In Julia Benfield's job as an emergency room nurse, the next domestic violence case is never far away.
On average, every shift Ms. Benfield works at Mercy St. Vincent Medical Center, someone - usually a woman - comes in with injuries inflicted by the person who should love them the most.
The injuries range from cigarette burns, to punch wounds, to shootings, stabbings, or strangulation.
They can be difficult for any medical professional to handle emotionally.
"The horror stories go through my head at night. Everyone has the horror stories," Ms. Benfield said. "It's just disheartening to see how much violence there is within the family. And with the economic situation in the Untied States, we've seen an increase in domestic violence."
That widely reported increase has prompted calls for more education and public discussion on the problem of domestic violence, an issue too often weighed down by stigma and ignorance, those who work in the field say.
For professionals such as Ms. Benfield and members of the community in general, knowing how to recognize interpartner violence and how to help its victims s are also increasingly crucial.
To that end, the Neighborhood Health Association, a provider of health services to various Toledo neighborhoods, is holding a symposium next month to offer training on domestic violence awareness and prevention, and to reach out to those who have been affected by it.
The public event, to be held Oct. 1 at the Holiday Inn French Quarter in Perrysburg, is aimed at community groups, health-care workers, social service agencies, legal professionals, law enforcement organizations, elected officials and also domestic violence victims themselves.
The event's keynote speaker will be Rory Kennedy, daughter of the late Robert F. Kennedy and an acclaimed documentary filmmaker who has addressed the domestic violence issue in her work.
"The idea is to educate, advocate, and empower women to take control of the issues that negatively affect their lives," NHA's chief executive officer, Doni Miller, explained. "What we really want to have happen is to have all these people go back and talk about domestic violence in their churches and in their groups and in their clubs so that they keep the issue of domestic violence alive."
To order tickets for NHA's domestic violence symposium, call 419-720-7883 or visit its Web site, www.nhainc.org. Tickets are $75 per person, or $40 for students and educators.
According to the National Coalition Against Domestic Violence, one in every four women will experience domestic violence in her lifetime. Types of violence include physical aggression, sexual abuse, emotional intimidation, economic deprivation, and all types of domineering behavior.
Although women make up the majority of domestic violence victims, men can also be affected. Violence can also occur between couples that are dating, including teens.
Abuse among intimate partners is prevalent across cultures, race, and economic class.
In Lucas County, there were 49 domestic violence-related deaths between 2003 and 2006. Local police agencies are swamped with calls about domestic violence, with the Toledo Police Department alone receiving nearly 7,000 calls about it to 911 in the first half of this year.
"It's definitely a problem," said Mary Jo Jaggers, a detective with the Toledo Police Department who specializes in domestic violence cases. "When you listen to the police scanner and listen to the calls that are coming in to 911, it's probably one of the top calls that the officers are receiving. … It ties up a lot of police officers' time and energy."
In addition to causing widespread trauma to victims and families, domestic violence can be expensive for society as a whole. Police departments, health-care workers, and social service agencies all spend substantial time dealing with domestic violence.
The problem can also lead to loss of productivity in the work force because victims are often harassed by their partners at work or forced to quit their jobs. For Lucas County, providing intervention services for domestic violence costs an estimated $13 million a year, according to one study.
One major challenge in the fight against domestic violence is getting victims to seek help. Often they are too afraid, or too beaten down by their abuser, to report what is happening to them. At St. Vincent's, even in the most self-evident cases of partner abuse, many victims won't admit the truth, Ms. Benfield said.
"They'll say, 'I fell down the stairs,' or 'I ran into a door.' Mostly they put it on themselves," Ms. Benfield said. "They're oftentimes afraid to disclose because their family has been threatened if they make a statement, or maybe the perpetrator's in the room with them."
Even if they're alone, the victims often blame themselves for their injuries. "The perpetrator has decreased their self-esteem so much that they think, 'I deserve this,'•" Ms. Benfield explained.
When they do open up about the abuse, many victims will still go back home to their abuser, even though staff at the hospital offer an alternative place to go, the nurse said.
Although frustrating, Ms. Benfield said staff are trained to recognize this reluctance as part of the cycle of violence. Victims will often return to the hospital several times before they accept help, she said.
"It's the emotional abuse that the perpetrators have put them through," said Ms. Benfield.
"They've ingrained in them that they don't deserve help and that they deserve all the abuse they're getting."
Some victims don't understand what is happening to them, said psychologist Dan Schaefer, who runs Person to Person Resources in Perrysburg. He said victims might have grown up with domestic violence at home and see it as an ordinary part of their own relationships.
Often they may come to his office complaining of mental health problems such as depression, anxiety, or post-traumatic stress disorder, and not realize their relationship is the cause.
"If a woman is in a relationship, if she's married or dating, I would routinely ask" about domestic violence, Mr. Schaefer said. He said about 1 in 10 married couples he sees has experienced some kind of domestic violence problem.
Like Ms. Benfield, Mr. Schaefer said victims are often reluctant to seek help. He has to point out to them that their partner's abuse is illegal.
"They're entitled to feel safe in their own home," Mr. Schaefer said. "Once they believe that … you can get them to an advocate. Then you've got some traction."
One agency that helps domestic violence victims is the YWCA of Greater Toledo, which operates a battered women's shelter and a specialized helpline. President Lynn Jacquot said the YWCA's outreach services to domestic violence victims have increased 200 percent this year, with more people than ever asking for help. She said many of the callers are young women.
Ms. Jacquot cautioned that when a woman is caught in an abusive situation, getting out of the relationship can be extremely difficult and must be handled delicately.
"The most dangerous time is when she's leaving. Eighty percent of fatalities happen when she's leaving. That's when his control is most threatened," Ms. Jacquot indicated.
She said anyone experiencing domestic violence should call the YWCA's help line, through which they can get help with developing a safe strategy for leaving the abusive partner.
For the YWCA's 24-hour crisis line, call 419-241-7386 or 1-888-341-7386.
Contact Claudia Boyd-Barrett