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Abstract:
Many women on welfare in BC are not the primary recipients of the financial assistance by the Ministry of Human Resources. The cheque is frequently issued to their partners, creating financial difficulties. The barriers created by that situation are presented and illustrated by two case studies.
In-depth interviews of the women were conducted and complemented by a comprehensive review of the literature on the economic and health consequences of such barriers. The results were summarized in a report presented to important policy stakeholders, including Medical Health Officers, the Office of the Provincial Health Officer of British Columbia, the Deputy Provincial Health Officer, and the Ministry of Human Resources. It was favourably received by all, and the Ministry of Human Resources committed to improving the education of their employees on economic and health consequences of domestic violence, as well as the importance of financial barriers in leaving violent relationships. The ministry also planned to increase the visibility and awareness of existing policies in the Ministry available for victims of violence. Dr. Ouelette concluded that more research into recipients of BC Employment and Assistance programs, domestic violence incidence, and the interrelation between health and economic impacts of financial assistance policy should be conducted.
Author:
Dr. Veronic Ouellette, MD, MSc, CCFP, is a Family Physician with a masters in health administration. She is currently a Community Medicine Resident in the Department of Health Care and Epidemiology at UBC, a specialty training program which combines rotations in clinical medicine and public health. She is very interested in domestic violence issues.
Preamble
This report is based on the clinical experiences of the author during a family practice rotation in 2002, discussions with local Employment and Assistance Program employees, and subsequent telephone and internet inquiries; as such it may not fully reflect current policies. It is written in order to generate awareness of the difficulty the “one cheque per family” policy of the Ministry of Human Resources poses to women in abusive relationships. It is anticipated that this report will be used by relevant governmental agencies to discuss current policies and advocate for changes that will benefit women in abusive relationships on welfare in British Columbia.
Acknowledgements
Dr Shaun Peck, Deputy Minister of Health at the time of the publication of the background reports.
Dr L. Reib, supervisor in the clinical setting where this issue was raised
Dr Gilbert, editor and author of the reports serving as the basis for this paper
The women who have collaborated in the stories
All others who have contributed information and advice in the analysis and writing of this paper.
Introduction
Violence against women is a significant issue in BC and Canada with estimates of one in every four women suffering abuse by their intimate partner in their lifetime, to one in eight women physically abused at least once during their relationship , . The consequences on the physical end mental health of those women and the children in those relationships are drastic, including higher rates of depression and anxious disorders, significant injuries and deaths. The impact on society is also considerable. A Canadian study has estimated that more then 1.5 billion dollars per year are spent nationally in health costs related to violence against women, and if other costs are included (social services, education, criminal justice, labour and employment) the total rises to 4.2 billion per year.
Violence not only affects the health of women and children, it affects the ability of women to seek employment and to control household finances in a beneficial way for themselves and their dependants , , . Access to financial resources is often a determining factor in leaving violent relationships18, , , ,30.
Considering the prevalence of violence against women on welfare; the consequences of that violence on health; the cost to society and the importance of access to financial resources to leave those violent relationships, the BC Employment and Assistance Program (EAP) should attempt to mitigate those factors. We will present some issues related to the BC Employment and Assistance Program and evidence that some policies, notably the issuing of one cheque per family unit, have resulted in barriers for women to break free of those abusive relationships. One issue particularly at stake is the definition of what constitutes a family unit. At the time of the two cases presented, it was commonly understood by welfare recipients and EAP workers that if two people lived together for more then one month, they were considered a family unit and only one cheque was issued for that household . Two case studies will be reviewed, based on examples drawn from clinical practice, to illustrate the difficulties face d by women affected by this policy. This will be followed by an overview of the current MHR policies and a review of the evidence on: (1) violence against women on welfare, and the negative medical, social and financial consequences of this abuse; (2) the association between violence against women and personal finances. Finally the implications of this for the “one cheque per family” policy will be discussed, as well as some policy options.
This is done in order to propose constructive solutions that can benefit the health of women victims of violence and their children and improve their ability to be part of the active work force. These solutions should also aid in reducing the financial burden borne by the government due to violence against women in British Columbia.
