This month we turn our attention towards teen dating violence (TDV) as an important public health topic with long-term impacts into adulthood. Unhealthy relationships can start early and last a lifetime. Adults who report sexual violence, physical violence or stalking by an intimate partner in their lifetime are likely to have experienced these or other forms of violence in a romantic relationship as a minor (Black et al, 2011). It can occur in-person or electronically and comes in many forms including physical violence, sexual violence, stalking and psychological aggression.
It’s important to note that certain populations are disproportionately affected by TDV including sexual minority groups and some racial and ethnic groups (Black et al, 2011). TDV is considered an Adverse Childhood Experience (ACE) and combined with other ACE’s can result in a significantly heightened risk for a variety of adverse outcomes. Teens who are victims of dating violence are more likely to drop out of school, engage in substance misuse, experience depression, anxiety and consider suicide.
Effective prevention includes early education for youth and parents about safe dating practices and learning skills to have a safe and healthy relationship. Below are strategies that primary care doctors can adopt in order to prevent TDV, raise awareness and intervene early.
- During routine care, screen often using open-ended questions about safety and the health of teen relationships. For example, questions can include “Have there been any new boyfriends or girlfriends?” “How has that changed life for you?” “Do you feel safe with that person?
- Include clear messages in conversations with teens that physical, sexual, or threatened harm is not normal or acceptable emphasizing that healthy relationships are an important component of overall health.
- Advise parents to start talking about expectations for relationships with middle schoolers and maintain open lines of communication about their dating relationships as they enter high school.
- Provide information and advise parents and youth on what makes a healthy relationship and signs that a relationship is not healthy.
- When a young patient discloses that they are a victim of TDV, steps that you can take are:
- Help them identify an adult at home, school or in the community that they can trust.
- Help them identify friends who can be allies.
- Encourage and educate: Their partner should treat them with respect and they should not be afraid of that person or feel they must do things that they do not want to.
- Provide crisis and support resources and information (see below).