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Violence Against Women

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Domestic Violence Programs: Understanding the Restraining Order Process

WHEC Practice Bulletin and Clinical Management Guidelines for healthcare providers. Educational grant provided by Women's Health and Education Center (WHEC).

Domestic violence is the willful intimidation, physical assault, battery, sexual assault, and/or other abusive behavior as part of a systematic pattern of power and control perpetrated by one intimate partner against another. It includes physical violence, sexual violence, threats, and emotional/psychological abuse. The frequency and severity of domestic violence varies dramatically. Domestic violence is prevalent in every community, and affects all people regardless of age, socio-economic status, sexual orientation, gender, race, religion, or nationality. Physical violence is often accompanied by emotionally abusive and controlling behavior as part of a much larger, systematic pattern of dominance and control. Domestic violence can result in physical injury, psychological trauma, and even death. The devastating consequences of domestic violence can cross generations and last a lifetime. In the United States, on an average of 20 people are physically abused by intimate partners every minute. This equates to more than 10 million abuse victims annually. The presence of a gun in a domestic violence situation increases the risk of homicide by 500%. The Women's Health and Education Center (WHEC) works with its partners to better understand the problem of violence and to prevent it before it begins.

The purpose of this document is to describe the current state of the problem around the world and the extent to which countries are collecting data on fatal and non-fatal violence to inform planning and action, to assess the status of programmatic, policy and legislative measures to prevent violence, and to evaluate the status of health, social and legal services for victims of violence. This report identifies gaps and stimulates local, regional and national action to address them. By providing an assessment of violence prevention efforts at the global level and a snapshot of the state of violence prevention efforts in each country, this document is a starting point to track future progress and offers a benchmark that countries can use to assess their own progress.


Domestic violence is one of the most serious public health problems in the United States (U.S.). More than 27.3% of women and 11.5% of men 18 years of age and older have a lifetime history of spousal abuse, battering, or intimate partner violence (1). In many states in the U.S., the weighted lifetime prevalence of domestic violence (including rape, physical violence, and/or stalking) is 34.2% among women and 24% among men (2). Although many of these incidents are relatively minor and consist of pushing, grabbing, and hitting, domestic violence resulted approximately 1,200 deaths in the United States in 2014, with 205 deaths in Florida. One of the difficulties in addressing the problem is that abuse is prevalent in all demographics, regardless of age, ethnicity, race, religious denomination, education, or socioeconomic status, and it is either unreported or under-reported universally.

Victims of abuse often suffer severe physical injuries and will likely seek care at a hospital or clinic. The health and economic consequences of domestic violence are significant. Statistics vary from report to report, and due to the lack of studies on the national cost of domestic violence, the U. S. Congress funded Centers for Disease Control and Prevention (CDC) to conduct a study to determine the cost of domestic violence on the healthcare system (3). The 2003 CDC report, which relied on data from the National Violence Against Women Survey conducted in 1995, estimated the costs of intimate partner by measuring how many female victims were non-fatally injured; how many women used medical and mental healthcare services; and how many women lost time from paid work and household chores. The estimated total annual cost of intimate partner in the 1995 survey was more than $5.8 billion (3). When updated to 2003 dollars, the amount was more than $8.3 billion annually. The costs associated with intimate partner now would be considerably more, but no further studies have been conducted. It should be noted that the costs of any one victimization may continue for years; therefore, these statistics most likely underestimate the actual cost of intimate partner violence.

The national rate of non-fatal domestic violence against women in U.S. declined 72% between 1993 and 2011 (4). The rate of overall violent crime fell by nearly 60% in this same period. Studies reveal that several factors may have contributed to the reduction in violence, including a decline in the marriage rate and decrease of domestically, better access to federally funded domestic violence shelters, improvements in women's economic status, and demographic trends, such as the aging of the population (5). Of note, declines in the economy and stress associated with financial hardship and unemployment are significant contributors to intimate partner in the U.S. Following the economic downturn in late 2008, there was a significant increase in the use of the National Domestic Violence Hotline in 2009, with more than half of victims reporting a change in household financial situation in the past year (6).

