intervention

Court-Mandated Interventions for Individuals Convicted of Domestic Violence

IMPACT:

LOCUS:

ORIGIN: Campbell Collaboration systematic review & meta-analysis

Author(s): NPO Staff

The Problem:

Domestic violence – the physical, sexual, or emotional abuse of intimate partners or cohabiters – is a significant public health problem. Annually, intimate partner violence accounts for almost 5 million assaults or rapes of women and almost 3 million assaults or rapes of men; more than 1,500 of these incidents resulted in death in 2005.  CDC Factsheet: Intimate Partner Violence. Sexual violence is a particularly common occurrence in intimate relationships. More than 10 percent of all women report being forced into sex at some time in their lives; almost 55 percent of rapes of women are committed by family members or intimate partners. CDC Factsheet: Sexual Violence.

The Law:

As cultural norms have changed over the last half century, the laws and legal response to domestic violence have changed markedly. Starting in the early 1980s states began to take domestic violence much more seriously by adopting mandatory arrest laws, which require police officers arriving at domestic disturbances to issue one or more arrests, and instituting court-mandated batterer intervention programs (BIPs). These intervention programs attired to prevent repeat domestic abuse by educating the batterer – typically male – to better understand gender equality and constructive anger management. Although they vary in some key aspects, these programs are widely implemented in U.S. jurisdictions. California law, for example, sets as a condition of probation or parole for individuals convicted of domestic abuse the completion of a batterer’s program that lasts at least one year and includes two hours or more of class time per week.  Cal Pen Code § 1203.097(A)(6).  For other examples laws requiring BIPs, see Fla. Stat. § 741.281 (Florida) and R.I. Gen. Laws § 12-29-5 (Rhode Island).

The Evidence:

Feder et al. reviewed and conducted a meta-analysis of studies that assess the impact of court-mandated batterer intervention programs. Feder et al. Court-mandated interventions for individuals convicted of domestic violence. Campbell Systematic Review 2008:12. Of the 10 studies that met the authors’ inclusion criteria, 4 employed experimental designs and 6 employed quasi-experimental designs. The measures that were subject to meta-analysis were official reports of post-BIP abuse and victim reports of post-BIP abuse. Across the studies, Feder et al. found a small association between BIPs and reductions in official reports of re-battery, though they caution that some of the underlying studies have been subject to reinterpretation and methodological criticism. For example, one of the studies initially presented as evidence of the effectiveness of BIP programs was subsequently reinterpreted by its authors as showing the impact of another intervention (monitoring) rather than the BIP. For victim reported re-battery, the evidence is inconsistent and statistically insignificant. According to Feder et al., the methodological problems in studies reporting a beneficial effect of BIPs, along with the weak effects found in meta-analysis, raise significant doubts about the effectiveness of BIPs in preventing repeat domestic violence.

The Bottom Line:

According to the authors of a systematic review sponsored by the Campbell Collaborative, there is not enough evidence to establish that batterer intervention programs effectively reduce recidivism.

Categories:
How can public health law support intervention in drug overdoses?

Drug overdose deaths have surpassed traffic fatalities in Washington State and 15 other states. This study will examine the legal intent, implementation and outcomes of a new Washington state law to support intervening in drug overdoses. The law includes a Good Samaritan component that provides legal immunity from drug possession charges for people who overdose or seek aid for another person’s overdose. It also allows the prescribing of an opioid antidote medicine (Naloxone) to drug users and their partners. Evaluation will be conducted on the development of the legislation and the impact of the law on Seattle area heroin users, bystanders, and police during overdoses as well as the impacts on community health outcomes.

Grant Number: 68396

Funding Date: Mon, 11/15/2010

Researching Institution: University of Washington

Researcher: Caleb Banta-Green, Ph.D. M.P.H. M.S.W.; Patrica Kuszler, M.D., J.D.

Results

Summary of Initial Findings

Passage of the “911 Good Samaritan Overdose Law” took five years, keys to passage included:

  • Framing the law as a public health issue, not primarily as a legal issue.
  • The emergence of prescription medicines (e.g. opiate pain medicines) as the drugs involved in a  majority of drug overdoses. This increased the perceived public health risks of overdose and broadened the populations, demographically and geographically, that could be helped by legislative action.
  • Keeping the scope of immunity narrow, just drug possession, was the only way to get support of law enforcement, prosecutors, and some legislators.

First responders’ and opiate users’ experience with overdose included:

  • Opiate overdoses are common---42% of opiate users and 62% of Seattle police reported being present at the scene of a serious opiate overdose in the prior year.  (Almost all opiate users surveyed at syringe exchange used heroin.)
  • Most paramedics had been at an overdose in the prior year and approximately 45 serious opiate  overdose victims (heroin or pharmaceutical) are transported by Seattle medics each month.
  • Police were at the scene of most overdoses for which 911 was called according to drug users and paramedics.
  • Arrests of overdose victims and bystanders were very rare according to drug users, paramedics, and police.

Impacts of Good Samaritan Law on planned behaviors:

  • 88% of opiate users indicated that now that they were aware of the law they would be more likely to call 911 during future overdoses. 
  • 62% of police surveyed said the law would not change their behavior during a future overdose because they would not have made an arrest for possession anyway, 20% were unsure what they would do, and 14% said they would be less likely to make such an arrest.

Information dissemination:

  • Funding for implementation of the law was not included in the legislation and no state agency was assigned responsibility for implementing the law.
  • Information dissemination has involved the limited distribution of written educational materials.
  • The website http://stopoverdose.org appears to be a frequently accessed source of information.

Caleb Banta-Green at the University of Washington

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