Are Domestic Violence Homicides Preventable?

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Early one morning in 2006, Steven Van Keuren broke into the suburban home of his former girlfriend Teri Lee, in Minnesota's Washington County. He shot and killed Lee, a widowed mother of four, and her then-boyfriend, Tim Hawkinson.

Van Keuren was duly punished. He's serving two consecutive life sentences for the double homicide—but the case continued to gnaw at local authorities.

“(It) got Washington County thinking about how we can do things differently,” Sgt. Randy McAlister of the Cottage Grove, Minn. Police Department, who was one of the first officers at the shooting scene, said in a talk broadcast on Minnesota government-access TV this month.

One of the key questions: was it possible to proactively identify those most at risk of being killed by an intimate partner?

The county's response came four years later: in 2010, authorities introduced a domestic violence intervention tool, known as the Lethality Assessment Program (LAP), which involves a structured 11-question interview of domestic violence complainants at the scene of the assault.

The questions are designed to elicit crucial information about the abusive partner, including previous incidents of violence.

According to McAlister, LAP represented a major improvement in guiding law enforcement's ability to detect the potential for domestic abuse or stalking behaviors to escalate into lethal violence.

“We're much more aggressive with these things, (in part) because of the LAP program,” said the officer, who now is part of a team training other officers in the region in the use of the tool.

Similar assessment programs are now in use elsewhere in the country, with efforts to spread the LAP bolstered by federal dollars.

Supporters call these assessments critical preventive tools in addressing intimate partner violence, which results in nearly one out of every seven murders nationally according to the Bureau of Justice Statistics.

Skeptics, however, question whether the science exists to back up claims that such intervention efforts can catch many of these cases before they end in death. They also warn that, even as the LAP is rapidly growing in popularity among police and domestic violence victim advocates, some women could be harmed.

Based on the interview, if police identify victims as being at increased risk for homicide, an officer makes an an immediate phone call to a trained counselor able to discuss safety concerns with the victim.

Would such a program have saved Lee's life? The answer remains uncertain, but McAlister argues that the system in place at the time “failed” Teri Lee.

Van Keuren had no criminal record two months before the September, 2006 shootings. But there were already telltale signs of menacing behavior that authorities had ignored, McAlister said.

In May, “he shows up at her kids' school, they get in an argument and she ends up slamming his hand in her car door because he won't leave her be,” McAlister said. That same month, a hockey net went missing from Lee's driveway. On the morning of July 29, beer cans show up in Lee's mailbox, “part of the pattern that had been going on,” McAlister said.

Later that same day, Van Keuren's behavior escalated, according to police. Armed with knives, he broke into Lee's home and lunged at her.

Yet, although Lee testified at a subsequent court hearing that she did not feel safe, Van Keuren was allowed to go free on $75,000 bail.

The introduction of LAP has become part of a more pro-active program of intervention with domestic abuse victims, said McAlister.

Now, he says, “we're watching these people from the moment they're arrested through the trial process.” Moreover, probation officers armed with results of the lethality evaluation can inform a judge when there is an increased risk that a domestic abuser will commit lethal violence, with the information a factor in setting conditions for release from jail when charges are pending. .

According to Tom Adkins, director of Washington County's community corrections, the tool is only one element of a wide-ranging strategy to revamp authorities' response to domestic violence.

“It's not about the questions,” Adkins said in an interview with The Crime Report. “It's about how you coordinate and respond to people you identify as high risk.”

Even so, the concept behind the tool itself remains suspect for some researchers.

“You're looking at an increased sense that we can predict outcomes in domestic violence cases, which, to be blunt, I'm not sure that we can,” said Neil Websdale, director of the National Domestic Violence Fatality Review Initiative.

Introduced in Maryland

The assessment tool used by police In Washington County was first developed in Maryland a decade ago, in part to address the reluctance of some victims to reach out to those who could shelter them from further abuse.