According to World Health Organization (WHO) global consultation on violence and health; 1996: "Violence is the intentional use of physical force or power, threatened or actual, against oneself, or against a group or community that either results in or has a high likelihood of resulting injury, death, psychological harm, maldevelopment or deprivation." In 2003, the World Health Assembly adopted resolution WHA 56.24, which called upon Member States to appoint a focal point within their ministries of health and actively make use of the conclusions and recommendations of the World Report on Violence and Health. In 2014, the World Health Assembly drew attention to the important role of health systems in addressing violence, in particular against women and girls and against children, and called upon WHO's Director-General to develop a global plan of action to strengthen the role of the health system in addressing interpersonal violence, in particular against women and girls, and against children (WHA 67.15).

Domestic Violence Law Enforcement Guidelines 2017

Commonwealth of Massachusetts (USA)

The provisions of MGL c209A impose specific responsibilities upon the police regarding a domestic abuse situation. All officers are expected to be thoroughly familiar with the contents of that and all other statutes referenced within these guidelines, as amended and construed by case law, and to act with appropriate discretion and competence in carrying out these provisions. According to MGL c2009A, 6: "No law officer shall be held liable in any civil action regarding personal injury or injury to property brought by any party to a domestic violence incident for an arrest based on probable cause when such officer acted reasonably and in good faith and in compliance with this chapter and the statewide guideline as established by the Secretary of Public Safety" (7).

Supervisors shall ensure that the appropriate and mandated reports are filed for children, persons with disabilities, and the elderly (7).

  1. Supervisors shall ensure proper safety plans are in place for the survivor and other family members. These measures shall be in place immediately enabling those affected to make informed decisions;
  2. The safety plan may include all, some or additional items:
    • Drive-by;
    • Welfare spot checks;
    • Arresting the abuser;
    • Serving 209a orders;
    • Assisting in obtaining 209a order;
    • Arranging transportation for medical, shelter, or other locations;
    • Referral to a Domestic Advocate.


As a victim, the Commonwealth has afforded you certain rights. The Abused Person's Notice of Rights (described further down this article) outlines your rights as a victim of domestic violence as provided by Massachusetts General Laws Chapter 209A. In accordance with Chapter 2009A, you have the right to appear at the Superior Court, Probate and Family District Court or Boston Municipal Court if you reside within the appropriate jurisdiction, and file a complaint requesting of any of the following orders (8):

  1. An order restraining your attacker from abusing you,
  2. An order directing your attacker to leave the household, building or workplace,
  3. An order awarding you custody of minor children,
  4. An order directing your attacker to pay support for you or any minor child in your custody, if the attacker has a legal obligation of support, and/or
  5. An order directing your attacker to pay you for losses suffered because of abuse, including medical and moving expenses, loss of earnings or support, costs for restoring utilities and replacing lockers, reasonable attorney's fees and other out of pocket losses for injuries and property damaged sustained.

For an emergency on weekends, holidays, or week nights the police will refer you to a Justice of the Superior, Probate and Family, District or Boston Municipal Court Departments. You have the right to go to the appropriate Court and seek a criminal complaint for threats, assault and battery, and assault with a deadly weapon, assault with intent to kill or other related offenses. If you are in need of medical treatment, you have the right to request that the police officer drive you to the nearest hospital or otherwise assist you in obtaining medical treatment. If you believe that police protection is needed for your physical safety, you have the right to request that the officer present remain at the scene until you and your children can leave or until your safety is otherwise ensured.

You may also request that the officer assist you in locating and taking you to a safe place, including, but not limited to designated meeting place for a shelter or a family members' or friend's residence, or similar place of safety.

You may request a copy of the police incident report at no cost from the police department. To obtain a restraining order you do not need an attorney and it will not cost you any money.

The officer shall leave a copy of the forgoing statement with such person before leaving the scene or premises.

Definitions of Violent Crimes (9):

Homicide: murder and non-negligent manslaughter is defined as the willful killing of one human being by another.

Rape: forced sexual intercourse, including both psychological coercion and physical force. Forced sexual intercourse means vaginal, anal, or oral penetration by the offender (s). This category includes incidents where penetration is from a foreign object, such as a bottle. This definition includes attempted rapes, male and female victims, and heterosexual and same sex rape.

