Health care system responses to children exposed to domestic violence

The health care system has only recently adopted protocols and training to enable practitioners to identify and respond to Victims of domestic violenc e. Currently, most hospitals have domestic violence protocols in place, alt hough training in the use of protocols is less routine. However, because th e provision of health care focuses on the treatment of the individual, the well-being of the children of adult domestic violence victims has received little attention in adult health care settings. Pediatricians do not routin ely receive training in domestic violence identification and do not see res ponding to battered mothers as within the purview of their practice. Innova tive programs in children's hospitals in Boston, Massachusetts, and San Die go, California, recognize that the safety of children is integrally tied to the safety of their mothers. These programs identify abused children whose mothers are the victims of domestic violence and provide advocacy and supp ort that allow mothers and children to remain together in most instances. L ittle is known about the health impacts of teen dating violence, and opport unities for screening exist in the settings where teens receive health care . Likewise, prenatal visits provide regularized opportunities for domestic violence screening. Integrating the health care needs of mothers and childr en from violent households will require continued and expanded training, co llaboration with community institutions, and improvements in insurance reim bursements to cover the costs of needed services.