Police officers in Maryland frequently gave abusers the phone numbers of advocacy organizations that could provide an emergency refuge, help victims plan for their own safety at home or develop a plan to leave an abusive partner. The organizations also often provide assistance in navigating the legal system.

But authorities “were concerned that a lot of women were not following up on that,” said Jacquelyn Campbell, a pioneer in domestic violence assessments, and a professor at the Johns Hopkins University School of Nursing.

Campbell helped develop the LAP as a more user-friendly version of a tool she created in the 1980s, known as the Danger Assessment. Still in wide use, the 20-question assessment is designed to document how often physical abuse takes place and its severity. The assessment also features a weighted scoring system and was originally designed to be used by health care professionals.

The new tool was established to make it easier for police and groups working with domestic violence victims to coordinate their efforts.

Some of the 11 assessment questions seem obvious; others less so:

• “Has he/she ever used a weapon against you or threated you with a weapon?”

• “Has he/she threatened to kill you or your children?””

• “Do you think he/she might try to kill you?”

• “Does he/she have a gun or can he/she get one easily?”

• “Has he/she ever tried to choke you?”

• “Is he/she violently or constantly jealous or does he/she control most of your daily activities?”

• “Have you left him/her or separated after living together or being married?”

• “Is he/she unemployed?”

• “Has he/she ever tried to kill himself/herself?”

• “Do you have a child that he/she knows is not his/hers?”

• “Does he/she follow or spy on you or leave threatening messages?”

The questions relate to results from published research.

For example, a 2008 study—building on earlier research — found that homicide victims were more likely to have experienced non-fatal strangulation than even other abused women. The study found non-fatal strangulation in 43 percent of homicides and 45 percent of attempted homicides, compared to only 10 percent of the time in a control group of abused women.

Campbell was involved with the research, but other researchers have reported a similar finding.

In a 2003 study with Campbell as the lead author, a statistical analysis of women killed by an intimate partner listed unemployment as “the most important demographic risk factor” compared to characteristics like age and education level.

“I would say, because of a lot of the research that's been done, we can better identify at least the majority of cases that are at high risk for re-assault, being hit again and for near fatal or actually fatal events,” Campbell said.

The Maryland lethality assessment, she added, “was never intended to accurately predict who's going to get killed or not, but rather that we can identify cases that are at high risk for either lethal or near-lethal violence.”

Statewide, about 55 percent of victims taking the screening score as high risk.

Websdale, of the national domestic violence fatality initiative, said assessment tools have value.

“To be fair, there is something in these risk assessments that may educate victims of violence, domestic violence and help them make more informed decisions,” he said.

His experience with fatality reviews examining domestic violence cases, however, leaves him skeptical about using patterns, even if they exist, to create a statistical model predicting risk of death.

When reviewing a murder, “we have all the case materials, we have access to surviving family members, often, and we really dig into the case in great depth,” Websdale said. “And these cases are really very, very complicated,” adding, “what the system knows about risk markers in those cases is often limited.”

Such reviews don't always lead to answers.

“I come across a lot of cases where there is no prior history of violence, where there are no risk markers, where he just kills ,” Websdale said.

Assessments focus too much on measuring the seriousness of previous violent episodes, according to another researcher, Evan Stark, author of a book about domestic violence called Coercive Control: How Men Entrap Women in Personal Life.

Instead, controlling behaviors and assaults not causing physical harm should be viewed as greater warning signs for future serious violence, Stark said, even pointing to research done by Campbell showing such incidents can be a risk factor leading to homicide.

“Those episodes are significant not because of their severity, which is what the Maryland scale measures to a large extent, but because of their frequency and their duration, and because they have a cumulative effect on the victim,” Stark said.

To Campbell, it's a given that the LAP will miss a few cases that do end tragically. However, it's built on multiple research studies done at many sites, she said. Much of this research has involved interviews with relatives of homicide victims.

“We do know more than just saying, 'Who knows what's going to happen?'” she said.

'Narrow Windows'

If it needs a catchier name, call it the “narrow windows” theory of domestic violence.

