Date of Award

Fall 8-2020

Degree Name

Doctor of Philosophy (PhD)

Advisor(s)

GRETCHEN L. GEMEINHARDT

Second Advisor

SHERYL A. MCCURDY

Third Advisor

VANESSA R SCHICK

Abstract

Women with disabilities (WWD) are at pronounced risk of experiencing multiple forms of severe and prolonged violence, and they face barriers to accessing help. A multitude of factors associated with disability and rurality may compound the experience of violence, including geographic and social isolation, forcing WWD in rural settings to navigate extremely dangerous situations with limited avenues for accessing help and securing safety. This research explored how women with disabilities experiencing violence while living in rural communities navigate programs and policies, make decisions about seeking and securing help, and build resilience despite experiencing violence. The current study methodology empowers this marginalized population to use their own words to interpret their lived experiences and addresses an important gap in existing scholarship concerning the intersection of rurality, disability, and violence.

This examination used a qualitative data collection and analysis approach, with descriptive data to summarize the sample. Thirty-three rural women with diverse disabilities and experiences of violence completed one semi-structured in-depth interview. Interview transcripts were analyzed using thematic content analysis. Women described key personal qualities and supportive networks and services, which contributed to their resilience, despite their violence-related adversity. These findings inform interventions and promote approaches to build on women’s strengths and resourcefulness. WWD also described overarching health and mental health care provider and system factors that influenced their trust and confidence in these services to support their safety. Women described ways interactions with health care during their experience of violence were a missed opportunity for identifying and responding to their abuse and connecting them with resources. Women illuminated important gaps in services and emphasized a need for training and education about disability throughout the health care system and mental health workforce. To be effective providers for WWD, clinicians and counselors need to demonstrate cultural competencies related to disability and have awareness about the forms of abuse WWD experience. WWD are open to, and even welcome, clinician screening for abuse; however, it is crucial screenings preserve women’s privacy and, if not conducted at inperson appointments, are available through an accessible tool for women to disclose independently.

Finally, WWD described challenges accessing mental health care services that met their abuse-related needs. Women described overcoming their own stigma, learning about available services, finding an appropriate counselor fit, and struggling to secure resources to continue accessing mental health care. WWD identified opportunities for including individuals with disabilities more prominently in the mental health workforce. Finally, women discussed the necessity to ensure promising telemental health advancements are optimized for accessibility (using adaptive technology), to allow individuals with disabilities to have broader and more flexible access to mental health services.

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