Probability sample surveys suggest that at least 2 to 3 million women are physically assaulted by their male partners each year in the United States (Straus and Gelles, 1990, in Browne, 1993). Every year, some 1.8 million women, 3% of the female population in the U.S., endure severe assault; they are punched, kicked, choked, beaten, threatened with or attacked with a knife or gun every year. Other researchers have found that over 25% of couples surveyed reported physical aggression had been a part of their relationship (Straus and Gelles, 1990, in Krishnan et al., 1997). Clearly the problem of intimate partner violence is significant in terms of its prevalence within the overall U.S. population.
Physical and psychological effects resulting from the violence directed against women are detrimental to their health and mental/emotional well being. Physical injuries sustained from these attacks include bruises, cuts and abrasions, black eyes, concussions, broken bones, miscarriages, and other internal injuries (Browne, 1993). At the most extreme end of the injury scale are permanent effects such as damaged bones or joints, scarring, loss of hearing or sight, head injury, internal organ damage, and even death. Psychological effects of intimate partner violence include anxiety, depression, suicidal ideation, mild to moderate self-harming behavior, suicide attempts, and successful suicides (McGrath, Keita, Strickland, & Russo, 1990, in Browne, 1993). The problem of intimate partner violence is significant in terms of its effects on women's health.
The problem specific, although less clear
Estimates of the number of women victimized by partner violence are based on self-reports from telephone, mail, and in-person interviews. Unfortunately, use of such survey methods selects against those most at risk of facing partner violence; the poor, those not fluent in English, those living in remote areas, and those without telephones (Goodman et al., 1992, in Chester et al., 1994). This selectivity particularly affects Native American women living on reservations, as many of these women live in poverty, do not speak English, nor own telephones (Chester et al., 1994). To a progressively lesser degree, these selection factors affect rural nonreservation and urban Indians as well, who are more likely than reservation Indians to speak English, but are still at increased risk of poverty and not owning a telephone compared to the white population. Overall, about a third of American Indian adults are illiterate, thereby making completion of mail surveys quite unlikely even amongst those Natives with a defined address. Not surprisingly, due to these methodological limitations, and for other reasons, the problem of partner violence in Indian communities, reservation, rural, and urban, has received little coverage in the literature (Bachman, 1992, p. 89-90; Chester et al., 1994; Norton & Manson, 1995, 1997).
About a quarter of the 2 million registered American Indians live on federal reservations, the remainder live in off-reservation rural areas or in cities, although ongoing migration between these areas is quite common (Norton & Manson, 1997). Although classified according to common racial origin as American Indians/Native Americans, the grouping actually represents over 500 nations that were present within the current boundaries of the U.S. prior to European conquering. These nations followed distinct customs, languages, and family structures, although a significant amount of overlap and commonality can be seen for these variables amongst the first nations peoples. Perhaps the most significant commonality that they face today is that their traditional lifeways were severely altered beginning five centuries ago with European invasion into the Americas.
Native people are known to be at increased risk for poverty, with typical unemployment rates on reservations being about 30%, but ranging up to 80% on certain reservations (U.S. Senate Select Committee on Indian Affairs, 1985, in La Fromboise, 1993). They are the most impoverished of the defined racial/ethnic groups outside of a small subpopulation of Asian immigrants, the Hmong. American Indians are at increased risk for problems of substance abuse and dependence, showing an alcoholism death rate in 1991 that was more than five times the rate for the U.S. population overall (Indian Health Service, 1996, in McNeece & DiNitto, 1998, p. 260). Accidents, suicides, and homicides, often associated with drinking or use of other drugs, are excessively present amongst Native Americans. Native Americans are at increased risk for mental health problems including depression and domestic violence (Nelson et al, 1992). Clearly, Native peoples are a population at risk for multiple problems.
