New work is being done in Ohio to help free people who are caught in the complex web of domestic violence, addiction and mental health.

Cheryl Stahl, who is heading the Ohio Domestic Violence Network's new Substance Use Mental Health Project, said most survivors who seek services are facing multiple traumas and concerns.

"You're working with women who - say, from childhood - have had sexual-abuse experiences and then date people who are abusive," she said "Those people perhaps are using drugs. They get introduced to drugs; they may have mental-health concerns that are being masked by the trauma."

Research indicates that between 47% and 90% of women who seek substance-use disorder treatment say they've experienced domestic violence. Stahl said the project is teaching advocates at shelters about addiction and mental health, and how they can better assist people who struggle with these challenges.

Stahl said domestic-violence survivors can be reluctant to leave because of mental-health and substance-use coercion, when an abuser uses tactics to undermine their sanity and sobriety.

"The abusers will often use substance use particularly as a way of threatening to take custody of children," she said. "You may have the abuser as the person who is providing the drugs and sort of in control of when they get them and when they don't."

Stahl said the training will teach shelter staff how to talk about addiction in ways that encourage change and can connect survivors with peer-support services, and provide help for people who are actively using but not ready to enter treatment.

"Survivors aren't going to shelter necessarily to get off of drugs, that's not what they're seeking that service for," she said. "So, introducing some harm-reduction strategies - safety planning with people on how to hopefully prevent overdose."

Stahl said some of the work will focus on identifying brain injury as it pertains to substance use and mental health. The three-year project is starting in seven counties and Stahl said she hopes to expand it to 30 shelters.

Sexual assault survivors in rural Ohio may have to travel hours to get a forensic exam.

During National Forensic Nurses Week, Ohio advocates say they're working to expand access to these trained professionals who can offer trauma-informed care.

Tammy Robertson, statewide director of forensic nursing for the Ohio Alliance to End Sexual Violence, said beyond a medical exam, forensic nurses can provide courtroom testimony, and assist patients in ways other health care professionals typically do not. She wants survivors of sexual assault, elder abuse, domestic violence, child abuse or human trafficking to know some hospitals have forensic nurses on staff.

"And, at least if the hospitals are unaware of that program, or doesn't have a program, they can potentially reach out to a surrounding hospital and get that patient services," Robertson advised.

Robertson added advocates are working to educate community partners, including law enforcement, prosecutors, child protective services and others about the resources forensic nurses provide.

If you or someone you know is experiencing a crisis or needs help, call the Ohio Sexual Violence Helpline at 844-644-6435, 24 hours a day, seven days week.

Robertson pointed out the holistic approach to care and support forensic nurses offer has been shown to improve survivor outcomes.

"There is, statistically, shown that there is a better healing outcome for those patients who receive care from a forensic nurse," Robertson noted.

Nationwide, between 17% and 20% of hospitals have a sexual assault examiner or forensic nurse available, according to the Rape, Abuse and Incest National Network and the International Association of Forensic Nurses.

Domestic Violence Awareness Month might be coming to an end, but a recent panel discussion was aimed at educating Nevadans about policy changes as well as dispelling misconceptions surrounding domestic violence.

Serena Evans, policy director for the Nevada Coalition to End Domestic and Sexual Violence, said as a state, Nevada tends to be what she calls "reactive instead of proactive," relating to policy implementation. She adds Nevada is one of a few states that does not fund prevention and intervention through its general budget- making it more difficult to get victim survivors the help they need.

"So many other states fund domestic and sexual violence in their general budget. We do not. So a lot of our programs struggle to make ends meet, and we do not have enough funding in the state to meet the needs of victim survivors," she explained.

For 23 out of the last 25 years, Nevada has ranked among the top 10 states with the highest rates of women being killed by men, according to the Violence Policy Center. It also ranks 21st in the nation in terms of household firearm ownership rates. Domestic violence experts call the combination a dangerous mix. Evans said Nevada policymakers can vote to better support housing and education initiatives to decrease the rate of domestic violence.

One of the laws that was passed during Nevada's latest legislative session was Assembly Bill 51. It expands the window for when people can be arrested in domestic-violence cases from 24 hours to seven days. Before AB 51's passage, law enforcement officers only had 24 hours to make an arrest before they had to obtain a warrant. Advocates say it should help reduce survivor's vulnerability.

Kristen Kennedy, executive director of the Domestic Violence Resource Center in Reno, said they not only provide emergency services for those fleeing domestic-violence situations, but also work with victim survivors to get them back on their feet.

"We assist in helping individuals rebuild their lives. We have a transitional housing program so individuals can be in our program and live in our housing for up to two years," she explained. "And during that time, we do some very intensive financial coaching with our clients and trauma counseling."

Kennedy added many have the misconception that one needs to find themselves in what she calls a crisis situation to seek help. She said that isn't the case at all, and encourages those who want to learn more or simply get advice to reach out to organizations like hers, as they are there to help and provide resources.

For some people experiencing domestic violence, concern about the safety of their household pet can prevent them from leaving. In a survey of 2,500 domestic-violence survivors
, about half reported they feared the perpetrator would harm their pet. Nearly a third reported their pet had been harmed or killed.

Pat Carraher, managing attorney with Legal Aid of Nebraska, said as of September 1st, Nebraska law allows pets to be included in domestic-violence protection orders, and added the law should deter perpetrators from using pets as leverage, since violating a protection order is a crime.

"It's a Class I misdemeanor, and if you violate it twice, it gets bumped up to a felony. Up until now, a perpetrator of domestic violence could make a lot of threats about a household pet without really worrying about much criminal liability," Carraher explained.

Carraher said when an individual fills out the paperwork for a domestic-abuse protection order, they can check one box asking for possession of the household pet, and/or another requesting that the other party "be enjoined from harming" it. He says Legal Aid of Nebraska
puts "high priority" on representing victims of domestic violence, including in protection-order cases.

The Nebraska Humane Society's Project Pet Safe
will temporarily shelter domestic pets for people working with a caseworker in domestic-abuse situations. Pam Wiese with the Humane Society says they will help in other ways, too.

"While they're with us, we try to provide anything that we can, so if they need spaying and neutering, microchipping; if they need some type of medical (care) done, we work to try to get that pet into the best shape that it can be so that they can kind of start their new life on a good footing, " Wiese explained.

Wiese added some pet owners will realize they can't reunite with their pet, but Project Pet Safe provides them valuable time.

"Even if they feel that they can't take care of the pet moving forward, they are able to make that decision for themselves, and it's not forced upon them," Wiese said.

Some victims of domestic violence find they have to leave their pet behind, and Carraher said the new law is designed to help in those situations, too.

"If for some reason they can't take the pet with them, they might check that second box, knowing that they are going to leave the pet but that the perpetrator of domestic violence will be ordered not to harm the pet," Carraher continued.

As of 2022, 38 states had some provisions for adding pets to domestic-violence protection orders.