Sexual assault: includes a wide range of victimizations distinct from rape or attempted rape. These crimes include completed or attempted attacks generally involving unwanted sexual contact between the victim and offender. Sexual assault may or may not involve force and include such things as grabbing or fondling. Sexual assault also includes verbal threats.

Robbery: completed or attempted theft of property or cash by force or threat of force, directly from a person, with or without a weapon, and with or without injury.

Assault: the unlawful physical attack or threat of attack. Assault may be classified as aggravated or simple. Rape, attempted, and sexual assaults are excluded from this category, as well as robbery and attempted robbery. The severity of assaults ranges from minor threat to incidents which are nearly fatal.

Aggravated assault: the attack or attempted attack with a weapon, regardless of whether or not an injury occurred and attack without a weapon when serious injury results.

Simple assault: an attack without a weapon resulting either in no injury, less serious injury (for example, bruises, black eyes, or cuts) or in undetermined injury requiring less than 2 days of hospitalization. Also includes attempted assault without a weapon.

Language Barriers

High-risk teams build upon the work of risk assessment by providing systematic responses to monitor offenders and enhance safety for victims. These teams are made up of multiple agencies and provide a vehicle for communication among the different disciplines involved in the domestic violence response system. Ideally, high risk teams are focused equally on offender accountability and victim safety. Teams pool information on high-risk cases and create individualized intervention plans, provide ongoing risk management, and track case dispositions and victim safety. Teams are made up of victim advocacy organizations, law enforcement, probation, parole, prosecutors, Intimate Partner Abuse Education Programs (formerly known as "Certified Batterer's Intervention Programs"), and health care. Other members could include the Disabled Persons Protection Commission, Department of Transitional Assistance (DTA), Department of Children and Families (DCF), educational institutions, correctional facilities, as well as organizations that will ensure cultural sensitivity and representation. Team members are well trained in domestic violence dynamics and risk assessment. They work together to leverage all possible safety options for victims at highest risk.

Critical Elements of Successful High-Risk Teams

  1. Train law enforcement and first responders in risk assessment, strangulation, and the high-risk model (ideally from a training team made up of an advocate, officer, and prosecutor).
  2. Sign a memorandum of agreement that outlines each other's roles, responsibilities, and accountability practices.
  3. Create and adopt high risk assessment protocols in each member's organization.
  4. Include victim advocacy organizations in the leadership of the team to ensure that victim safety remains paramount.
  5. Ensure quality, comprehensive, and adequately funded victim services.
  6. Utilize all effective and appropriate pre-trial containment options, including GPS and electronic monitoring, dangerousness hearings, and pre-trial conditions of probation.
  7. Coordinate efforts to contain and monitor the offender through pre-trial detention, dangerousness hearings, GPS monitoring, and/or batterer's intervention.
  8. Engage the community in the formation process and establish support from the top management of partner organizations.
  9. Address and correct systemic gaps that are uncovered through case management.
  10. Track and evaluate effectiveness and provide a yearly outcome report to the community.
  11. Ensure funding is in place for the lead organization to sustain the efforts.

Whether or not you obtain a Restraining Order, call your local shelter to make a SAFETY PLAN

  1. Are you or have you been:
    • Placed in fear of imminent serious physical harm;
    • Forced to engage in sexual relations, and/or
    • Physically harmed or has someone attempted to physically harm you?

  2. II. Is the person who did this to you a:
    • Family member (past or present);
    • Former or current spouse;
    • Household member (past or present); or
    • A person who you are or were in a dating or engagement relationship?

You can IMPROVE YOUR SAFETY through a restraining (209A) order:

  1. Call your local police department
  2. Go to the court house yourself. A victim witness advocate is available to assist you at the District Attorney's Office.

Complete 209A petition and affidavit. In the affidavit state the facts which causes you to come to court and ask the orders you are requesting. You will need to identify where the abuser lives, works and where the abuser spends a lot of time at, so that the police may give a copy of the order to abuser. If you want to the police first obtain the restraining order in this method, you will not have to repeat this step.