Case study 1: Jody
Jody has been in a common-law relationship for 7 years, and there is a long history of physical abuse by her partner. They both live on social assistance in BC. A single cheque is issued under the name of her partner, following the “one cheque per family” policy. To her physician, she complains of not receiving her fair share of the cheque. She reports that her partner keeps the money. This results in a lack of money to spend on food; her partner prefers to send her to the food bank rather then allowing her to spend money on food. He keeps the money for alcohol and recreational drug use. She wants to leave this relationship, recognizing as well that the physical and financial abuse are impeding her ability to participate in the methadone program.
She went to the local BC EAP Centre, where she was told she needed to re-apply to receive welfare on her own because her file was under her partner’s name. She was told it would be a long process, starting with waiting for 3 weeks to get an initial interview. She was not screened to see if she was fleeing an abusive relationship, and she did not volunteer this information. She was not provided any sources of information with the exception of how to do a job search. She chose to stay with her abusive partner, as she was unable to see how she could comply with all the EAP requirements.
Case study 2: Donna
Donna is pregnant, and lives with her husband and son on welfare. Her husband beats her, and she left him to go to a shelter. She went to a local BC EAP Centre where she was told she would need to re-apply for assistance as the file is under her husband’s name; it would take some time before she could get any money. She then mentioned she was fleeing an abusive relationship and could not wait, as she needed money soon for herself and her son. She was told she needed to show some proof of abuse, like a police report, which she did not have.
As she was already on welfare she complained, not understanding why it was so difficult to get some assistance on her own. She was assigned to another agent, who told her she would need original identification documents (ID) to re-start her file (e.g. a social insurance number). Donna did not have valid identification cards. The agent dealing with her case refused to consider the IDs in her file with her husband. She was referred to the Motor Vehicle Branch to start getting new IDs. When she phoned the Motor Vehicle Branch, she was told it would take 6 weeks to get the driver’s license. Donna was facing a situation where she had no financial resources, so she started prostituting to get money.
She complained again to the EAP, and they agreed to use the IDs in the old file with her husband in order to put her on hardship. She was told that she would need to reimburse the money that was given to her, and that she would need to attend a job-search training program. On hardship, she was receiving less money and fewer benefits than the regular assistance program, including the prenatal allowance. She was afraid that she was not eating enough to feed her unborn child. During this time, Donna was staying at a shelter in the Downtown Eastside, and she was raped. She became sick, and was hospitalized and lost her shelter place, because they could not keep it while she was hospitalized.
Due to these difficulties, she accepted the offer of her abusive partner to go back and live with him.
Ministry of Human Resources Policies
Status of the “one cheque per family” policy
At the time of initial application for assistance from the British Columbia Employment and Assistance program (BCEA), the Employment and Assistance Workers (EAW) assess whether applicants residing in the same dwelling should be treated as a “family unit”. A family unit is defined as comprised of either married persons or any persons living in a marriage-like or dependent relationship, with or without dependent children. There is no rigorous definition of what comprises a dependent relationship; it is based on the judgment of the EAW during the initial assessment whether or not significant sharing of expenses exists between persons. There is also no minimum duration of co-habitation required prior to being considered a family unit – if a dependent relationship exists at the time of initial assessment (regardless of duration) then a family unit is deemed to exist.
If two persons independently receiving assistance enter into a dependent relationship then they will be considered a family unit when the EAW becomes aware of this new living situation. They will then become ineligible for individual benefits. This is common practice in Canada, where an estimated 69% of women in a family receiving social assistance are indirect recipients; i.e. their partner is the direct recipient to whom the cheque is issued.
