speaker 4: You don't even have to put out that much information from people to, and you shouldn't.
• 22:57
  Speaker 4: You know, you tend to stop on the things that have short but impactful information on most social media platforms, and ODVN is on Facebook, we're on Instagram, we're on X I believe we're still on X or formerly, twitter.
• 23:15
  Speaker 4: I might be missing one, but we do put out during Domestic Violence Awareness Month, during Brain Injury Awareness Month, which Rachel talked a bit about her work in brain injury, and you know, we put out these kind of short little blurbs, these eye-catching things, hopefully eye-catching things out on social media, like results from this study that we'll put out, and you know, over the course of time on social media, so that hopefully people are seeing it and at least stopping and saying whoa, that's a whole lot more than I thought or that's a whole lot bigger problem than I anticipated it was, or you know, and I put things out for substance use awareness and mental health awareness and things like that.
• 24:06
  Speaker 4: So I think social media is a great way to do that, because you get millions of people with eyes on what you're putting out there.
• 24:17
  Speaker 3: I think the other thing is, you know, when we think about talking about I was listening to Cheryl talking about some of her clinical experience and there is, you know, legislation that there needs to be information about healthy relationships in school and just really thinking about, particularly in the technology age that we're in, just thinking about what are relationships supposed to look like?
• 24:39
  Speaker 3: What should they be?
• 24:41
  Speaker 3: I think that there are.
• 24:42
  Speaker 3: I have three kids and two teenagers, so there was a recent movie that came out that was called it Ends With Us.
• 24:48
  Speaker 3: That was off of a book.
• 24:49
  Speaker 3: I mean I think that there are also opportunities.
• 24:53
  Speaker 3: Yes, I went to see the movie with my kids, but I think it is sometimes when we think about there are sometimes news stories of a person gets arrested and kind of what that is.
• 25:04
  Speaker 3: I think that there are opportunities there, kind of what that is.
• 25:07
  Speaker 3: I think that there are opportunities there.
• 25:08
  Speaker 3: But I also think you know one of the things that often has us concerned about from the domestic violence space when we look at you know, what do relationships look like in today's age, in the digital age, where you know I go to the mall and my daughter pulls out her phone and sees she knows who's at the mall, she knows where everybody is and she's always like mom.
• 25:26
  Speaker 3: Like mom, because I always that stuff always freaks me out, because back in the day, like it's weird when people follow you and track you but you know how how many snaps is too many snaps and what do relationships look like when there's so much?
• 25:38
  Speaker 3: It's just a.
• 25:38
  Speaker 3: It's a very, very different time, um, than when we were um.
• 25:44
  Speaker 3: As somebody who's been married for almost 21 years like like this is like I mean, I mean it was like finding somebody on the internet was creepy, you know, and really thinking about how are we talking about where people learn a lot about what relationships are and what they should be and what they shouldn't be, and they're learning, you know, I think you know, as Cheryl was talking about earlier, you know we know that the home is a very, very powerful place to teach people things, whether it's violence.
• 26:08
  Speaker 3: We know that most people, when we think about if people come from homes where parents have college degrees, they're much more likely to have college degrees.
• 26:16
  Speaker 3: I mean it kind of goes and you know there's a lot of ways in which home shapes us, but there's also a lot of ways in which other places shape us and there are many of us who are in the domestic violence field who you know.
• 26:28
  Speaker 3: For some of you remember, you know, fifty Shades of Grey and that came out and there were a lot of real concerns about the dynamics in that relationship from a domestic violence perspective.
• 26:38
  Speaker 3: But how it is shown as like this is exciting and this is sexy and this is, you know kind of really thinking about that.
• 26:45
  Speaker 1: Yeah, there were segments on, you know, good morning American, the today show.
• 26:48
  Speaker 1: Like it got like a ton of positivity and like that excitement around.
• 26:55
  Speaker 3: 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 you know our domestic violence stuff and the power and control wheel and the surveillance and the degradation and the emotional abuse and all that kind of stuff that we talk about, and then it's like put on this movie, almost kind of like glamorized and yeah, you know, when we think also about young people and I again have two teenagers at home like they haven't had relationships before and you're learning how to do this stuff so I think it is also really being able to have conversations and figure out you know where all of that stuff plays a role.