Several sources indicate that domestic violence is a serious and common problem affecting Indian communities (Allen, 1990, in Norton and Manson, 1995; Indian Health Service, 1993, in Norton and Manson, 1997). A national survey looking into one-year prevalence rates of violence in marriage found that 15.5% of Indian couples reported violence within the marriage, and 7.2% reported severe violence (Bachman, 1992). White couples in the same survey reported violence/severe violence rates of 14.8% and 5.3% respectively. These findings themselves indicate that Native American married couples are slightly more likely to face violence within the relationship, and are at significantly increased risk for severe violence.
On top of the other factors such as English literacy and language barriers, lack of a mailing address, or lack of a phone, that act to hinder study and underestimate the incidence of domestic violence amongst Native Americans, this survey polled married couples only. The general youthfulness of the Native population, the tradition of common-law marriage rather than certified marriage, and the fact that domestic violence seems to be a phenomenon of youth, all act to underestimate the incidence of Native domestic violence in this survey.
The resources and services available to address the effects of domestic violence in Native communities seem to be much fewer than those available to the population in general (Bachman, 1992). Although the first woman's shelter to open on a reservation occurred in 1977 (Norton & Manson, 1995), the trend of developing services on other reservations was delayed until the mid-eighties and early-nineties, for the few reservations that have any services at all (Bachman, 1992, p. 90). In reviewing the Indian Health Service budget assigned for mental health care, from which domestic violence services are drawn, Nelson et al. (1992) concluded that the funding was only half of that required to provide even minimal level care. These are sound reasons for the field of human service to be particularly and acutely concerned with Native American battering.
Why else to care?
That Native Americans are a population known to have higher than average rates of problems in areas of unemployment, poverty, substance abuse, and physical and mental health, suggests that they will be in contact with service providers, such as social workers, in numbers beyond their proportion in the U.S. population overall. Nelson et al. (1992) report that the most common group of service providers to Native Americans through the Indian Health Service are social workers who constitute 21% of direct service staff. Service providers, regardless of employing agency, who are seeing Native clients for any presenting problem should be attuned to the possibility that other problems exist within the individual or family system. Perhaps social workers, with their more holistic training which emphasizes the person in the environment and explicitly attempts to respect client culture, may be the best professionals to detect and address such problems. Asking the appropriate questions in effective ways, or using quality screening instruments to check for the presence and extent of such problems, including domestic violence, is essential to effective and ethical practice.
The field of social work was based conceptually on a commitment for social justice and the protection of those facing oppression. Both these themes call upon social workers to have an interest in and take action on behalf of Native peoples of the Americas. Besides their presence in extreme risk categories regarding many life areas, the history of Native Americans, prior to and following European invasion, calls social work to intervene in order to help address these problems.
Indian people did not seem to have many of the problems they face today prior to European invasion, suggesting that their ongoing life problems may be a result of their conquered status. While a few tribes in what is today termed the southwestern U.S. did produce and consume alcohol as part of specific religious ceremonies, most Native Americans had no contact with nor concept of alcohol prior to its introduction from Europeans from the 1500s on (Indian Health Service, 1977, in McNeece and DiNitto, 1998, p. 257). Economic problems are difficult to measure for Native peoples prior to European conquest, which brought with it the modern concept of economics. However, few early accounts of Native people speak to poverty in terms of lack of essential life needs, a closer measure of poverty in pre-Columbian America. The prevalence of domestic violence is unclear for Native peoples even today. However, it is noteworthy that the lack of information on domestic abuse amongst Native Americans in early accounts, along with its association with poverty and alcohol/drug abuse, suggest that domestic violence rates were significantly lower prior to European disruption into Native lands and lives. The counter argument would be that the very real life disruption, increased poverty, and increased alcohol/drug problems of Native Americans since 1492 decreased or did not affect domestic violence rates. This argument is clearly weak.