Appear before the judge and explain what occurred. Tell why you are in fear. Explain why and what you want the court to do.

  1. The judge issues a temporary 209A order. You should go to the clerk's / registrar's office to obtain you copy of the temporary order. You will need to return to court within 10 days for a hearing to extend the time for the Restraining Order. OR
  2. The judge denies your request for a 209A.

New Requirements on Employers

(Domestic Violence Law Enforcement Guidelines 2017)

The law creates MGL c149, 52E, which requires employers of fifty or more employees (including the Trial Court) to provide up to fifteen days of leave in any twelve-month period if the employee, or a family member of the employee, is a victim of abusive behavior and is using the leave to seek or obtain a variety of medical, community and legal services relating to the abusive behavior, including appearing in court or addressing "other issues" directly related to the abusive behavior. Abusive behavior extends beyond domestic violence to stalking, sexual assault, and kidnapping.

Employers may require employees to provide documentation demonstrating the employee is a victim of abusive behavior, including a document on court letterhead. The employer has the sole discretion to determine whether any leave taken under this section shall be paid or unpaid.

The Attorney General will enforce this section and may seek injunctive relief or other equitable relief. Any benefit received from this section "shall not be considered relevant in any criminal or civil proceeding" as it relates to the alleged abuse unless, after a hearing, the judge determines that such benefit is relevant to the allegations. MGL c149, 52E (as inserted by Act 10).


Abused Persons Notice of Rights
Directions to a Police Officer:

"You have the right to appear at the superior, probate and family, district or Boston Municipal
Court, if you reside within the appropriate jurisdiction, and file a complaint requesting any
of the following applicable orders:
(a) an order restraining your attacker from abusing you;
(b) an order directing your attacker to leave your household, building or workplace;
(c) an order awarding you custody of a minor child;
(d) an order directing your attacker to pay support for you or any minor child in your custody,
if the attacker has a legal obligation of support;
(e) an order directing your attacker to pay for losses suffered as a result of abuse, including
medical and moving expenses, loss of earnings or support, costs for restoring utilities and
replacing locks, reasonable attorney's fees and other out-of-pocket losses for injuries and
property damage sustained."

"For an emergency on weekends, holidays, or weeknights the police will refer you to a justice
of the superior, probate and family, district, or Boston Municipal Court departments. You have
the right to go to the appropriate district court or the Boston Municipal Court and seek a
criminal complaint for threats, assault and battery, assault with a deadly weapon, assault
with intent to kill or other related offenses. If you need medical treatment, you have the
right to request that an officer present drive you to the nearest hospital or otherwise assist
you in obtaining medical treatment."

"If you believe that police protection is needed for your physical safety, you have the right
to request that the officer present remain at the scene until you and your children can leave
or until your safety is otherwise ensured. You may also request that the officer assist you in
locating and taking you to a safe place, including but not limited to a designated meeting place
for a shelter or a family member's or a friend's residence, or a similar place of safety.
You may request a copy of the police incident report at no cost from the police department."

The Officer shall leave a copy of the forgoing statement with such person before leaving
the scene or premises.

Opportunities for Prevention and Action

Lifetime and one-year estimates for intimate partner violence, sexual violence and stalking are alarmingly high for adult American, with intimate partner violence alone affecting more than 12 million people each year (10). Collective action is needed to implement prevention approaches and ensure appropriate responses. It is important for all sectors of society, including individuals, families, and communities, to work together to end intimate partner violence, sexual violence and stalking. Opportunities for prevention and intervention include:

  • Promote healthy, respectful relationships in families by fostering healthy parent-child relationships and developing positive family dynamics and emotionally supportive environments.
  • Provide coordinated services for survivors of intimate partner violence, sexual violence, and stalking to ensure healing and prevent recurrence of victimization.
  • Hold perpetrators responsible by enforcing laws adequately and consistently.
  • Implement strong data systems for the monitoring and evaluation of intimate partner violence, sexual violence, and stalking to help understand trends in these problems.
  • Provide information on which to base development and evaluation of prevention and intervention programs, and
  • Monitor and measure the effectiveness of these efforts.

