Lethality Assessment Program The Maryland Model  New Orleans, LA April 19, 2012

1. Lethality Assessment ProgramThe Maryland ModelNew Orleans, LAApril 19, 2012

2. Agenda LAP • Background • How the LAP Works • The Phone Conversation • Results and Evolution • Issues: Logistical and Philosophical • Conclusion: Testimonials

3. BackgroundDefinitions • Lethality Assessment Identifying victims who are in danger of being killed. • Lethality Assessment Program forFirst Responders (1) Identifying victims of domestic violence who are at the greatest risk of being killed, (2) for the purpose of getting them out of harm’s way, if necessary, and (3) encouraging them to go into domestic violence services.

4. Why Lethality Assessment?Numbers = Opportunity • 1,500 DV fatalities a year in U.S. • For every 1 DV homicide, 8-9 near homicides • 53% of LAP victims in MD strangled over a 6-year period (12% sampling of lethality screens) • Police previously on scene in 50% of DV homicides • Only 4% of DV homicide victims had ever availed themselves of DV services • Re-assault dropped by 60% when victims went into shelter Intimate Partner Homicides 1976: 1,587 women + 1,304 men = 2,894 2005: 1,181 women + 329 men = 1,510 ● 48% reduction overall 75% reduction for men 26% reduction for women

5. Why Lethality Assessment?Information = Opportunity • Because the information is already there... • Through research-based work of Dr. Jacquelyn C. Campbell, and • Her validated assessment instrument: Danger Assessment (www.dangerassessment.org)

6. Why Lethality Assessment?Presence = Opportunity Lethality assessment, just by administering an instrument: • Causes greater awareness of danger and lethality. • Causes greater consideration of proactive interventions. • Educates system participants. • Allows victims to see through “different lens”. • Enhances 3 C’s: coordination, communication, cooperation Lethality Assessment is now a part of the “Conversation.”

7. Development • Goal:to create a user-friendly instrument and a proactive protocol. • Purpose: to enable first responders to identify domestic violence victims who are at greatest risk of being killed.

8. Considerations 2 0 0 3 • Be responsible and deliberate — first time such an effort had been made • Include field experience and research in a development committee • Make the instrument user-friendly • Make the protocol proactive • Define “first responder” • Field test

9. What We Learned • Right track • 84% “easy-fairly easy” • 50% boost in confidence • Main goal accomplished—“user friendly” • Phone call protocol—not an issue • Majority of officers, all of counselors— “worthwhile endeavor” • LAP—doable • One officer said, “Don’t over-tweak it.” 2 0 0 5

10. Conducting a Lethality Screen for First Responders Initiating the Protocol LAP…How It Works Paradigm Shift… Culture…

11. Lethality Screen • Evidence-based, field instrument • Applied to 4,000+ research victims, 90% of Lethality Screen victims would have screened in at High Danger--Reliable • Danger Assessment serves as model • Standards for initiation • Intimate Partner relationship • Manifestation of Danger • “Scoring” + Discretion

12. When to Initiate a Lethality ScreenOnly in Cases of Intimate Relationships… • When you believe there’s been an assault or other act of domestic violence, • When you believe the victim faces danger once you leave, • When the home or parties are repeats, or • When your gut tells you the situation is dangerous.

13. Screen-ins and Cut-offs • Yes to Q. #1, 2, or 3 =Protocol Referral (PR). • No to above, but Yes to any four of Q. #4-11=PR. • No to all, or no more than 3 of Q. #4-11, may still trigger PR if officer believes it appropriate. • Officer may trigger PR whenever he/she wants. • If PR not triggered, officer may ask additional question on Screen to help decide whether to trigger PR.

14. Protocol Assess • Officer introduces screen simply, privately, positively • Officer Alerts victim to danger unequivocally • Officer makes phone call • Officer encourages victimto get on phone • Hotline provides immediate safetyplanning • Worker encourages victim to go in forservices • Program offers enhanced services Connect PREVENTIVE

15. The Phone Conversation The phone conversation between hotline worker and victim is: • Brief (to get officer back into service) • Focused (required creation of Guidelines) • Different for EVERYONE (victim, officer, and hotline worker)

16. The Guidelines The Guidelines for Conversationbetween hotline worker and victim incorporate the: • Stages of Change(Prochaska)and • Victim-Centered Advocacy(Davies).