The area of domestic violence in general is of interest to the author because of his feelings regarding violence, women and other minorities, oppression, justice and compassion. These areas are common concerns to many human service providers, and social workers specifically. On a more personal level, the author's mother was killed as a result of domestic violence some 21 years ago. Native people are of interest to the author due to the injustice and oppression they have and continue to face, which contribute to their multiple problems. His paternal lineage is Native American.
What we know, and what we don't know
Knowledge of the extent of domestic violence amongst Native Americans is limited (Chester et, 1994). Sorenson et al. (1991, in Krishnan et al., 1997) point to the lack of research, particularly systematic research, that adequately estimates the incidence and prevalence of battering amongst minority populations overall. Krishnan et al. (1997) commented that compared to other minorities, information regarding Native American domestic violence is even more limited.
As early as 1985, Allen (in Krishnan et al., 1997) warned that partner violence was at extremely high rates throughout Indian populations on reservations, in urban, and rural settings. Allen further noted that both tribal officials and government agencies were hesitant to document the extent of the problem, much less address it. Allen's work was unavailable to this author, and as cited by Krishnan et al.(1997), no statistics were listed to back up this assertion. Allen (1985) explained the rampant domestic violence to be a result of the introduction of alcohol and the patriarchal beliefs that came to Native peoples from the European invaders (in Krishnan et al., 1997). Durran et al. have unpublished data which indicates that Indian subjugation in the U.S., along with internalized self hatred, explain the high levels of violence amongst first nations people (Koss, 1994, in Krishnan et al., 1997).
Krishnan et al. (1997) state that the work of Allen (1985) and McIntire (1988) indicate that domestic violence is prevalent, and the rates are increasing for Indian people, both on and off reservations. They point out that small studies like that conducted by Poelzer (1986), which often include informal interviews, back up the assertion that partner violence is present at high rates amongst Native people. However, Krishnan and colleagues (1997) admit that systematic research on domestic violence within Native populations, identifying its correlates and typology, as well as services required, has not yet been done.
Although the number of Native American women included in their exploratory study of domestic violence amongst culturally diverse rural residents was quite small, 9 of the 242 participants, Krishnan et al. (1997) did include information on this subset of shelter residents in their article. Specific demographics such as age, education, number of children, and income were not listed for the different ethnic subpopulations, only for the participants overall. Similar to the other ethnic groups in the study (whites, Hispanics and African Americans), they found that the majority of Native women reported that the violence began early in their relationships, either during dating or the first year of living together. A difference that they did find was that the majority of women of color reported being victimized on a weekly or monthly basis, whereas almost half of white women reported daily abuse (Krishnan et al., 1997).
Native women had similar rates of reaching out to family and friends for help in dealing with the abuse as did other ethnic groups (85-95%), but along with African Americans, had higher rates of seeking medical attention and reporting the abuse to legal authorities than whites or Hispanics (Krishnan et al., 1997). Native American women reported that they were most commonly abused in severe physical ways, through blows and kicks, consistent with the other women who sought shelter as a result of the abuse. All Native women, along with African American women, reported that their partners used alcohol or other drugs (Krishnan et al., 1997). This rate was reported as 90% for whites and 94% for Hispanics. Only 22% of the Indian women reported that they used alcohol or drugs themselves, while white women did so at 55%, Hispanics 32%, and Blacks 42% (Krishnan et al., 1997).
More than half (56%) of the Native women indicated that they had been in abusive relationships in the past (whites 61%, Hispanics 37%, Blacks 40%), while 44% stated that their partners had a history of violence previous to the current relationship (whites 48%, Hispanics 28%, Blacks 50%) (Krishnan et al., 1997). Some 40% of Native and African American women reported witnessing partner abuse as children (whites 62%, Hispanics 51%). The majority (60% and 72% respectively) of Native and Black women's partners had witnessed partner abuse as children, comparable to white (70%) and Hispanic (66%) partner rates (Krishnan et al., 1997). Indian and Black women reported that physical abuse was the most common form of abuse that they and their partners endured as children. This finding was also true for white women and their partners, as well as Hispanic women's partners, but Hispanic women reported verbal abuse was the top form of abuse they themselves faced as children (Krishnan et al., 1997).
