Helping families who have experienced domestic violence will be a focus for 2024

Supporters and friends of The Floating Hospital know that we provide healthcare and support to families living in New York City homeless shelters, but many don’t know we also serve the city’s domestic violence safe houses. As with the city-operated shelters, that outreach is performed under our Families in Temporary Housing department. Families in Temporary Housing director Iván Romero says some 56 safe houses are operated under the city’s Human Resources Administration (others may be separately run by religious or other private groups), and we have reached out to all of them.

Domestic violence (DV) is a major driver of homelessness for women and children. Nationally, 22 to 57% of all women experiencing homelessness report that DV was the immediate cause, according to the Washington, D.C.-based National Network to End Domestic Violence. Last year, the National Alliance to End Homelessness, also based in Washington, D.C., reported that approximately 11% of all emergency shelter, transitional housing and safe-haven beds in homeless service systems were targeted to survivors of domestic violence and their families.

Locally, the New York City comptroller’s 2019 report, “Housing Survivors,” found in 2018, domestic violence accounted for 41% of the family population entering shelter–the single largest cause of homelessness and a 44% increase in five years. That was before the well-documented spike in at-home violence during the coronavirus pandemic, causing a pandemic within a pandemic.

Because it takes on numerous forms—physical or sexual assault, emotional, economic or psychological control and intimidation, there is no easy diagnosis for domestic violence, and it largely depends on the survivors’ ability to articulate their experience. Once women are admitted to our clinic, they are screened and asked about their experiences with DV but “that’s still an admitting note, not a diagnosis,” says Shani Andre, M.D., The Floating Hospital’s chief medical officer who oversees all clinic operations.

“We don’t code for it because it’s a socio-economic circumstance, not a medical diagnosis,” she said. “Women can be coded as depressed, anxious, with PTSD and other trauma, but not diagnosed as having experienced DV.

“It is often a hidden problem because it doesn’t always involve physical injury.”

Clinicians at The Floating Hospital are trained to spot check for physical or emotional signs that might telegraph abuse and are able to refer women to the appropriate department for care. Still, treating women and their children who have suffered abuse is not a one-dimensional approach. Fortunately, women seeking help—whether relief, physical or emotional recovery—can check off many of the boxes in our whole-person model of care. Aside from primary medical and counseling, women who have suffered injuries to their teeth or jaw are referred to our dental clinic: 75% of head and neck trauma associated with domestic violence occurs with oral injury, reported the April 2019 issue of the Journal of Aggression, Maltreatment and Trauma.

Women recovering from domestic violence experiences can also seek help in The Floating Hospital’s health education department. “Our programming includes information on healthy relationships, self-esteem and self-care—all topics that women experiencing homelessness and DV often cannot access,” says Meghan Miller, Ed.D., director of health education. “If we can help them identify some of these issues, we can help them with their individual needs.” In tandem with that assistance are social support and linkages to benefits women who are rebuilding their lives will need: sources of food, clothing and personal necessities for themselves and their children; applications for housing, insurance, education and child-care assistance.

And, to help women manage on their own, we help with essential literacies such as financial management. In many DV situations, financial control was part of the abuse and many survivors have no experience with managing finances. Most of these needs were identified in The Floating Hospital’s Social Determinants of Health study conducted in 2020-21. It revealed the real-time, real-world needs of women on their own or as heads of the household, even if that household is a safe house or shelter.

“When we surveyed our patients, we understood that many women who left abusive situations did not have the financial literacy they need to be independent—things such as establishing credit and a bank account,” said Floating Hospital sociologist Sarajane Brittis, special projects consultant who designed and administered the survey. “We are building a program that addresses financial health so women can build and manage their financial identities.”

Tameka Cook is a long-time patient who left an abusive situation and came to New York with her daughter. She needed medical treatment, behavioral health therapy and then more. She was one of the women surveyed who helped inform the new department and spoke about it at our fundraising gala last year.

“I spoke up and said if you really want to make the change, you have to hear what our problems are,” she said. “Create an outlet for us to speak and be heard and for someone to not just hear us, but help us figure it out and get the help that we need. We’re not asking for a full service center, but we’re asking for you to refer us to somewhere that can help us.”

And, she was heard. The survey and patients such as Tameka informed a new life-skills department, which had its pilot year in 2022, thanks to a grant from the Frances L. & Edwin L. Cummings Memorial Fund and contributions from board members and supporters. As the program enters its second year, it aims to expand more targeted services to help domestic violence survivors regain their confidence and their lives.

By Lana Bortolot

This post is featured in our monthly newsletter from August 2023.

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A Timeless Commitment to Family

News and Events August 2023