“What we've learned is that when a police officer shows up at the scene, or a victim shows up in an emergency room, the time to talk with her is then and there,” said Vice President Joe Biden, speaking at a news conference last year.

Along with U.S. Attorney General Eric Holder, Biden was announcing federal funding for a new demonstration project aimed at reducing domestic violence homicides, with an emphasis on putting in place lethality assessments in more communities.

“What we've learned from the very beginning is there's a very narrow window for most women to have the courage and capacity to say what happened to them,” Biden said.

Timing is a key concept of the lethality assessment program created in Maryland, where the news conference took place.

After asking the 11 yes/no assessment questions, officers following the protocol inform victims at the scene if their scores indicate a high-risk circumstance. Depending on the assessment, or perhaps just their own judgment, officers call a trained advocate and then hand the phone over to the victim, encouraging a conversation with the advocate to establish a safety plan.

Advocates emphasize the importance of such contacts for victims.

“The goal is to get them into services,” said Michaele Cohen, executive director of the Maryland Network Against Domestic Violence.

While it may seem like an uncontroversial statement, the protocol shouldn't effectively quash the right of women to make choices for themselves, said Margaret Johnson, an associate professor at the University of Baltimore School of Law and director of the school's Family Law Clinic.

“Women are actually predicting their risk all the time,” continued Johnson, who is also one of three co-directors of the law school's Center on Applied Feminism.

But Johnson isn't sure if everyone involved with lethality assessment protocols completely grasps this basic premise.

While about nine percent of domestic violence victims in Maryland say no to the screening, Johnson is concerned that victims could feel pushed into taking action. She noted that police at the scene represent a “powerful authority” speaking with victims who have likely experienced “some pretty significant trauma.”

It's easy for time-pressed police to forego any discussion of pros and cons, Johnson observed.

Stark expressed concern about how police might react when a victim declines to speak to an advocate.

“The next time, I'm going to be more reluctant to respond appropriately,” said Stark, describing his worry of how police might perceive such victims.

Johnson, in her academic writing on the topic, emphasizes a concern about liberty. Websdale talked about the uncertainty involved with picking safe choices.

“And that's hard to deal with, if you're trying to reassure a woman at the scene that we know best and we're going to recommend that we call the advocate, because I'm not sure we do know best always.

“I'm not sure we can guarantee that calling an advocate results in a safer outcome.

“It may; it may not.”

Although the Maryland protocol is considered the most popular domestic violence assessment, at least in this country, police agencies elsewhere sometimes establish their own domestic violence risk assessments and protocols. Different tools for instance are in use in Canada and the United Kingdom.

In Tulsa OK, an eight-question assessment adopted last year doesn't involve police making a phone call to domestic violence services.

“We always allow the victim to make that phone call for themselves,” said Tulsa Police Sgt. Stephanie Jackson, supervisor of the department's family violence unit.

The department's decision isn't in agreement with the local provider of domestic violence services.

“I feel that an important piece of the protocol in Maryland is having the officer actually call the help line during the visit to the home,” said Tracey Lyall, executive director of Tulsa-based Domestic Violence Intervention Services.

She cited an oft-repeated statistic, which just happens to be incorrect: “We know that nationwide, only 4 percent of domestic violence homicide victims ever availed themselves of domestic violence services,” Lyall said.

McAlister, in his talk, shared the same finding. The Maryland network recently stated the same finding on its website.

But the actual study — published in 2001 — only looked at a time period of one year prior to a victim's death at the hands of an intimate partner.

More recently, a report by Georgia domestic violence program officials published last year found that 16 percent of domestic violence homicide victims in the state had contact with domestic violence programs or safe houses within five years of their deaths.

Biden, at the Maryland news conference, made it clear how he viewed the demonstration project effort.

“This whole idea is to identify women who are most at risk and, hands on, get her to a better place, get her to a different place. Let me make it clear: we believe that this will save lives,” Biden said.

“It already has.”