Adding to this smorgasbord of findings regarding Native domestic violence is the work of Bohn (1993), who looked into the prevalence of domestic abuse amongst a population of 30 pregnant Indian women who attended an urban medical clinic in Minnesota for prenatal and postpartum care. Bohn found that 87% of the women had been victims of domestic violence as adults, 70% from their current partners. Regarding their present status, 33% of the women reported that they had been battered during their current pregnancy, and 55% stated that they had been battered during previous pregnancies (Bohn, 1993). Other forms of abuse, including childhood abuse and sexual abuse as an adult were measured in the effort to associate abuse with negative outcomes such as chemical dependency, depression, low birth weight, and subsequent child abuse. That this population was not chosen based on particular risk of abuse history, such as is the case for shelter based studies, suggests that domestic violence and other forms of abuse are quite common in Native communities. These high rates may be more accurate than those reported in national surveys which are artificially lowered due to factors that select against Indian women most likely to face abuse.
Fairchild et al. (1998) also documented the prevalence, incidence, and demographic factors associated with partner abuse amongst Native Americans. Their sample was drawn by surveying Navaho women who presented for routine ambulatory care at the general medical clinic or the maternal-child health clinic of an Indian Health Service facility during two specific weeks. Incredibly, 41.9% of those surveyed indicated that they had been victims of physical abuse from a partner, and 31.7% stated that they had endured severe physical violence (Fairchild et al., 1998). The rate of physical violence during the past year for this population was 13.5%, slightly larger than the 11.6% rate reported for the overall population in the 1985 national survey on husband-wife violence (Straus & Gelles, 1990, in Fairchild et al., 1998). The team's analysis showed that being younger than 40 years of age, and getting government financial assistance, were independently associated with domestic violence occurrence within the last year.
Durst et al. (1999) reported on domestic violence amongst Natives of Canada. Although this population does not qualify according to the U.S. Government definition of American Indian/Native American, it is important to note that these artificial designations are imposed definitions derived from the boundaries laid down by the conquering European powers and their descendants. Many Indian nations lived in and continue to live in areas whose traditional boundaries were split by the borders laid out by the new governments of the Americas, so part of their people live on land called Canadian property, while others live on land termed U.S. property. Therefore, data from the Durst et al. (1999) study seems in many ways pertinent to the study of Native battering.
Durst et al. (1999) point to the work of the Ontario Native Women's Association (1992) which showed that Natives of Canada had domestic violence rates eight times higher than Canadian residents overall. Amongst Native women who resided within the borders of Ontario, a full 80% reported that they had been victimized by such violence, and nearly as many reported that a family member was regularly being victimized by such abuse. The Ontario Native Women's Association (1992, in Durst et al., 1999) also highlighted the lack of services and resources to fund such services to address the problem of battering amongst Native populations.
Explaining Native domestic violence
Drawing clear conclusions on the extent and specific characteristics of intimate partner violence amongst Natives of the Americas is difficult to do based on the limited research that exists, particularly the lack of systematic research. The problem is further compounded by the fact that small sample sizes, selection factors, and the differences that do exist within the population generically identified as Native American make application to the wider Indian population questionable for the data that is available. The knowledge we have in this area is rather poor for all of these reasons, and needs to be further developed through systematic study that more accurately investigates the incidence, prevalence, and associated characteristics of Native battering. This information will be useful to better inform our interventions. Yet in the mean time, our givers of life continue to be attacked and killed in places that should be safe havens from a world outside that is often cold and hostile to them for who they are. The perpetrators of this acute violence are most often the very men that should be protecting and caring for these women. Therefore, the information that we do currently have regarding Native battering, as well as battering within the wider population, must be used to guide our understanding of Native American domestic violence.