In Ontario, a similar rule has been considered discriminatory regarding sex and marital status, under the provision of chapter 15 of the Charter of Rights. The court judgment recognized that other kinds of legitimate relationships exist that are not spousal, such as with men who are roommates or boyfriends, where there is likely no accompanying commitment to assume financial responsibility of the woman and her dependents. The policy was recognized as a:
“…historical disadvantage and continuing prejudice against social assistance recipients, particularly sole-support mothers…The definition of spouse at issue in this appeal perpetuates this historical disadvantage. It creates financial stress from the beginning of the relationship. It reinforces the stereotypical assumption that a woman will be supported by the man with whom she cohabits and will have access to his resources. And it devalues women’s desire for financial independence.”12
It is important to note that the two cases presented in this paper were happening at a time when MHR policies were changing. The Employment and Assistance Act had been created in April 2002, and accompanying regulations were finalized in the fall of that same year (September 2002) – including policies related to women in abusive relationships. Consequently training of the Employment and Assistance Workers (EAW) and revision of policies regarding these changes occurred at the time of the experiences described in the original report, or afterwards. Relevant policies were still being revised and educational efforts aimed at the EAWs about these policies were on-going in February, 2004.
Current BCEA measures in place for women in abusive relationships
EAWs are not trained to screen women for abuse, and instead all current BCEA policies for women in abusive relationships are triggered by female clients self-reporting abuse. At the time of disclosure, an Emergency Needs Assessment is conducted.
If the BCEA policy is applied as intended, the three-week job search requirement does not apply to a woman who is a ministry client staying in a transition house. The joint file is split and a new file is automatically created for the woman as quickly as possible. She will also receive a “comfort allowance” while in the transition house. The same procedures apply for women who are ministry clients not staying in a transition house.
The process differs for women who are not already ministry clients (i.e. who are applying for assistance). If the woman is either staying in a shelter or staying with friends or family then the need for waiving the three-week job search will depend on financial need and will be assessed during the Emergency Needs Assessment. For example, in theory, if a woman fleeing abuse requires funds for rent immediately, the woman will be granted an eligibility interview as soon as possible (usually the same day). Women fleeing abusive relationships may be eligible for “hardship” assistance if they are not eligible for regular assistance (this exists for persons in emergency situations who are not already recipients of BCEA or not eligible for regular income assistance).
Review of the evidence from the literature
1. Violence against women is prevalent among women on welfare.
Violence against women is a significant health issue for all women of BC. The BC Institute Against Family Violence reports that one in every four women in BC has been abused by their intimate partners in their lifetime. It has also been reported that one in eight Canadian women is assaulted by her male partner at least once during their relationship. Similar results have also been reported in the United States, where studies show that between 9% and 14% of women are attacked by their present or former partners each year, with lifetime prevalence between 18% and 36%.14,
Few data are available about the prevalence of violence against women on welfare in Canada. Data from the US shows that about 20% of the women on welfare are physically abused by their partner each year, and about 60% report having been abused as an adult. , , , , The definition of physical abuse used was the legal definition used in the US: “hit, slapped, kicked, thrown, shoved, hurt badly enough to go to see a doctor, use [of a] weapon in a frightening way, forced sexual activity, or “made you think you might be hurt.”” Other US studies estimate that more then 50% of homeless families became so because the mother was fleeing domestic violence. In Canada, a large proportion of homeless women are past and current victims of violence, and this violence is frequently a precursor of homelessness.
2. Violence has a significant impact on the health of women.
The physical and mental health of women experiencing violence from an intimate partner is significantly affected by the abuse. Abused women are significantly more likely to experience depression and anxiety , panic-related somatic symptoms, musculo-skeletal disorders and chronic pain, genitourinary disorders and respiratory illness. Post traumatic stress disorder (PTSD) is also extremely prevalent among women victims of abuse. For example, PTSD was identified in 45% to 85% of women seeking refuge from abuse at women’s shelters. Women who experience violence are also more likely to misuse drugs and attempt suicide.25
Pregnant women are particularly vulnerable. A study done in Saskatoon found that 5.7% of the women receiving prenatal care at a community health centre reported having experienced abuse during pregnancy, and that pregnant women who were aboriginal or had a partner abusing alcohol were more likely to be abused . Similar findings have been reported elsewhere. The impact of that violence is considerable on both the woman abused and her fetus. It increases the risk of miscarriage, abruptio placenta, preterm labour and delivery, fetal fracture and low birth weight. It also has adverse consequences for the woman abused, including uterine rupture, liver or spleen hemorrhage and pelvic fractures.26
The impact on society is also considerable. A Canadian study has estimated that more than 1.5 billion dollars per year are spent nationally on health costs related to violence against women, and if other costs are included (social services, education, criminal justice, labour and employment) the total rises to 4.2 billion per year. In the US, domestic violence is the second leading cause of injury for all US women and is the leading cause of injury for women 15 to 44 years old. Of women seeking medical assistance at emergency departments, 22% to 35% are there because of domestic abuse; however, in only 5% of these women is the abuse correctly identified. Finally, the World Health Organization reports that rape and domestic violence is responsible globally for 5% to 16% of healthy years of life lost by women of reproductive age.