Our Solutions

Women's right to live free from violence is upheld by international agencies such as the Convention on Elimination of All Forms of Discrimination against Women (CEDAW), especially through General recommendations 12 and 19, and the 1993 UN Declaration on the Elimination of Violence against Women (11). The Women's Health and Education Center (WHEC) in collaboration with its partners and UN Women works with countries at the global level to advance the international normative framework through support provided to inter-governmental processes, such as General Assembly and the Commission on the Status of Women (CSW).

The CSW is the principal global intergovernmental body exclusively dedicated to the promotion of gender equality and the empowerment of women. A functional commission of the Economic and Social Council (ECOSOC), it was established by Council resolution 11 (II) of 21 June 1946. The CSW is instrumental in promoting women's rights, documenting the reality of women's lives throughout the world, and shaping global standards on gender equality and the empowerment of women.

At the country level, WHEC supports Governments in adopting and enacting legal reforms aligned with international standards. WHEC partner with Governments, UN agencies, civil society organizations and other institutions to advocate for ending violence, increase awareness of the causes and consequences of violence and build capacity of partners to prevent and respond to violence. We also promote the need for changing norms and behavior of men and boys, and advocate for gender equality and women's rights. We support expanding access to quality multi-sectoral responses for survivors covering safety, shelter, health, justice and other essential services.

WHEC supports expanding access to quality multi-sectoral responses for survivors covering safety, shelter, health, justice and other essential services. Policy guidance helps to step up investments in prevention - the most cost-effective, long-term means to stop violence.

WHEC works with Governments to develop dedicated national action plans to prevent and address violence against women, strengthening coordination among diverse actors required for sustained and meaningful action. We also advocate for the integration of violence in key international, regional and national frameworks, such as the post-2015 development agenda.


Building global commitment to violence prevention

Violence shatters lives. Many who live with violence day in and day out assume that it is intrinsic part of human condition. But this is not so. Violence can be prevented and should be prevented. Governments, communities and individuals can make a difference. Around the world almost half a million people are murdered each year. Beyond these deaths, millions more children, women and men suffer from the far-reaching consequences of violence in our homes, schools and communities. Violence often blights people's lives for decades, leading to alcohol and drug addiction, depression, suicide, school dropout, unemployment and recurrent relationship difficulties. In crisis and conflict-affected countries, violence can hamper recovery and development efforts by exacerbating societal divisions, perpetuating crime, and in some cases leading to the recurrence of war. In addition, the costs of violence are high. Families on the brink of poverty can be ruined when a breadwinner is killed or disabled because of violence. For nations, social and economic development is eroded by the outlay on the health, criminal justice and social welfare responses to violence.

The Violence Prevention Alliance (VPA) is a network of the WHO Member States, international agencies and civil society organizations working to prevent violence. VPA participants share an evidence-based public health approach that targets the risk factors leading to violence and promotes multi-sectoral cooperation. Participants are committed to implement the recommendations of the World report on violence and health (12). The Global status report on violence prevention 2014, which reflects data from 133 countries, is the first report of its kind to assess national efforts to address interpersonal violence, namely child maltreatment, youth violence, intimate partner and sexual violence, and elder abuse (12). The report made recommendations for action at local, national and international levels. In short, the report recommended that governments:

  1. Create, implement and monitor a national action plan for violence prevention;
  2. Enhance capacity for collecting data on violence;
  3. Define priorities for, and support research on, the causes, consequences, costs and prevention of violence;
  4. Promote primary prevention responses;
  5. Strengthen responses for victims of violence;
  6. Integrate violence prevention into social and educational policies, and thereby promote gender and social equality;
  7. Increase collaboration and exchange of information on violence prevention;
  8. Promote and monitor adherence to international treaties, laws and other mechanisms to protect human rights;
  9. Seek practical, internationally agreed responses to the global drugs trade and global arms trade.