Intimate partner violence is more common amongst those who are poor, unemployed, or hold low-prestige jobs (Wolfner & Gelles, 1993, in Gelles, 1993). Those in these categories face more life stress, and the more stress individuals and families have to deal with, the more likely it is for family violence to occur (Milner & Chilamkurti, 1991, in Gelles, 1993). Intimate partner violence is more common amongst young adults, with the highest rates for those aged 18-30 (Gelles & Straus, 1988, in Gelles, 1993). Low education level, often associated with poverty, unemployment, and low status jobs, increases the risk of domestic violence (Bennett, 2000, personal communication). Kaufman-Kantor & Straus (1987) found that blue collar status and excessive drinking are associated with partner abuse.
Native Americans are the most poor of the major racial/ethnic groups, endure extremely high unemployment rates, and are over-represented in low-status jobs such as farming, forestry, and labor. LaFromboise (1993) reports that the median age for Indian people, 20.4, is significantly lower than that for the U.S. population overall, 30.3. The median amount of schooling for Indian adults over 25 years of age is 9.6 years, the lowest of any major ethnic group in the nation ( Brod & McQuiston, 1983, in LaFromboise, 1993). Native people are at elevated risk for problems of substance abuse and dependence, and the literature on Native battering indicates that use of such mood altering substances is a common feature of these violent events. The cultural invalidation faced by Natives is both qualitatively and quantitatively different than that endured by other minority populations in America, for Indian people were and in many ways continue to be the target of an active and rather effective policy of genocide. Each of these factors, economics, age, education, substance abuse, and cultural disruption, seem likely to contribute to the high rates of domestic violence amongst Native peoples.
The salience of these factors in Native peoples' current lives, along with the evidence indicating high rates of domestic violence amongst Indian people, leads to the conclusion that resource theory offers the most reasonable explanation for domestic violence in Native American couples. According to Goode (1971, in Gelles, 1993), open violence is turned to when one has inadequate command of needed resources. Lack of adequate resources and control certainly describes the current picture of Native people who struggle with unemployment and underemployment, inadequate incomes, lack of education, lack of political power, losses of language, culture, homelands and continents overall, due to their conquered status. The use of alcohol and other drugs are quite common amongst the Native population, perhaps in an attempt to alleviate this great unhappiness.
However, these substances can contribute to problematic behavior in themselves, atop the primary problems which they were used as an escape from. Domestic violence, suicide, and homicide are examples of such violent behaviors that can be unleashed due either to the expectation or the real effects of the mood-altering drug used. Women are the targets in cases of domestic violence because they are present and "safe" to aim at, being generally smaller and weaker than men. The hesitation for outside authority to become involved in such matters seen in the U.S. overall is all the more real amongst Native populations. This is because Indian cultural values emphasize privacy of family matters and tolerance of the inadequacies of others, particularly males, because their offerings to the family, clan, and tribe are thought too important to risk alienating them through open confrontation.
Dealing with Native battering
Social work should begin to use present contacts with Native women, such as through Indian Health Service, to screen for the presence of domestic violence, to document it, and to offer culturally sensitive counseling where appropriate. While any service provider in contact with Native people should follow this recommendation, the difficulty in information exchange between Indian Health Services and the many other agencies that would be involved has inspired this pilot recommendation to be tried first with Indian Health Service facilities. Indian Health Service programs are available free of charge to all registered American Indians who present, and therefore these facilities are the ones to which most Indians who receive services turn. Using quality screening tools, women who come to Indian Health Service facilities for routine medical or other types of care should be assessed for domestic violence currently, and in their past. Tracking this information and comparing it to the number of tribally registered Indian women will yield important information on the prevalence, incidence, characteristics, and even regional and intra-Indian cultural differences that exist regarding Native battering.
