The intersection of intimate partner violence (IPV) and brain injury (BI) has been nearly completely overlooked in research, practice, and policy, despite the known risk associated with the two conditions. The majority of physical injuries sustained by women as a result of IPV are from battery to the head, face, and neck, including strangulation. In the IPV context, an external force, such as blunt force trauma to the head or face or violent shaking is enough to sustain neurological deficits. The lack of research on the intersection of IPV-related BI (IPV-BI) makes for limited understanding of survivor’s healthcare needs and a scarcity of services tailored to their needs. With one in three women expected to experience intimate partner violence (IPV) in their lifetime, and up to 75% of those women incurring suspected brain injuries, IPV-BI is a significant public health concern. Along with increased risk of mental health challenges, addictions, and complex health needs, IPV and BI are also associated with elevated rates of unemployment, poverty, and homelessness. These physical and social determinants of health impact women and can leave them vulnerable to ongoing violence and permanent disability. The intersection of IPV-BI is uniquely and extraordinarily complex. Each component individually presents significant challenges on multiple fronts: medically, emotionally, psychologically, economically, and socially. This complexity presents singular challenges to the development and delivery of effective, timely healthcare and social service supports. Since COVID-19, healthcare systems have experienced unprecedented strain resulting in longer wait times, fewer services available, and an inability to address the complex needs of survivors of IPV-BI, particularly in rural and remote communities. Seeking alternative approaches to addressing these gaps is of critical importance. Collaborations between knowledge producers, community-based service providers from diverse geographical areas, advocacy groups, and volunteer organizations can be one such approach. Presented here is an example of how this approach can be effective. Engaging in a community-driven collaboration with the goal of providing research expertise and knowledge support to the Canadian Royal Purple Society, the ongoing project has resulted in the development of a national campaign to address IPV-BI including public awareness events, funding and donation programs, policy impacts, and the development of blueprints for community capacity building to support and prevent IPV-BI. This ongoing project addresses a critical gap in addressing the impact of IPV-BI on survivors on both an individual and a community level. Presented here is an innovative grassroots approach to addressing the unique care needs of survivors of IPV-BI while building capacity at a local level. This talk is intended to provide insights, resources, and practical suggestions for fostering community collaborations, involve the volunteer, and work together to better support women exposed to IPV-BI.

INTRODUCTION: Intimate partner violence (IPV) primarily affects women and gender-diverse people. A recent study found 98% of a sample of 2S/LGBTQ Canadians had experienced IPV in their lifetime (physical, psychological, financial, sexual or identity-based abuse). While IPV can manifest in various forms, physical violence is particularly concerning due to its potential to cause significant harm, including brain injury (BI). Although incidence rates are difficult to determine, various studies have demonstrated 70% of those who have experienced IPV, had symptoms consistent with a BI as a result of physical violence. This potentially indicates a substantial number of 2S/LGBTQ people who may access a service provider organization (SPO; e.g., public, private, and mental-health care, emergency services, domestic violence shelter, victim services) after experiencing IPV-caused BI. 2S/LGBTQ survivors are likely to face unique challenges that limit access to necessary support systems following IPV-caused BI. Addressing gaps within SPOs that hinder 2S/LGBTQ survivors from receiving comprehensive, affirming care requires further investigation.

METHODS: To explore the unique challenges and solutions for 2S/LGBTQ survivors who access SPOs following IPV-caused BI, semi-structured interviews were conducted using an interpretive description approach for applied disciplines. Interviews discussed survivor and service provider experiences around 2S/LGBTQ access to SPOs, with a focus on issues and potential resolutions. Interviews were transcribed, de-identified, and analyzed. Line-by-line initial coding was used to group data which was interpreted and mobilized into challenges and informed solutions guided by expert participants.

RESULTS: Eleven service providers and three survivors participated in interviews (N=14; 10/14 (71%) identified as 2S/LGBTQ). The study identified three key challenges 2S/LGBTQ survivors may face when attempting to access SPOs with corresponding solutions. First, most SPOs operate within a cisgender, heteronormative understanding of IPV, making it difficult to recognize IPV and resulting BI within 2S/LGBTQ communities. To amend this, mandatory training and awareness campaigns were suggested as critical steps toward more inclusive care. Second, due to framing IPV in a cisgender, heterosexual lens, 2S/LGBTQ survivors, particularly racialized survivors, often feel excluded and underserved. To address this, restructuring SPOs to create inclusive, intersectional, and trauma-informed services was recommended. Lastly, the compounding effects of adverse social determinants of health (SDOH) further limit survivors’ access to services. Targeted interventions addressing both IPV and the specific SDOH commonly faced by 2S/LGBTQ individuals were suggested to remedy these barriers.

CONCLUSION: Understanding the challenges 2S/LGBTQ survivors of IPV-caused BI encounter is essential for creating equitable services. Targeted solutions like mandatory 2S/LGBTQ specific SPO training, addressing adverse SDOH, and restructuring services are crucial steps. These real, urgent problems affect the lives of 2S/LGBTQ survivors, who deserve access to comprehensive, empowered, and informed care.

Introduction: Intimate partner violence (IPV) often involves several forms of abuse, including physical violence, which can lead to traumatic brain injury (TBI). For women victims of IPV, TBI can significantly impair their cognitive, emotional, and physical capacities, directly affecting their ability to assume parental responsibilities. Protecting women and their children against violence from their partners requires a multitude of services, including child protection authorities and women’s shelters. However, navigating legal systems, particularly those related to child protection, can be daunting for women, particularly when they must also manage the consequences of TBI and the reality of living within a women’s shelter. Though occupational therapy (OT) services have the potential of providing crucial services to these women, particularly in addressing their parental roles, few OT services specialized in TBI rehabilitation are provided within the context of women’s shelters in Montreal Canada.

Objectives: This study aims to explore the potential role of OT in evaluating and documenting the parenting capacities of women with possible TBI, living within women’s shelters, while also considering the potential legal implications of these evaluations in judicial processes.

Methods: This study used a qualitative, descriptive, and exploratory design. Three focus groups were conducted to gather data: one involving occupational therapists (n= 6) with expertise in IPV, TBI, and child protection cases, and the other two with both occupational therapists and legal experts specializing in family law (n=1), criminal justice (n=1), and forensic evaluations (n=1). Staff from local shelters for women (n=2) also participated in all three focus groups. Data were analyzed using thematic analysis, focusing on the challenges and strategies related to supporting the parental roles of women victims of IPV with possible TBI.

Results: Preliminary findings revealed key themes and subthemes that highlight the clinical and legal complexities of these cases. These include : 1) the potential for harm due to incomplete or misinterpreted documentation, influenced by professional mandates and inconsistencies in the interpretation of reports among different professionals; 2) the multifaceted effects of IPV and TBI, which complicate accurate assessments—compounded by factors such as insufficient trauma-informed care education and societal biases affecting professional judgments; 3) strategies to address these challenges, emphasizing the need for trauma-informed approaches that integrate women’s coping mechanisms and strengths.

Conclusions: In conclusion, there is a need for an increased offer of TBI-informed OT services in women’s shelters and improved documentation of these services, particularly in legal contexts involving child protection. Particular attention needs to be paid to what information is (or is not) included in a report, and how it is documented. This study underscores the importance of multidisciplinary collaboration and continued education in trauma-informed care to reduce harm and enhance the support provided to women victims of IPV and TBI.