3. Children in families are also significantly affected by violence against women.
The BC Institute Against Family Violence reports that children are abused in up to 70% of families in which abuse of women occurs. But even when children are not physically abused, they are likely affected by the situation. They are more likely to have problems including difficulties in school, being aggressive, and using drugs and/or alcohol.31
The effects also persist into adulthood, since witnessing parental violence increases the chance that a child will become a perpetrator or victim of abuse.23 One study reported that 80% of men who batter and 67% of women who are battered come from families where there was wife assault or child abuse.14 Women who were abused as children are significantly more likely than other women to suffer intimate partner violence (66% versus 28%).23
4. Financial issues are a significant contributor to violence against women in abusive relationships.
Physical abuse is only one part of the phenomenon of battering:
“Battering generally consist of men’s continuous use of physical, and often sexual, assaults along with verbally and emotionally abusive behaviors that may become more severe and damaging over time. In addition to assaulting their partners, batterers also threaten, intimidate and humiliate them; isolate them from family and friends; restrict their access to money and other resources; threaten the safety of children and other in their families; and control their activities outside the home.”33 (emphasis added)
Violence against women is related in many ways to personal finances. As the quote above illustrates, the restriction of money and access to resources by batterers is common. “Economic abuse is one way that batterers control and intimidate their partners, [and] survivors seldom have access to finances”. There is strong evidence recognizing the importance of financial assistance and financial independence in leaving abusive relationships.18, , , It is also recognized that “economic independence is the single most important variable determining whether women enter and leave abusive relationships” . The WHO has reported that asking a man about money is a trigger for violence against women in industrialized countries, and that low income is a risk factor for abuse.30 Consequently, access to financial resources for women victims of violence is an important way to prevent further violence and its consequences.
Employment is one way for a woman to have financial independence; however, this is not an easy task for a woman in an abusive relationship. The US literature shows that abusers will sabotage a woman’s efforts to find a job by inflicting visible injuries, creating conflicts, hiding or destroying personal items, disturbing her transportation or child care arrangements, or harassment at work.19 For example, a review of new applicants for public assistance in four Colorado welfare offices in 1997 found that 44% of domestic violence victims reported their abusive partners had prevented them from working.19 In addition, physical abuse also decreases the ability to perform at work as it causes a decreased ability to focus, memory impairment, decreased self-esteem and impaired planning abilities, in addition to the other health effects listed above19.
5. Women in families spend money differently than men.
There is some evidence both from developed and developing countries , that women and men spend their money differently. The unitary approach to modeling household behaviours (i.e. assuming that money given to a household is equally distributed on the basis of needs) has been rejected by a substantial body of literature. , , ,
Differences in spending patterns have also been found in Canada, as seen in the 1992 Statistics Canada Family Expenditure Survey.42 An increase in a woman’s income was more likely to result in an increase in expenditures for household food, children’s clothing, and childcare, while an increase in a husband’s income was more likely to result in an increase in spending on transportation. There were no differences found for housing, recreation, tobacco and alcohol expenditures, or donations. Historically, policies in Canada have recognized these differences in spending patterns. For example, family allowances are given to mothers, with the idea that they are more likely than fathers to spend the income received on their children.39
6. Magnitude of the problem in British Columbia
Applying the prevalence figures cited above, we can arrive at an estimate of the number of women in abusive relationships affected by the “one cheque per family” policy in BC. According to current EAP caseload statistics, 8930 women on assistance live in couples or two-parent families. Applying the US estimate of 20% prevalence of violence against women on welfare, 1786 of these women are in a physically abusive relationship.