While this data is limited to those women who come to Indian Health Service facilities, it avoids the limitations previously discussed that seriously skew the representativeness of Native women in national surveys. Having good data on the incidence and prevalence of battering among Indian populations, both on and off reservations, will be vital in order to overcome the tribal and government denial on the extent of the problem noted by Allen (1985, in Krishnan et al., 1997). Getting an accurate picture of Native battering is important to justify the set-up of domestic violence specific programming such as shelters and programs for batterers, to guide intervention techniques used to address it, and to place funding for such programs in places where it is most needed.
Long (1986) highlights some of the obstacles that can interfere with even this seemingly straightforward step of information gathering regarding domestic violence among Indian people. The very definition of partner abuse may differ between worker and client, with many worker-defined victims being unaware of, or refusing to accept their title as a domestic violence victim. Aside from the tribal tradition of deeming domestic abuse as a private matter, specific actions and context are important differing points of abuse definition between workers and clients. Long (1986) explains that many Native people see striking a partner in the face as acceptable as long as no permanent disfigurement results. Additionally, very harsh forms of abuse may be considered acceptable if in response to culturally offensive actions on the part of the victim, such as disrespect of an elder. In observing these differences in definition, explicit descriptions of actions, rather than generic words like battering and abuse, must be used to assess the prevalence and incidence of domestic abuse amongst Native women. A quality screening instrument will adequately address this potential problem with clear, action oriented questions. Whether worker definitions of abuse are accepted by the client is not important to the task of assessing the prevalence of the actions so defined. Yet they are quite important in determining if a woman will recognize the action as dysfunctional for her and come for services to address the situation.
Concern about confidentiality in reporting abuse is common amongst Indian people, who often live at low population densities and have extensive social involvement through family, clan, tribal, and community connections (Long, 1986). The author speaks from her experience in Montana that despite workers' best efforts to hold confidentiality, news of the abuse accusation, and the identities of those involved, often quickly circulate through informal channels within the community. Sanctions from the accused, and even the entire clan or tribe of the accused, often deter victims from coming forward despite being asked in detail about abuse (Long, 1986). The tribal traditions of passive acceptance and privacy can also lead the victim's family, clan, or tribe to ignore the abuse or to see the victim, informant, or professional, as in the wrong for interfering.
This is a factor that can skew data on incidence and prevalence of Native battering, as well as keep women in need of help from coming forward to get it. Work with significant members of Indian communities, including community leaders, tribal leaders, and tribal court officials, will be necessary in order to change community and tribal reaction to the issue of domestic abuse. Training and using Native professionals and paraprofessionals inside and out of the human service field to change community perception of domestic violence seems most likely to alter the negative repercussions of the long traditions of privacy and noninterference.
Specifically, since men have more control regarding when and if battering will occur, they must be targeted for primary and secondary intervention efforts. On the primary level, the Native traditions that allow battering to go unchecked must be overshadowed through community leaders highlighting and educating about the traditional male role as protector and caretaker of women. Shame should fall to men who do not fulfill these roles, rather than upon women who seek help in dealing with abusive men. On the secondary level, men who batter should be brought into culturally adapted group work that integrates current methods used in batterers' groups with methods deemed more effective with Indian men, such as the indirect communication used in Talking Circles. The batterer intervention suggested is necessarily speculative due to the absolute absence of literature on Native men who abuse their partners.
Long (1986) urges service providers to do more than to blindly follow the legal and professional guidelines when assessing and addressing abuse amongst Indian people, as this approach ignores some cultural factors that can lead to unintended disastrous effects. Thoughtful, and sometimes compromised treatment ideals are called for in order to allow for work that is ethical, as well as helpful and effective, when dealing with such subcultural contexts. It is not enough to urge women to report abuse from a partner if this reporting places her in danger of further abuse in retaliation from the accused, or from his family, friends, clan, or others. The presence of professionals in the matter may itself be the reason for the strong retaliation of the accused or other community members against the victim.
