Ontario’s Domestic Violence Death Review Committee (DVDRC), of which I am a member, has just released its 2022-2023 report. those not familiar with the mandate and scope of the DVDRC, you can find that information here.
This report contains the reviews of 28 cases that involved 43 deaths, including both homicides (14) and homicide-suicides (14). Cases are reviewed once all related investigations and legal proceedings have been completed. Each case is then analyzed by one committee member, who has access to relevant police, child protection, health and legal records. Our job in conducting this analysis is to identify risk factors, emerging themes and possible recommendations for system change. We then present our findings to the full committee for discussion and revision so our recommendations are as informed as possible.
Seven themes
In working towards this report, the committee established subcommittees to explore seven major themes that emerged across the cases we reviewed, which are reflected in the chapters of this report:
- Intimate partner homicide in aging populations
- Children in the aftermath of intimate partner homicide
- Intimate partner homicide and family law
- Intimate partner homicide by firearm
- Immigrant, refugee and precarious status populations experiencing intimate partner homicide
- Mental health and substance use: intersections with intimate partner homicide
- Intimate partner homicide in the 2SLGBTQQIA+ communities
Also for the first time, the DVDRC established an Indigenous subcommittee to “follow a more inclusive and culturally and trauma-informed review process that acknowledges the ongoing legacy of colonialism and the realities and resilience of Indigenous communities.”
Risk factors
A key element of our work is identifying risk factors in each case. Over the past 20+ years of the DVDRC’s work, the committee has developed a list of 41 risk factors that are common in many cases of intimate partner homicide. This list can be found in the current report at page 101. I think this is helpful for anyone –whether a professional, neighbour, friend, family member or work colleague – who has concerns about someone they know who may be at risk of lethal violence by their partner, so I encourage you to take a look at it.
In the cases reviewed for this report, the most commonly found risk factors were:
- A history of intimate partner violence (89% of cases)
- Victim vulnerability, which includes problems or life circumstances of the victim that may make it more difficult for them to reach out for help (82% of cases)
- Actual or pending separation, perpetrator unemployment, excessive use of alcohol or drugs by perpetrator (each of these was present in 61% of cases)
In 80% of the cases, seven or more risk factors were present. In other words, in very few cases were there no warning signs.
In the 28 cases reviewed for this report, 25 of those who caused the deaths were men. Twenty-three of the victims were women, two were men and four were children. In some cases, children were not killed but were in the home when their mother was killed.
Twenty-four victims died by asphyxia, 15 by trauma (cuts, stabs, assault, blunt force) and four by firearms. Twenty-six of the victim deaths occurred in their homes or on their property.
The recommendations
Across all the cases, the committee made 66 recommendations for changes that may, if implemented, help prevent future similar deaths. These recommendations are wide ranging and worthy of being read – you can find them beginning at page 121.
It’s a dangerous game to identify any as more important than others, but I am going to do so anyway. Consistently, since the DVDRC’s first report, the committee has made many, many recommendations about the need for training and education. This report is no different.
Once again, you will see recommendations for judicial education as well as training and professional development for lawyers, law students, social workers, psychologists, doctors, frontline workers and others.
There are also recommendations for public education. As I have written here before, gender-based violence is a society-wide problem that requires a society-wide response. One of the first steps to building that response has to be to ensure that all of us know what to look for and what to do when we are concerned that someone we know may be in an unsafe situation.
Sadly – actually, infuriatingly –the recommendations of this and all other DVDRC reports are not legally binding, and there is no obligation on those to whom they are directed to implement them. That said, those bodies that receive recommendations – often, but not only, government – are asked to report back to the DVDRC on the status of implementation within six months of receiving them.
You can obtain those responses by writing to: occ.deathreviewcommittees@ontario.ca . I encourage you to do so: we need to hold decision- and policy-makers accountable to us in ensuring that important recommendations are meaningfully implemented.
Being a member of the DVDRC is not an easy job. Reviewing deaths can be traumatizing and trying to think of recommendations that have not been made before is difficult. Sometimes we have to chase the files we need to be able to analyze our cases properly. We bring different and sometimes conflicting perspectives to our task.
I’ve thought about leaving the committee more than once. But, I’m sticking it out; at least until the end of my current term in March 2027. Sharing the hard work with dedicated fellow committee members – even when we disagree — as well as the Coroner’s Office staff that guide and support us makes this possible. And, as the Executive Summary of the 2022- 2023 report says:
“We recognize that each life lost to IPV was someone’s loved one – a parent, child, sibling, friend or neighbour. These individuals are not defined solely by the circumstances of their deaths. Through our work, we strive to honour the lives of those who have died by learning from their stories, identifying opportunities for prevention, and working towards a future where such tragedies no longer occur. . . .
“The findings and recommendations presented in this annual report reflect the urgent need for coordinated, intersectional and sustained action to prevent IPV and the devastating loss of life it causes. The DVDRC’s work is intended to support learning, collaboration and system-wide improvement. By continuing to examine these deaths with care and respect, the committee aims to contribute to a more informed, responsive and supportive approach to preventing IPV and promoting safety for all individuals and communities.”