17. Stages of Change Meeting victim at her level: • Pre-contemplation: • Victim’s situation:There is no problem.●Victim’s options:None. • Contemplation: • Victim’s situation: Admitting existence of problem. ● Victim’s options: Considering change. • Preparation: • Victim’s situation:In better touch with reality.●Victim’s options:Things can be different. • Action: • Victim’s situation:Determination to be free of abuse.●Victim’s options: Things will be different. • Maintenance: • Victim’s situation:Process of change is clear. ●Victim’s options:Things are different.

18. Purpose of Guidelines • Purpose: To focus conversation • Goals: -- To do immediate safety planning, and -- To get victims into services

19. Points of Conversation • Gather information. • Build rapport. • Reinforce victim’s potential danger. • Educate and safety plan. • Encourage victim to go into services. 5

20. Results and Evolution

21. Statusof LAP in Maryland & Other States • 14 States since June 2009 • 300+ law enforcement agencies (incl. LVMPD, Broward County SO, KC, Savannah, Ft. Wayne, Gainesville) • 36+partner DV service providers • 110 counties • Maryland since October 2005 • 102 law enforcement agencies (91% of 112) • 20 partner DV service providers (100% of 20) • 24 counties (100% of 24) Maryland & Jackson Co., Missouri 2010

22. Maryland Intimate Partner Homicides4-year reduction = 41%

23. Results and Evolution“Best Practices” • Assessing protective order petitioners • Following-up with High Danger victims • Guidelines for conversation between hotline worker and victim • Regular LAP meetings • Newsletters, updates, training bulletins, surveys, new protocols… • Standard of Practice, more ideas... Always New Things Screening hospitalized victims and mutual battery cases, retraining, maintaining levels of performance, etc. Data & Reports

24. Logistical Issues • What phone are we supposed to use? • What do we do while the victim is on the phone? • What if we just can’t do a screen? • What do we do in mutual battery cases? • Sounds like this will keep us on the scene too long.

25. Philosophical Issues • Do we disempower or bring harm to a high risk victim when we follow up with her/him? • Where is the line between encouragement and empowerment/decision-making? • When a victim does something we promote rather than what she really wants to do, do we harm her emotionally? • How do contain dangerous abusers? • Is the LAP successful? • Is trying to prevent homicide a secondary goal?

26. ConclusionTestimonialOn the Occasion of an Award Nomination I feel humbled by this nomination, but the bottom line is this program does work, and I have been waiting for 15 years for something like this program to evolve. When I worked the streets, I felt we were missing the beat on our response to domestic violence assaults and our contact was more of a reactionary thing and we were doing nothing to prevent future abuse. I started in law enforcement at a time when people were just starting to address the cycle of violence issue. Officers at my department are beginning to grasp the idea that if a victim gets into services the assault rate for future abuse drops dramatically. Even the older officers who would generally go around using the old terminology of “why don’t you just leave the guy and you won’t get beat up” now know that the cycle of violence goes deeper and they figure in the mental aspects of an abusive relationship when using the LAP screening form. Detective Greg Smith Grandview, MO, PD

27. Comments of High Danger Victims Who Went in for Services… “I didn’t realize how common my boyfriend’s abusive behaviors were until the hotline worker explained them to me.” “The officer and hotline worker really had an impact on my thinking. They made me feel better and worth it.” “The deputy was very encouraging of ____ services. He was very cool and made me feel worth it.” “I felt like I could trust the hotline worker and the officer.” The hotline worker helped me to relax and focus….That really helped me.” The hotline worker told me that people in similar situations have been killed. That opened my eyes.” My mom had told me about ____ services…and I decided not to go. Once I was encouraged to talk to them by the officer, I decided it was time to seek help.” 2010

28. January 2011…Advocate’s and Deputy’s first ever unannounced home follow-up visit in one Maryland county…as the victim said to the same advocate when the victim went in for services… (When I saw you and the deputy walking up,) “I felt special.”

29. Contact Information David Sargent Maryland Network Against Domestic Violence 6911 Laurel Bowie Road, Suite 309 Bowie, MD 20715 Phone: 301-352-4574 Email:info@mnadv.org Web:www.mnadv.org