Declining 'Precipitously'

There's another frequently cited statistic that's true, as far as it goes.

The Maryland website has noted a 34 percent decrease statewide in intimate partner homicides from July 2007 to June 2012. As McAlister put it in his talk, the rate has dropped off “precipitously.”.

But a similar percentage decrease can be found from July 2002 to June 2006—before the lethality assessment protocol was in wide use—when all domestic violence deaths (including suicides) decreased by 42 percent.

Maryland domestic violence deaths fell from 89 in fiscal year 2003 to 52 in fiscal year 2007. Such deaths then spiked to 75 the next year (a number recently revised to 73). In the 12-month period ending in June 2012, the state tallied 49 deaths resulting from intimate-partner related violence.

With data just in, the number stayed about the same, with 50 deaths from July 2012 to June 2013.

Only beginning in fiscal year 2008 did the Maryland network tally homicides separately from suicides.

“I think we've seen a drop. We don't say it's caused by the LAP,” Cohen said.

In the year ending June 2013, suicide accounted for one out of every six deaths. Excluding suicides, the number of intimate partner homicide victims has now increased the last two years in Maryland.

Stated another way, from July 2007 to June 2013, there has been a 25 percent decrease in intimate partner homicides.

Cohen expressed doubt on the accuracy of numbers from earlier years. The Maryland network now has better contacts and more resources to do a more accurate count of intimate partner fatalities, she said.

Even so, “these cases are not always clear cut,” Cohen said.

Relationships can sometimes be tough to decipher. The network relies on police sources for information about cases.

“Sometimes it's hard to know who to include and who not to include,” Cohen said.

Many states, but not all, have domestic violence fatality review teams. Websdale leads a group offering support for such initiatives.

The Bureau of Justice Statistics, part of the federal Department of Justice, in 2009 published estimates on intimate partner homicides. In 2007, an estimated 2,340 deaths were tallied.

Out of all homicides, intimate partners were responsible for about 14 percent of all deaths.

The report also examined trends in homicide from 1993 to 2007, concluding that intimate partner homicides decreased by 29 percent during that time period.

“Female victims killed by an intimate partner declined from 2,200 to 1,640 victims, and male intimate partner homicide victims declined from 1,100 to 700 victims,” the report states. For the same years, all homicides decreased by 31 percent.

Growing Interest

Nevertheless, interest continues to build in lethality assessments.

In Pennsylvania, pressure from local domestic violence advocacy programs has already persuaded 54 police agencies to use the protocol, said Jill Swiontek, staff attorney at the Pennsylvania Coalition Against Domestic Violence.

“Our goal is statewide implementation,” said Swiontek.

The Maryland network last year began working under a new three-year federal grant to train 40 jurisdictions who apply to learn the protocol. Federal authorities confirmed the grant amount is $651,191.

Separately, the demonstration project has awarded about $1 million in funding to go to the Maryland network. Sen. Barbara Mikulski, a Maryland Democrat who has called the LAP “a model for the nation,” praised the financial commitment to the demonstration project.

“This funding will take the Maryland Network Against Domestic Violence’s work on lethality assessment nationwide to turn victims into survivors,” Mikulski said in a prepared statement announcing the grantin March.

This year, the funding for training related to lethality assessments was included in a $417 million appropriations bill on domestic violence intervention.

In Seattle, police have developed their own assessment tool. Websdale said Phoenix also has developed its own assessment.

But the Maryland protocol seems to be getting the most attention.

According to Dave Sargent, senior program manager with the Maryland Network Against Domestic Violence, the protocol is in place with agencies in 32 states [including Maryland], and he estimates that it has spread to more than 500 law enforcement agencies outside of Maryland.

That number remains a tiny fraction of the roughly 18,000 law enforcement agencies nationwide, but major cities taking up the Maryland lethality assessments include Kansas City, MO; Dallas and Las Vegas, he said.

Sargent credits a 2007 Washington Post article with generating more widespread interest in the state's LAP tool.