Women deserve to make informed choices about keeping themselves safe. Service providers who do not address these real factors of Indian existence are not doing any favors for the victim, who may be revictimized by the backlash against her uninformed move for freedom from abuse. Careful consideration of each of these factors, and others that the victim or worker may be aware of, are in order so that an appropriate and safe solution to the problem can be found. This requires that service providers be both familiar with and open to understanding the client situation as derived from the client herself, as well as from knowledge of the outside community. The use of Native professionals and paraprofessionals may be especially useful here in building client trust and decreasing the backlash of the community over "outside" interference. Use of Native community members to address problems within the community is consistent with the long Native tradition of "taking care of our own." Having "insiders" speak and act against the violence may seem a more justified challenge to the traditional noninterference that most community members have followed on this matter.
Yet the use of members of the Native community to address the problem of domestic violence, while perhaps more acceptable to community members, might also be used as a way of covering up serious problems within the community from outside officials and the public at large. There may be a variety of political reasons that community leaders and community members might desire this. Perhaps the most salient reason is that Native people are known to have a multitude of problems, including economic, educational, unemployment, and substance abuse problems. The exposure of high rates of domestic abuse previously undisclosed will do little to further esteem this already troubled and marginalized group. Tribal and government officials may not want to acknowledge the extent and severity of Native battering, as each wants to appear as if they are doing their jobs properly. Furthermore, each may be aware that there is little money available to take care of this "new" problem.
Norton and Manson (1997) report on their efforts, both successful and not so, in order that others dealing with battered women in Indian communities might learn from their experiences. Taking account of the cultural traditions of Native people was found to be vitally important in providing effective service for these women. Taking counseling out of the office and into the homes of the women was a strategy that allowed them to more effectively address the issue of abuse, although careful planning had to be followed in order to avoid the abuser when visiting (Norton & Manson, 1997). The authors explained that their greatest successes were due to the integration of Native traditions such as home visits, sharing food, and doing therapeutic work with women in the tradition of the Talking Circle.
McDonald (1975) reported success in working with Native American women through the group method. He noted a strong theme of isolation amongst the displaced women he worked with, which speaks to the Native experience of defining self through and in relation to others. Although this factor was responsible for the resistance experienced at the start of the group, it was also what allowed the group to work in ways that the author knew individual sessions with a white male therapist would not.
The work of Norton and Manson (1997), as well as McDonald (1975) suggest that culturally sensitive group work can be helpful for Native American women dealing with various problems. For this reason, group work based on the traditional indirect communication method of the Talking Circle is the intervention suggested for Native women who are or have been battered, as well as Native men who batter or have in the past. Work in these formats should illuminate important differences between Native clients facing these problems, and domestic violence victims and perpetrators from the wider society. This information, along with the information gained from detailed screening of domestic violence in women who make nonspecific contact with Indian Health Service facilities, will help to guide interventions for this population.
Outcome studies done with populations of Native women and men receiving services for domestic violence will be most useful to discover if the respective interventions are working to decrease battering. Data from the Indian Health Service screenings may not be immediately accurate in showing if battering rates are decreasing due to time-lag effects. That is, more Indian women would be likely to come forward to talk about their abuse as Native culture becomes more accepting of the victims' perspective. Thus, domestic violence rates may appear to be increasing even as effective interventions to decrease battering are put in place.
The most important obstacle to this plan is clearly funding. Both Allen (1985) and Nelson et al. (1992) explained that financial resources are severely limited and grossly inadequate to address the problem of Native American domestic violence. This statement is one of political reality, not one of scientific reality. If funding of Indian Health Service programs were a more important priority than they currently are, this would not be an obstacle. For both ethical and ultimately, financial reasons, this author warns that both we can not afford not to fund these vital services. However, dealing within the boundaries of the present and historical limits of funding for Native programs seems prudent, lest nothing get done to address this issue.