• 27:35
  Speaker 3: There was just a few weeks ago I was listening to a you know, it was actually a podcast on all of the smart cars that people have now and just about how that's become a tool of tracking people.
• 27:47
  Speaker 3: When we think about that, I actually had my sister, who was on some like mom's Facebook group, who she texted me a question because there was somebody.
• 27:56
  Speaker 3: This was not so again, I want you to remember, this was not somebody who called our program.
• 27:59
  Speaker 3: This is not some of our hundred thousand people who reached out to us.
• 28:02
  Speaker 3: She had a sleep number bed and you have an app with the sleep number bed and her abusive partner.
• 28:08
  Speaker 3: She had kicked her abusive partner out and he kept messing with her bed when she was sleeping and she was trying to figure out like.
• 28:18
  Speaker 3: I tried to call, like the sleep number customer service and would use that as a.
• 28:20
  Speaker 3: I mean, it's just the kind of stuff that you don't even and, like I said, that was like my sister's little neighborhood mom's Facebook group.
• 28:27
  Speaker 3: That wasn't our everybody who, everyone knows someone and she was just like and I go into the store but hearing things about people who have cars that are all connected and all of that kind of stuff, really thinking about it just is a very, very different world.
• 28:42
  Speaker 3: And thinking about how to respond and how to think about how much social media contact is acceptable, when does it get to be too much?
• 28:53
  Speaker 3: It's just a very different characterization of what that looks like with technology.
• 28:58
  Speaker 3: That didn't exist for many of us.
• 29:01
  Speaker 2: Okay, so you mentioned, Cheryl, something about Brain Injury Month.
• 29:05
  Speaker 2: Tell us more about that, Rachel.
• 29:08
  Speaker 2: The association between brain injury and domestic violence.
• 29:13
  Speaker 2: Yeah, you know a little something about it.
• 29:15
  Speaker 3: We're gonna have to come have a whole nother podcast.
• 29:16
  Speaker 3: Cheryl and I have so many things that we could talk about related to this, but I think that that's another as we talk about, as we know more and as we learn more.
• 29:25
  Speaker 3: Our organization got a grant about eight years ago to start looking at the intersection of domestic violence and brain injuries or concussions, which is something that many of us hear concussions and most of us, the vast majority of people when you hear concussions, you think football, as most of us do, but anybody and I think even you know anybody who's ever worked in domestic violence know that a lot of times, if people are physically abused, they're physically abused their heads, necks or faces, like they're physically abused in the head, or another very, very kind of terrifying and traumatic tactic of abuse is strangulation, which is a new felony which was recently passed felony legislation in 2023.
• 30:08
  Speaker 3: The state of Ohio was the last state to make strangulation a felony, but that is again very problematic in a ton of different ways.
• 30:17
  Speaker 3: But it also deprives the brain of oxygen and when we think about some of the protocols that have been developed to address concussions in other places in military spaces or in sports spaces.
• 30:30
  Speaker 3: Thinking about that being one of the health consequences of domestic violence is something that both Cheryl and I, who have been doing this work for a very, very long time, had never even really considered.
• 30:42
  Speaker 3: So that's another piece of awareness raising that we're really thinking about.
• 30:48
  Speaker 3: What does that mean and what are some of the long-term consequences of that, particularly when we have brain injuries that hardly ever get identified because there's also we think about how much I don't know.
• 31:00
  Speaker 3: If any of you have kids, have them play sports, get a little concussion fact sheet from the Ohio Department of Health, because you're there watching right Like people don't get beat up in front of other people.
• 31:11
  Speaker 3: You know that doesn't happen.
• 31:13
  Speaker 3: There's not that I caught kind of like the bystander intervention piece.
• 31:16
  Speaker 3: That's not like really a thing, because you don't do these kinds of things to people and we think about that being one of the potential very long-term consequences.
• 31:26
  Speaker 3: We know that most domestic violence survivors, if they have been hit or hurt in the head, it's been repeated, it's often been over a long period of time and then have people who could have longer-term consequences because of that.
• 31:38
  Speaker 3: So Ohio is really doing some leading work around that.
• 31:42
  Speaker 3: And then once I got started talking about that.
