Domestic and Interpersonal Violence Services and Substance Abuse Treatment: Evidence from a National Survey

Background: Domestic violence (DV), including intimate partner violence (IPV), is recognized as a major public health issue. Data from epidemiological surveys and studies of clients in substance abuse treatment have documented the relationship between substance use and DV/IPV. It is estimated that substance us is involved in approximately 40 to 60% of DV/IPV incidents in the United States. Yet, only 27% of outpatient substance abuse treatment facilities offer treatment programs for DV/IPV. The purpose of this paper will be to examine the organizational characteristics that predict the availability of DV/IPV services in outpatient substance abuse treatment facilities and to examine the pattern of treatment and recovery services offered to these clients.

Methods: Data for this study were drawn from the 2019 National Survey of Substance Abuse Treatment Services (N-SSATS). The N-SSATS is an annual survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) of all known treatment programs in the United States and its jurisdictions. In 2019, N-SSATS collected data on 15,961 programs, of which 12,579 were identified as regular or intensive outpatient programs. It is these outpatient programs which form the data base for this study. DV/IPV programs were identified as those programs who reported having a substance abuse treatment program or group specifically tailored for clients who have experienced IPV or DV (N = 3,411). The organizational variables included ownership, financing and funding sources and accreditation status. The services included treatment services, medical services as well as recovery support and social services. The analysis consisted of two steps. In the first step using binary logistic regression the organizational variables were treated as independent variables and DV/IPV status was the dependent variable. In the second step, DV/IPV status was the independent variable, the organizational variables were treated as covariates and the pattern of services offered was the dependent variable.

Findings: The overall findings show that organizational variables such as ownership and funding mechanism are important predictors of DV/IPV services. The findings also show that DV/IPV programs are more likely to offer recovery and social support services such as peer mentoring, self-help groups, assistance in locating housing, employment training, counseling and case management services.

Implications: It is well documented that substance use and abuse are factors that contribute to the cycle of domestic violence and intimate partner violence (DV/IPV). Even with increased calls to screen for and provide services for DV/IPV, less than one-third of outpatient programs provide services or specific programing related to DV/IPV. Many treatment organizations appear to lack the resources and bandwidth to train and equip staff with the skills to adequately identify and intervene within their service populations. Finally, federal and state level efforts to collect data on the substance abuse treatment system and DV/IPV continue, for the most part, to decline. Without renewed efforts, policy makers at all levels will find it difficult to develop targeted policies to address these complicated problems or assess the impact of policies and programs that are put into place.