Nelson et al. (1992) stated that
currently Indian Health Service mental health programs are funded at only
50% of the need. While adequate funding may be a valid need, more efficient
service can also act to allow more "bang for the buck." Excessive use of
medical care is noted for those with emotional and mental disturbance as
a result of stress, abuse, and other negative life events. Part of the
funding for addressing domestic violence through Indian Health Services
could come from savings on the excess and unnecessary use of medical and
other mental health services that are the sequalae of unaddressed domestic
violence. These savings will not be realized if appropriate screenings
and treatments for domestic violence are not put in place. Perhaps more
importantly, many daughters of the earth and sons of the moon continue
to suffer as a result of tribal and government commitment, ironically enough,
to the Native tradition of noninterference.
References
Bachman, R. (1992). Death and
Violence on the Reservation: Homicide, Family
Violence, and Suicide in American
Indian Populations. Westport, CT:
Greenwood.
Bohn, D.K. (1994). The health
effects of domestic violence before and during
pregnancy among urban American
Indian women in Minnesota: An exploratory
study. Dissertation Abstracts
International: Section B: The Sciences and
Engineering, 54 (10), 5091.
Browne, A. (1993). Violence against
women by male partners; Prevalence,
outcomes, and policy implications.
American Psychologist, 48 (10), 1077
-1087.
Chester, B., Robin, R.W., Koss,
M.P., Lopez, J., & Goldman, D. (1994).
Grandmother dishonored: Violence
against women by male partners in American
Indian communities. Violence
and Victims, 9 (3), 249-258.
Durst, D., MacDonald, J., &
Parsons, D. (1999). Finding our way: A community
needs assessment on violence
in Native families in Canada. Journal of
Community Practice, 6 (1), 45-59.
Fairchild, D.G., Fairchild, M.W.,
& Stoner, S. (1998). Prevalence of adult
domestic violence among women
seeking routine care in a Native American
health care facility. American
Journal of Public Health, 88 (10), 1515
-1517.
Gelles, R.J. (1993). Through
a sociological lense: Social structure and
family violence. In R.J. Gelles
& D.R. Loseke (Eds.), Current Controversies
on Family Violence. (pp. 31-43).
Newbury Park, CA: SAGE.
Kaufman-Kantor, G., & Straus,
M.A. (1987). The "drunken bum" theory of wife
beating. Social Problems, 34
(3), 213-230.
Krishnan, S.P., Hilbert, J.C.,
VanLeeuwen, D. & Kolia, R. (1997). Documenting
domestic violence among ethnically
diverse populations: Results from a
preliminary study. Family and
Community Health, 20 (3), 32-48.
LaFromboise, T.D. (1988). American
Indian mental health policy. American
Psychologist, 43 (5), 388-397.
Long, K.A. (1986). Cultural considerations
in the assessment and treatment of
intrafamilial abuse. American
Journal of Orthopsychiatry, 56 (1), 131-136.
McDonald, T. (1975). Group psychotherapy
with Native American women.
International Journal of Group
Psychotherapy, 25, 410-420.
McNeece, C.A., & DiNitto,
D.M. (1998). Ethnicity, culture, and substance
abuse. In C.A. McNeece &
D.M. DiNitto (Eds.), Chemical Dependency: A
Systems Approach. (pp. 255-317).
Needham Heights, MA: Allyn & Bacon.
Nelson, S.H., McCoy, G.F., &
Vanderwagen, W.C. (1992). An overview of mental
health services for American
Indians and Alaska Natives in the 1990s.
Hospital and Community Psychiatry,
43 (3), 257-261.
Norton, I.M., & Manson, S.M.
(1995). A silent minority: Battered American
Indian women. Journal of Family
Violence, 10 (3), 307-318.
Norton, I.M., & Manson, S.M.
(1997). Domestic violence intervention in an
urban Indian health center.
Community Mental Health Journal, 33 (4), 331
-337.