“We've certainly got a lot of publicity about the program. A number of publications have written about it, so people see that,” said Cohen of the Maryland network.

She also credited the organization's work with domestic violence victim advocacy groups as part of the reason for the intervention's growing popularity. She didn't mention it, but presentations have been given at national conferences devoted to law enforcement or domestic violence advocacy.

“There's been a lot of buzz in the law enforcement community,” Cohen added.

NIJ Research

Recent research sponsored by the National Institute of Justice has focused on the Maryland protocol, examining how violence might be reduced by the tool used on an experimental basis by eight police agencies in Oklahoma.

“The study design was quasi-experimental, and that in research is the gold standard,” said Janet Sullivan-Wilson, the Oklahoma principal investigator on the research team, which also includes Campbell.

“Most professions, including law enforcement, want evidence-based practices, and, in order to do that, you have to test them with a comparison or a control group.”

While data has been gathered, no homicide took place during the experiment period, according to Jill Messing, another researcher on the team and an assistant professor at Arizona State University's School of Social Work.

Researchers also followed up with victims months later to ask about any recurring violence and also whether they sought out or received domestic violence services. Wilson said a review of their findings by the National Institute of Justice is expected to be complete by April.

She would like to see more research done on how assessment protocols work with different cultural groups.

It's not necessarily wrong for police to use different protocols, she said.

“I think that there could be different ways, that there's maybe not just one way,” Wilson said. “And if their programs and assessments work, that's great. But they all need to be tested.”

For the many police agencies already using the Maryland protocol, the enthusiasm seems strong.

“We really get sick of going back to the same locations time after time and dealing with the same problems,” said McAlister. “That's part of what we do, but we get sick of it. We find we go back to the same locations a lot fewer times now with this program because we're really proactively dealing with it at the front end.”

Stark has concerns about the emphasis on homicides, however, and having responses “based on an outcome which is so rare in domestic violence cases.” For instance, more common negative outcomes like a victim's feelings of being trapped in a controlling relationship may not get addressed by such a focused approach, he said. How should police departments view the assessments?

“I think they need to look at whether or not the main problem that they need to address in their department is the number of homicides and severe domestic violence cases, or is it the sheer volume of cases that they're experiencing in domestic violence calls?” said Stark.

That doesn't mean there's no value to some parts of the assessment protocol, he said.

“I do think it probably focuses police departments more seriously on domestic violence cases because at least it alerts them to the presence of a number of behaviors which they might not have previously identified,” Stark said.

Johnson, the feminist scholar, expressed concern about the consequences of the approximately 45 percent of victims not given a high-risk label.

“I worry about all the other people who are subjected to abuse, whether or not they're going to be shut out of resources,” Johnson said.

The tool can influence bail amounts in McAlister's home base of Washington County, for example, as well as conditions for release such as a requirement to remove guns from a home or even have an offender be monitored by GPS technology.

Nevertheless, Adkins, the corrections official, said such monitoring in Washington County isn't yet capable of warning victims that a suspect is nearby.

The use of the tool in the court system will vary, but Johnson said the concern is whether or not these assessment tools are being presented transparently to victims.

She added that she knows of one Maryland judge who uses it as a factor in child custody cases, for example. Many questions remain about the lethality assessment, Johnson said, “yet all these courses of action are going to take place in response to it.”

And “if the tool has not been validated, we're pushing our money and resources into an area we don't yet know is going to be effective,” she said.

Barbara Paradiso, director for the University of Colorado at Denver's Center on Domestic Violence, said some evidence suggests emotional abuse “is much more damaging in the long run” than physical abuse.

Nevertheless, assessments like the LAP offer “a place to start,” she said.

“We feel more in control about creating a solution that we have some faith that will work. It doesn't necessarily work—at least in all cases—but at least it helps us feel we're doing the most we possibly can.”

Jaime Adame is has written about crime and justice for 15 years, most recently for Oklahoma Watch and the now-deceased Urban Tulsa Weekly. He welcomes comments from readers.

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