It is likely that the majority of these women in couples or two-parent families would be considered family units and issued one cheque. Nationally, 69% of such women are the indirect recipient of assistance (i.e. the cheque is issued in the partner’s name). This arrangement likely creates financial strain in the relationship that can promote further abuse, as described above. If we assume that all 1786 women on welfare in an abusive relationship are in family units issued a single cheque, then 1232 women are estimated to be in a situation under this policy that may increase the frequency or severity of abuse.
The BC Employment Assistance Programs, theory versus practice: an attempt to advocate for those women
Based on the evidence presented above, the implications of the “one cheque per family” policy for women victims of violence are particularly troubling. This triggered the author to try to advocate for those women. The advocacy work will be presented in this second part. First, the author used the phone inquiry service of the EAPs, to discuss the two case studies. The author was told that the women could have applied originally to be the recipient of the cheque, and that their situations were not sufficient reason to change the “one cheque per family” policy as there were existing measures in place for women in abusive relationships.
Then the author was referred to the manager of client calls. The manager of client calls mentioned the existence of an emergency assessment process and exemption for women fleeing abusive relationships and referred the author to the website. The author asked for a specific web address and was told it was on the EAP web page. However, on the web site of the EAP, there was no direct link referring to spousal violence or fleeing abusive relationships. It took about an hour to find the criteria for exemption in order to waive the job search program. It seemed that this task would also be difficult for women fleeing abusive relationships.
The manager of client calls was alerted to the fact that in those two case studies the women were not offered the emergency needs assessment or the job-search waiver. The manager indicated that it would depend on women identifying themselves as fleeing from abusive relationships to employees at the local employment centre. Also, the manager felt that most women in abusive relationships present to women’s shelters, where they are provided with all the information they need. (This is not the reality, as only 20% of abused women seek refuge in a shelter or transition house. Many battered women on welfare are afraid to use off-site domestic violence services or are prevented from using them by abusers.19)
The author decided to go in person to a local employment centre and ask about the assistance program for women fleeing abusive relationships. The employee of the local EAP was not aware of the possibility of waiving the job-search period and offering emergency assessment. The employee was also not aware that the website states that the local employment and assistance centre will include with the application package information on how to find local community resources for emergency needs. Finally, the employee was not aware of the hardship program that is available for women fleeing an abusive relationship.
The author also contacted the agent in charge of the file of one of the cases described earlier. This agent explained that there is an annual review for all couples to determine which partner receives the cheque. However, as will be presented below, very few women in abusive relationships will tell their agent about their situation.
Subsequent to the above investigation and interventions, a presentation was made at resident research day at UBC in the fall of 2003, summarizing both the literature review and the two cases. The Deputy Provincial Health Officer was present at this presentation, and questioned whether a recommendation should be made by the Provincial Health Officer on this issue to the Ministry of Human Resources (MHR). This is in keeping with the mandate of the Provincial Health Officer to make recommendations to other government agencies on issues of public health importance.
Reports to the Deputy Provincial Health Officer
The Deputy Provincial Health Officer commanded an analysis of this issue first by requesting a report from Dr. Ouellette . The key issues identified are listed below:
Identification of women in abusive relationships: There is currently no strategy among welfare workers in BC to identify women in abusive relationships; instead, these women must self-identify in order to receive assistance and access to appropriate social services. This is a significant barrier, as “recent research and monitoring have shown that the majority of battered women on welfare do not tell their welfare workers about the violence”.19 In the United States, it has been reported that welfare workers were not aware of the vast majority of women on their case loads who were leaving or fleeing abusive relationships.18, , Consequently, 41 states have started screening programs for abusive women.19 However, even these screening programs do not necessarily identify the majority of women in abusive relationships; they fear their partner will find out, or they will lose custody of their children, and also because welfare workers do not always fulfill their screening role (e.g. distributing the information brochure).19 This is regrettable considering the need for assistance and the fact that disclosure, especially for particularly severe trauma, tends to have a beneficial effect physically and psychologically. Shared information between partners: It is questionable whether having one file for both partners is conducive to reporting abuse. Women may be afraid that their abuser will discover that they have mentioned the abuse or are considering fleeing the relationship. The practice of requiring