• 31:45
  Speaker 3: Then, cheryl, talk a little bit about your background and how this brain injury stuff plays a role in again mental health, not brain injury.
• 31:52
  Speaker 3: We're not talking about brain injury, substance use, that's not brain injury stuff, that's substance use stuff.
• 31:56
  Speaker 3: Maybe you can share a little bit about kind of that piece, because we are co-captaining the brain injury ship over here at ODVN.
• 32:04
  Speaker 3: I'm the skipper.
• 32:07
  Speaker 4: So, yeah, so you know, as I mentioned, 18 years of clinical work with both an outpatient, residential, with substance use.
• 32:18
  Speaker 4: That's my background.
• 32:19
  Speaker 4: And when I came to ODVN in 2022 and started working with Rachel, you know, of course, learning a lot about partner inflicted brain injury, which is not something I knew about, nor thought about, I should say, and so I started learning about that.
• 32:38
  Speaker 4: And then, you know, almost in a moment and I couldn't pinpoint when that moment was, but almost in a moment of like holy cow, wait a minute.
• 32:49
  Speaker 4: What about overdose-related brain injury?
• 32:52
  Speaker 4: And with the number of nonfatal overdoses you're looking at about roughly half a million people that visit the ER every year for non-fatal overdoses.
• 33:06
  Speaker 4: So these are people that you know obviously live through their overdose and have absolutely no care, treatment questions, nobody asking them.
• 33:17
  Speaker 4: You know, about anything related to brain injury.
• 33:21
  Speaker 4: So that got me thinking about all of my years of working and the clients that I had who were showing what now I know to be potential symptoms of cognitive impairment, and clients that I knew had overdosed not once, not five times, but 10 times, 12 times.
• 33:40
  Speaker 4: And I really started thinking back like, wow, how many of those people because they were showing, let's say, they weren't participating in group or they weren't showing up to their sessions or they weren't able to maintain their sobriety did I write letters to their POs, probation officers that said, hey, they're not participating, they're keeping their sunglasses on in group and their hoodies over their head and they're not engaged.
• 34:10
  Speaker 4: They're not all these things.
• 34:11
  Speaker 4: And never once did I have a conversation with somebody about well, we know this person's overdosed a bunch of times.
• 34:19
  Speaker 4: Maybe they have a cognitive impairment and the lights are bothering them, or having 11 other people in the room is impacting their ability to be successful in group or participate.
• 34:32
  Speaker 4: So that just led me down the rabbit hole of.
• 34:37
  Speaker 4: I really want other clinicians to understand that.
• 34:44
  Speaker 4: You know, with overdose you are guaranteed a lack of oxygen to the brain.
• 34:50
  Speaker 4: It's just part of what it is.
• 34:52
  Speaker 4: It's a certainty, and this is in no way to take away from what domestic violence survivors experience or victims experience.
• 35:00
  Speaker 4: But you don't always have physical violence in a relationship.
• 35:04
  Speaker 4: You may not with that physical violence.
• 35:06
  Speaker 4: You may not always have a hit, a person who's hit or hurt in the head, although that's likely where you're going to get injured.
• 35:14
  Speaker 4: But with overdose you are guaranteed a lack of oxygen to the brain period as a certainty.
• 35:20
  Speaker 4: So that's where I came into the brain injury space was really becoming very passionate about educating other clinicians, emergency room doctors, first responders to please just ask a few questions if you have an overdose person who's overdosed, just asking a few questions and giving some information that you know.
• 35:43
  Speaker 4: We're in the process of creating some overdose-specific brain injury-related tools and resources and you know please just hand them out to people so that they're aware that some of the symptoms they may be seeing in themselves could very well be the result of a brain injury, because of an anoxic or hypoxic brain injury resulting from their overdose and with that they're more prone to overdose in the future, with an injured brain less likely to be able to monitor their intake of drugs with an injured brain.
• 36:17
  Speaker 4: So you're also looking at situations where recovery becomes exponentially more difficult when your impulse control is affected by a brain injury and you're more likely to overuse substances, even if you're trying not to, because of an injured brain.
• 36:38
  Speaker 4: So lots of components that go with that that are similar to, and some that are very different than what people who are in abusive relationships experience with brain injury that's such important work.
