Brain Injury Screening Should Be Part of Treating Domestic Violence

Screening for traumatic brain injuries (TBI) should be part of the process of providing care to someone in a domestic violence (DV) situation, advise experts at the Brain Injury Association of Virginia (BIAV). 

But they also acknowledge this can be a challenge as it’s adding one more procedure to an often already overwhelmed DV program. 

Not being screened for a brain injury can put a DV survivor at risk of losing access to services, including being removed from a shelter placement. A brain injury leading to memory loss, both short and long term, can lead to unintended rule breaking, lack of emotional control, memory issues and interpersonal problems. 

Progress is being made in this area thanks to a collaboration between the BIAV and the Virginia Department of Health (VDH). “Project Screen and Intervene” includes a brain injury screening tool that’s accessible through its website to program participants.  

 Domestic violence (or, intimate partner violence) is a pattern of abusive behavior in any relationship used by one partner to gain or maintain power and control over the other. A TBI can be caused by a blow, hit, or jolt to the head, falls, and strangulation. 

The connection between the two is strong: nearly 75% of DV survivors have a traumatic brain injury because of the abuse. The sooner a TBI can be identified, through screening, the sooner the individual can be referred for medical care. From there, the BIAV can link them to necessary resources for ongoing treatment. 

“Screening is an indicator, not a diagnosis,” says the BIAV’s Amy Smith. She’s been instrumental in getting strangulation added to the screening tool. 

Until recently, strangulation was not necessarily connected with TBI. Explains Smith, “Strangulation causes a hypoxic brain injury, where oxygen is not reaching the brain. A loss of oxygen to the brain impacts the hippocampus, where memory is stored. So this kind of brain injury can cause all sorts of problems beyond the physical.” 

Smith joined BIAV to collaborate with the VDH in investigating the link between domestic violence and brain injury, with a focus on screening and building relationships between community providers. 

Forming partnerships with domestic violence programs around the state is key to getting the TBI screening added to their intake process, she says. “We’re also connecting individuals in these programs to local brain injury programs, support groups and for case management. And we provide education for the people working in the shelters. So if the indication is there that a brain injury has occurred, staff know to refer to a medical professional for care.”

To encourage linkages between DV programs, the BIAV is pairing them up with a local brain injury agency wherever this is geographically possible. Their intent is to continue to expand this process into other parts of the state. A public webpage specific to DV and screening for TBI is also in development. 

For more information about BIAV programs, including Project Screen and Intervene, call them at 1-800-444-6443 or email the info box (