partners present together for the “intake” appointment may also make it difficult for women to request direct assistance or disclose abuse. These procedures do not allow much confidentiality. Requirements for proof of abuse: The author confirmed that women fleeing abusive relationships are asked to provide proof of abuse, for fear that women will inappropriately use this reason to obtain more assistance. However, it was not well explained what would be acceptable as proof; a note from a physician or a court order was acceptable, but not the testimony of a family member or a friend. No information was available about this issue in the policy manual or on the program website, and it is not clear whether other information could be accepted, such as physical evidence of violence. Difficult interactions with EAP employees: Difficulties in the interaction of women on welfare with welfare agents have been explored in the US, where women describe welfare workers as overworked and incapable of sensitively responding to their needs. In turn, welfare workers have expressed difficulties understanding and helping clients who demonstrate patterns of relying on welfare while cycling between leaving and returning to their abusive partners.18 However, studies show that leaving an abusive relationship is a difficult process and multiple factors contribute to women returning to these relationships. The decision to leave an abusive relationship is not always easy, and women face the risk of increased violence, stalking and harassment, as well as threats to their children. Awareness of policies: Another problem is that information about assistance while fleeing an abusive relationship is hard to find. The information is scattered throughout different sections of the welfare manual, policies, fact sheets, etc. It is difficult for women to find out about their rights, both in the application package for social assistance, and on the ministry web page. This finding has been shown elsewhere: women have difficulties receiving information and are receiving wrong information. In addition, as is apparent from the examples above, employees within the EAP are not always fully aware of these policies. Women as direct recipient of assistance: Even though an option exists for women to ask to receive their own cheque, it is unlikely that this option will be used both because of the control exercised by the abuser and the legitimate fear of further abuse if women ask for a separate source of money. Several studies have shown increases in violence when women engage in activities potentially providing them with more independence.16, 19,20
On the basis of this report it is clear that this policy should be changed. Some options include:
The main option to be considered from this report is that separate cheques should be issued to both partners on welfare in households. This appears to be the best solution; the alternative of making women by default the direct recipient of assistance in a household may create financial strain and thereby trigger abuse by the male partner and is not appropriate. This will give more financial independence to women, and both reduce the financial stresses that trigger abuse and reduce the current barriers to leaving an abusive relationship. This policy change will also have other positive impacts. For example, it is likely to also improve the pattern of spending in households on welfare such that more of the basics needs for women and children are met. The EAP should have educational in-services on this issue for its employees. Employees should be educated about the prevalence of abusive relationships among their clients. This education should also cover the adverse health and social effects of violence against women, factors triggering abuse, barriers to fleeing abusive relationships, and that women may cycle in and out of an abusive relationship before ultimately leaving. Information should be provided for the employees to use as a resource, including details on local agencies and shelters that are available to women victims of violence. As demonstrated above, the majority of women clients will not voluntarily disclose about their abusive relationships. Interactions with employees provide an ideal opportunity to engage these women and screen for abuse. The Employee and Assistance Program should consider adopting a policy for screening female clients for the possibility of abuse, as has been done elsewhere. Employees would need to be comfortable asking about and supporting women reporting abusive relationships, as this disclosure is likely to be stressful and emotional for such women. If employees are not comfortable in this role, or if adequate local resources are not in place to support women after disclosure, it would be preferable for the EAP to have information on local resources available for women to take and read independently (i.e. passive screening). Given the considerable difficulty in locating information about the policies of the EAPs pertinent to women victims of violence, it would be beneficial for the Ministry of Human Resources to alter its website to include a section specifically dealing with assistance for women in abusive relationships. This section should include information regarding the exemption for job searching for women fleeing abusive relationships, and the eligibility for hardship pay when fleeing an abusive relationship in which the woman is not the direct recipient of assistance. Requiring women to present proof of abuse is problematic. Many women will not have proof, and obtaining proof will require time in which a woman may be exposed to further abuse. The Ministry of Human Resources needs to clarify what proof is acceptable, and create a mechanism by which women who need to obtain proof can be assisted in the interim. Ideally, the Ministry would adopt a policy of not requiring additional proof of abuse other than a woman’s testimony.
