INTIMATE PARTNER VIOLENCE (IPV) is a serious and potentially lethal public health problem. It is a problem that affects the lives of all Marylanders. A comprehensive, nationally-representative study conducted by the Centers for Disease Control found that 14% of men and 24% of women will experience severe physical violence at the hands of a partner in their lifetime. These statistics do not include other insidious forms of abuse, such as less severe forms of physical violence, psychological aggression, stalking, teen victims of dating violence, or children who are exposed to violence at home. The prevalence of domestic violence cuts across all genders, classes, races, religions, and sexual orientations. The trauma caused by domestic violence permeates through the entire family and support network of survivors.
With the recognition that IPV is a preventable public health challenge, efforts were undertaken to better identify and serve at-risk victims in the highest danger. Based on the research of Dr. Jacquelyn Campbell of Johns Hopkins University, MNADV led this work through extensive and comprehensive multi-disciplinary research and development. After several years of this work, the lethality screen and protocol were created and implemented in 2005. It provides an easy and effective method for law enforcement and other community professionals to identify victims of intimate partner violence who are at the highest risk of being seriously injured or killed by their intimate partners, and immediately connect them to a domestic violence program It is that link to a service provider in the immediate aftermath of the event which distinguishes the LAP from other related homicide prevention models.
The Need for the LAP
Research shows that for 28-33% of victims, the homicide or attempted homicide was the first act of violence, which shows that physical violence isn’t necessarily the most accurate predictor of homicide. This means that, when assessing for risk of homicide, first responders need to also look for other, non-physical tactics that abusers use—many of which would not even be classified as “crimes”—that could indicate the victim is in danger of being killed., 
Research also shows that, in the year prior to the homicide, more than 44% of abusers were arrested, and almost one-third of victims contacted the police. These contacts demonstrate missed opportunities to identify victims in danger of being killed by their intimate partners.
Alternatively, only 4% of abused victims had used a domestic violence hotline or shelter within the year prior to being killed by an intimate partner. This statistic shows that victims who need the most help aren’t self-initiating contact with domestic violence-specific resources. They do, however, come in contact much more often with law enforcement. The LAP capitalizes on the contact that law enforcement has with victims in danger of intimate partner homicide, and connects them to local resources.
This is why the LAP is needed—it gives law enforcement officers the knowledge they need to assess whether someone is in danger of being killed, and connects them to services that are protective.
Effectiveness of the LAP
When the LAP was first developed, a member of the development committee retroactively assessed a few hundred homicide or near-homicide victims using the Lethality Screen. At that time, about 87-92% of homicide or near-homicide victims would have been assessed at High-Danger. Recently, the LAP was evaluated in a study in Oklahoma.
In this study, the Lethality Screen was found to be highly sensitive, meaning it correctly identified 92% of women who experienced near-fatal violence between the baseline interview and follow-up.
Participants in the LAP experienced less frequent and less severe violence than victims in the comparison group.
They also engaged in protective actions (e.g., hiding their partner’s weapons, or accessing formal domestic violence services) more often than participants in the comparison group.
Abusive partners of participants in the intervention group were more likely to “go someplace where they could not see the victim” (e.g., jail). This could indicate that victims assessed through the LAP are more likely to engage the criminal justice system, or that the system sees the partners of High-Danger victims as more dangerous.
Participants in the LAP were significantly more satisfied with the police response than the comparison group.
Between 2008 and 2013, Maryland saw a 32% drop in domestic violence-related deaths. While this effect cannot be directly attributed to the LAP, increasing participation in the LAP contributed.
This project was supported by Grant No. 2011-TA-AX-K111 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.
 Nicolaidis, C., Curry, M.A., Ulrich, Y., Sharps, P., McFarlane, J., Campbell, D., Gary, F., Laughon, K., Glass, N., & Campbell, J.C. (2003). Could we have known? A qualitative analysis of data from women who survived an attempted homicide by an intimate partner. Journal of General Internal Medicine 18, 788-794.
 Sharps, P. W., Koziol-McLain, J., Campbell, J. C., McFarlane, J., Sachs, C., & Xu, X. (2001). Health care providers missed opportunities for preventing femicide. Preventive Medicine 33, 373-80.
 Messing, J. T., Campbell, J. C., Wilson, J. S., Brown, S., Patchell, B., & Shall, C. (2014). Police departments’ use of the Lethality Assessment Program: A quasi-experimental evaluation. U.S. Department of Justice, Award No. 2008-WG-BX-0002.