Strangulation emerges as a major concern for domestic violence care providers in Michigan

“We’ve had a victim who’s probably been strangled close to 20 times,” said Hannah Gottschalk, a domestic violence service provider in mid-Michigan. “The non-fatal impacts this has had on that victim are numerous: Brain damage, mental and emotional and physical impacts.”

It’s a story that is becoming more common, Gottschalk said, as strangulation is increasingly a reason why people come into SafeCenter in Shiawassee and Clinton counties. Gottschalk, the organization’s executive director, said in recent months, someone comes nearly weekly in after being strangled.

“Cases of strangulation and assaults with dangerous weapons including knives and guns … and even things such as kidnapping and being held hostage. It’s mind-blowing,” Gottschalk said.

Strangulation is widely regarded by advocates and law enforcement as one of the most lethal forms of domestic violence. And it is on the rise in Michigan, according to the Michigan State Police data.

Strangulation is a “very easy quick method for displaying that power and control on a victim,” said Kimberly Hurst, executive director for Avalon Healing Center in Wayne County who’s also a sexual assault forensic examiner.

“It only takes 10 seconds in order to completely occlude the oxygen to the brain and also the blood’s ability to get to where it needs to go and the ability for people to take a breath,” Hurst said. “Less than 30 seconds, somebody can be dead.”

Lack of blood flow and oxygen can quickly and easily become lethal, Hurst said, noting that 11 pounds of pressure — less than what it takes to open the tab on a can of pop — can cut off blood flow to the brain, causing a victim to be rendered unconscious. If the strangulation continues, a person can be dead in seconds.

“A lot of times, then, perpetrators will continue to use that, whether it’s with the same partner or with different partners to kind of control the situation. But what we see in DV [domestic violence] relationships, in particular, is that this often becomes something that happens more than once,” Hurst said.

The repeated physical trauma of depriving the brain of oxygen can cause an array of health issues, including injury to neck and facial nerves and damage to the brain. If repeated long term, symptoms can arise similar to dementia.

“In chronic DV cases where somebody really can’t get out of the relationship, and it happens over the years … they might have mood swings, personality changes, memory issues — things that you would potentially see after somebody’s had a stroke,” Hurst said. “The brain, they actually start to look like MRIs of patients who have had mini strokes.”

Multiple organizations, including the Training Institute on Strangulation Prevention agree with research published in the National Library of Medicine that says that women who have been strangled by their partner are seven times more likely to be killed by that partner than other women in abusive relationships who have not been strangled.

“I don’t think people realize just how deadly it is,” former Ann Arbor Judge Libby Pollard Hines said. 

Hines chairs the Michigan Domestic and Sexual Violence Prevention and Treatment Board. The governor-appointed board members advise on policies pertaining to domestic and sexual violence.

One goal of the board is to see an expansion of Michigan’s “assault with intent to do great bodily harm less than murder” criminal charge, specifically a new definition for “strangulation or suffocation.”

“We want to amend the strangulation statute to include suffocation by chest compression because abusers and sexual assault perpetrators unfortunately all too common, sit or lie on the victim’s chest and that can be easily lethal,” Hines said. “It doesn’t take much pressure and only a few seconds.” 

The Michigan State Police (MSP) has steadily recorded an increase in asphyxiation used as a weapon in its annual crime data on domestic violence incident reports. Michigan State Police defines asphyxiation to include, “drowning, strangulation, suffocation, gas, etc.”

Asphyxiation was listed as a weapon used in 47 domestic violence incidents reported in 2012, rising by nearly 300% to 182 in 2019, in annual reports from Michigan State Police. 

In 2020, the Michigan State Police began attributing weapon counts in domestic violence incident reports to the number of victims, not by offense. In 2020, asphyxiation was listed as a weapon used against 234 victims in domestic violence incident reports. And by 2022, the number jumped to 326 victims, nearly a 600% increase since 2012.

Any reports of increases in strangulations in domestic violence could or could not be indicative of an actual increase in occurrences, former Marquette County Prosecutor Matthew J. Wiese said. But they could also show how law enforcement and emergency medicine providers are becoming more aware of the signs of strangulation.

“The level of violence, I’ve seen a distinct rise in and I don’t know if it’s always occurred or just because we’re now looking for it more. But there has been an increase in the level of violence in intimate partner relationships, a lot more allegations of strangulation,” Weise said. “If you have a community where your community based advocacy program works hand in hand with law enforcement and prosecution, I think it sets a tone and a climate for survivors to be more confident to report.”

Injuries caused by strangulation can, at times, leave no physical bruising or lacerations and so there’s been a history of underreporting of strangulation, Hurst said, simply because law enforcement and even emergency medical providers haven’t known to look deeper.

Weise noted that things are improving and in the last decade, at least in Michigan, there has been a lot of intensive training for law enforcement to screen for strangulation when investigating domestic violence complaints. 

“We didn’t ask before; we didn’t know the level and the depth of the severity that strangulation was before,” said Lori Kitchen-Buschel, executive director of First Step resource center in Wayne County. 

However, in Wayne County, she said all agencies involved with domestic violence reporting have been taking steps to better understand strangulation and how to help.

But things have gotten worse for survivors since the start of the COVID-19 pandemic in 2020, Kitchen-Buschel said.

Many care providers in Michigan worried early in the pandemic about the welfare of victims who were locked in with their abusers during at home orders, and research indicates there may have been heightened violence for victims during the pandemic.

Members of First Step’s community response program, embedded into many of the police and court systems throughout Wayne County have been saying since the pandemic started, “mention of strangulation and the use of weapons has been significant,” Kitchen-Buschel said.

The lifelong problems a person can face due to strangulation make it an important topic to bring attention to, Kitchen-Buschel said. But strangulation is also one of the main indicators providers look for in determining possible lethality of a survivor’s situation.

Domestic and sexual violence are traumatic and reporting isn’t always easy for people, Hurst said. Additionally if a person survives strangulation, they may not be aware of what happened because it can impact their memory or they don’t know what “counts” as strangulation.

“It is kind of on us to explain what happened to you was strangulation; it is life-threatening. It could have caused severe damage and you could have been seconds away from death,” Hurst said. “This was a potentially life-threatening injury. This could cause injuries to your vessels in your neck. This could cause a stroke. This could cause death and I don’t want that for you.’”

It takes courage for someone to seek help after abuse, Gottschalk said. And the most important thing for those looking to help is to believe someone when they say they’ve been hurt.

“Violence takes many shapes and forms and it often doesn’t look like we think it looks and victims are not going to look like we think they’re going to look. Most often we’re going to be surprised to find out that the person who’s reporting to us is a victim,” Gottschalk said.

“It’s just so important that we believe them because that first response that we provide to somebody who reports to us, is going to be crucial to their healing and their ability to get the resources and support they need from that moment.”