• 36:52
  Speaker 1: Let's do this, let's make a pivot, as we start to wrap up our conversation, to things that are hopeful.
• 36:57
  Speaker 1: Of course, we're OSPF, the Ohio Suicide Prevention Foundation.
• 37:01
  Speaker 1: We talk about and we tackle some tough subjects.
• 37:04
  Speaker 1: We've done that in this very episode as well.
• 37:07
  Speaker 1: But in doing this work, we also see how mental health changes and saves lives every single day.
• 37:14
  Speaker 1: So, rachel to you, cheryl to you, what gives each of you hope?
• 37:20
  Speaker 3: Well, I think one of the things that gives me hope first of all, is the fact that we're here doing this podcast and to be able to think about having a deeper relationship and better understanding.
• 37:31
  Speaker 3: How can maybe our deepened understanding of suicide help us better support domestic violence survivors?
• 37:38
  Speaker 3: How can deepened understanding of domestic violence help us better support survivors of suicide and kind of what it is that that looks like are working hard to support survivors and just being able to help survivors know that they're not alone?
• 37:53
  Speaker 3: And there is this amazing network of 76 programs that's around, that's available for you and that really cares about you and wants to help you, available for you and that really cares about you and wants to help you.
• 38:26
  Speaker 3: So I'm really and also as somebody I actually did lose my older sister to suicide in 2011.
• 38:29
  Speaker 3: So I'm also very personally impacted by this.
• 38:31
  Speaker 4: Yeah, I don't know that I have much to add other than what Rachel said.
• 38:34
  Speaker 4: I just know that you know from my personal experience and seeing people go from the, you know the depths of their addiction to recovery has been one of the great joys of my career is, despite everything, all the seemingly insurmountable odds they have to face to get to a place where they can rebuild their lives and have a life that they find to be rewarding for them.
• 39:10
  Speaker 4: You know it's easy to get lost in these kinds of statistics and the dark side of the statistics and all of the things that are not going well.
• 39:20
  Speaker 4: But you see, millions of people go into recovery from substance use and mental health all the time and I think a spotlight needs to be shown on the people who have been there and made it through it and came out the other side of it.
• 39:41
  Speaker 3: I remember seeing a brain injury survivor at a conference and one of her she was a X Games athlete and actually had a terrible brain injury like during a competition almost died, and you know was at the height of her.
• 39:52
  Speaker 3: That was what she was.
• 39:53
  Speaker 3: She was a skier and you know she couldn't walk and she couldn't talk.
• 39:56
  Speaker 3: But she does a presentation talking about how I think after not only after brain injury but after trauma, it is possible to live a life you love.
• 40:04
  Speaker 3: That's what she talks about.
• 40:06
  Speaker 3: It might not be the same life and we know trauma can change people.
• 40:10
  Speaker 3: We know, when we even work with people who have been in really really you all work with people who have been in really really dark places and sometimes we have things that happen to us.
• 40:19
  Speaker 3: They do change us and we are different people, but that you can live a life you love and that life that you love might be different than it was before Whatever happened to you it is but that recovery is possible and that being able to have a life that you wake up in, that you're excited to be in, just is something that humans are designed to survive and designed to overcome incredible odds.
• 40:44
  Speaker 3: So it has just been such a privilege, I think, for Cheryl and I both to also be able to walk with people who are in really, really difficult situations and just be able to support them and being able to see themselves through some really dark times.
• 40:58
  Speaker 2: It has been so inspiring to talk to both of you.
• 41:00
  Speaker 2: I can't thank you enough for what you do for the community.
• 41:03
  Speaker 2: I have no doubt that you guys are saving people's lives.
• 41:06
  Speaker 2: I just I commend you.
• 41:08
  Speaker 2: I have the utmost respect for both of you.
• 41:10
  Speaker 2: Thank you both so much for joining us today, and to our listeners, thank you as well.
• 41:15
  Speaker 2: When you listen to our episodes, you break stigmas, break barriers and you care about mental health and saving lives.
• 41:20
  Speaker 2: This is Voices for Suicide Prevention, brought to you by the Ohio Suicide Prevention Foundation.
• 41:25
  Speaker 2: Thank, you.