Laws against violence send a clear message to society about unacceptable behavior and legitimize the actions needed to ensure people's safety at all times. A growing number of scientific studies demonstrate the preventability of violence. The evidence supporting certain prevention strategies is stronger and the prevention gains shown so far are greater for some types of violence than for others (for example, to address child maltreatment and youth violence). With some exceptions, most of the existing evidence for effective violence prevention programming also comes from studies in high-income countries, and may not easily be adapted to low- and middle-income settings where economic and social conditions, and the epidemiology of the different forms of violence, are very different (13).

Many countries have begun to implement prevention programs and victim services, and to develop the national action plans, policies and laws required to support violence prevention programs and response efforts. At international level, high-level resolutions that commit Member States to tackling interpersonal violence within their countries and through the establishment of networks and partnerships have been adopted. Yet serious gaps remain. Much work is still required before the full potential of the growing violence prevention field is realized. No country can rest on its laurels and assume it has successfully addressed interpersonal violence. The international community must continue to recognize interpersonal violence as an important health, criminal justice, development and gender equality issue, and must step up its support for the prevention of and response to all forms of violence.

Resources and Suggested Reading:

  1. Domestic Violence Programs in Massachusetts (USA)

  2. Domestic Violence Law Enforcement Guidelines 2017

  3. 3. Battered Women Resources

  4. Centers for Disease Control and Prevention (CDC)
    Violence Prevention


  1. Breiding MJ, Smith SG, Basile KC, Walters ML, Chen J, Merrick MT. Prevalence and characteristics of sexual violence, stalking, and intimate partner victimization-National Intimate Partner and Sexual Violence Survey, United States, 2011. MMWR. 2014;63(SS8):1-18
  2. Federal Bureau of Investigation. Crime in the United States, 2014. Available at >https://ucr.fbi.gov/crime-in-the-u.s/2014/crime-in-the-u.s.-2014 Last accessed on 1 October 2017
  3. National Center for Injury Prevention and Control. Costs of Intimate Partner Violence Against Women in the United States. Atlanta, GA: Centers for Disease Control and Prevention; 2003
  4. Catalano S. Intimate Partner Violence: Attributes of Victimization, 1993-2011. Washington, DC: Bureau of Justice Statistics, U.S. Department of Justice; 2013
  5. Farmer A, Tiefenthaler J. Explaining the recent decline in domestic violence. Contemp Econ Policy. 2003;21(s):158-172
  6. National Domestic Violence Hotline. Press Release: Increase Financial Affects Domestic Violence Victims. Available at http://thehotline.org/2009/01/increased-financial-stress-affects-domestic-violence-victims-2 Last accessed on 15 October 2017
  7. The Commonwealth of Massachusetts Executive Office of Public Safety & Security. Domestic Violence Law Enforcement Guidelines 2017. Available at http://www.mass.gov/eopss/docs/ogr/justiceprev/2017-domestic-violence-law-enforcement-guidelines.pdf Last accessed on 20 October 2017
  8. The 190th General Court of the Commonwealth of Massachusetts. Chapter 209 A. Available at: https://malegislature.gov/Laws/GeneralLaws/PartII/TitleIII/Chapter209A Last accessed on 5 October 2017
  9. U.S. Department of Justice. Office of Justice Programs. Female Victims of Violence. Available at: https://www.bjs.gov/content/pub/pdf/fvv.pdf Last accessed on 29 September 2017
  10. Centers for Disease Control and Prevention. Findings from National Intimate Partner and Sexual Violence Survey 2010-2012 State Report Findings. Available at https://www.cdc.gov/violenceprevention/pdf/NISVS-StateReportFactsheet.pdf Last accessed on 25 October 2017
  11. United Nations. General Assembly. Declaration on the Elimination of Violence against Women; A/RES/48/104, 23 February 1994. Available at: http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/48/104 Last accessed 26 October 2017
  12. World Health Organization. Global status report on violence prevention 2014. Available at: http://www.who.int/violence_injury_prevention/violence/status_report/2014/en/ last accessed on 24 October 2017
  13. World Health Organization. Preventing intimate partner and sexual violence against women: taking action and generating evidence. Geneva: World Health Organization; 2010

Published: 14 November 2017

Women's Health & Education Center
Dedicated to Women's and Children's Well-being and Health Care Worldwide