This policy change would also be in keeping with the recent Ministry of Human Resources program to support women fleeing abusive relationships - the Bridging Employment Program, which supports community programs that provide pre-employment counselling and life-skills support for women victims of violence. Changing the “one cheque per family” policy would be an appropriate complement to this program and would help women to start their journey out of an abusive relationship towards meaningful employment and independence.
The information in this report on the “one cheque per family” policy was based on discussions with local EAP employees, telephone inquiries, and the policy section of the EAP webpage. These discussions took place in 2002 and may not accurately reflect 2004 policies and programs. In follow-up to this report, it is recommended that the next step towards action on this issue is to discuss existing policies with representatives of the Ministry of Human Resources in order to knowledgeably advocate for policy change.
Therefore this report was followed by a request, from the Deputy Minister of Health to Dr. Gilbert, to investigate further the issue through discussions with staff at the Ministry of Health Planning, the Ministry of Community, Aboriginal and Women’s Services, the Ministry of Human Resources, and community transition house staff. The results of the analysis were also discussed with Dr. Ouellette, the author of the original report. The discussion relevant to each of the key issues and options identified in the original report were summarized in a second report , which can be made available to any interested party. This analysis served as the basis for recommendations by the Provincial Health Officer to the Ministry of Human Resources on this issue. Three main recommendations were made in a letter from the Deputy Provincial Health Officer to M. Robin Ciceri, Deputy Minister, Ministry of Human Resources, on March 26, 2004 :
That the accessibility of information regarding current BCEA policies from the Ministry of Human Resources and local community resources for women fleeing abusive relationships be increased.
That there be increased education of all BCEA workers regarding the nature and consequences of abusive relationships and training and education to prepare workers to deal with female clients who disclose abuse.
That the Ministry of Human Resources ensure that their employees have up-to-date knowledge and understanding of recent changes to BCEA policies pertinent to women in abusive relationships, and are applying these new policies consistently.
Conclusion
The report prepared by Dr. Ouellette on the “one cheque per family” policy has succeeded in its objective of raising awareness of this issue among relevant government agencies, and it appears that it has stimulated discussion of existing policies among MHR staff. Certainly there is no debate that the issuing of a single cheque to a family where a woman is in an abusive relationship can be problematic, and all efforts should be made to facilitate the means by which such women flee abusive relationships.
The results of this preliminary analysis suggest that the emphasis needs to be on facilitating a woman’s fleeing from an abusive relationship. As BCEA currently and likely will continue to require a woman to self-identify as being in an abusive relationship, the emphasis should be on increasing accessibility of BCEA policies and community resources through an increased availability of print and electronic media. Also, the education of EAWs regarding the effects of violence against women and the nature of abusive relationships appears to be warranted throughout the province.
It is crucial to recognize that this preliminary analysis suggests the need for further study of the issue in British Columbia and Canada and could lead to new interventions and approaches to violence against women that are requested by the World Health Organization. There is a lack of study on the prevalence in Canada of violence against women on welfare and the burden of diseases consequently sustained by them and their dependents.
Also, the definition of a “family unit” identified in this analysis raises some concern. A dependent relationship is not rigorously defined and includes relationships of short duration. This definition does include marriage-type relationships; however, it would also terminate the direct assistance to women not in a marriage-like relationship, but nonetheless sharing shelter and some expenses. A similar policy was judged discriminatory against women in Ontario (see original report), and is said “…to create financial stress from the beginning of the relationship.” This is relevant for women victims of violence, as access to financial resources has been shown to be one of the most important determinants for fleeing abusive relationships. The definition of a “family unit” is worthy of future policy analysis.
The original report triggering this analysis outlined many concerns about the incorrect application of policies by EAWs in ways that were detrimental to women victims of violence. A lack of understanding and knowledge of these policies appeared to be an important factor. Since the time of this report, new policies have been written and education of EAWs about these policies has been conducted. Unfortunately, due to time constraints this analysis was not able to independently re-examine how current policies are applied by EAWs. Any future analysis should consider re-visiting the current experiences of women in abusive relationships who are clients of the BCEA, and assessing the knowledge and understanding of EAWs of the relevant policies.
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