It’s more of a problem than you might ever imagine.

The Monmouth County Prosecutors office has launched a pilot program to focus attention on the dangers of near-fatal strangulation by partners in a domestic violence cases, and increase awareness about the services that are available to victims of such abuse.

The pilot program, known as the Enhanced Domestic Violence Initiative, provides first-responders and law enforcement officers with training to enhance their understanding of domestic violence incidents involving the strangulation or choking of victims, and the significant risks associated with those incidents.

Emergency first-responders and police are being taught how to talk to victims, what questions they should ask, and how to recognize patterns of behavior that can indicate a non-fatal strangulation or suffocation has taken place.

Monmouth County Prosecutor Chris Gramiccioni said the pilot program, which began three months ago but was announced on Monday,is educating emergency first-responders and law enforcement officers “on the lethality and certain steps for first-responders to take to make sure victims are aware of the immediate and delayed danger, medical danger.”

He said raising awareness about this is very important because “you don’t often see visible injuries.”

He said while there may not be outward signs of this type of attack on a victim’s neck, the victim may suffer a variety of neurological problems soon afterward, including loss of memory, headaches, fainting, vision and voice problems, depression and nightmares.

Gramiccioni said the victim advocacy group 180 Turning Lives Around in Monmouth County gets 8 to 10 calls a month where people acknowledge some kind of strangulation or suffocation had occurred, “and the odds for someone being killed by a partner increase by 750% whenever strangulation is a pre-existing situation.”

He said the Monmouth County Prosecutors Office is working with the Training Institute on Strangulation Prevention.

“What they’re learning across the country is strangulation or suffocation is the last step that somebody will typically take before a murder is committed, before a homicide is committed, we want to really shine a light on this," Gramiccioni said.

The Training Institute on Strangulation Prevention reports 1 in 4 women will experience intimate partner violence in their lifetime, and 10 percent of women who experience such violence are almost strangled to death.

Gramiccioni said first-responders might not have any idea this kind of attack has happened, and many victims may not say anything unless they’re asked a specific set of questions — partially because they’re concerned they may not be believed.

He added having a more accurate record of non-fatal strangulations in domestic violence cases can also enhance the ability of law enforcement to prosecute someone for this kind of attack.

Gramiccioni said a survey of victims by Emergency Medicine Journal found 70 percent of victims believed they were going to die during the assault.

Females account for 85 percent of the victims of strangulation or choking during domestic violence incidents, the survey found. Thirty-five percent of strangulation or choking incidents also involve some form of sexual assault or abuse, the survey said.

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