Anj Barker was just 16 when her abusive boyfriend changed her life forever.
"He tried to strangle me and repeatedly bashed my head into a steel bench and made it like jelly … and I ended up with a severe brain injury," she said.
He also stomped on her face, snapping her jaw and leaving her perilously close to death.
"He kicked her in her ear and she bled out of it for three days, with brain fluid leaking out of it as well," Anj's mother, Helen Barker, said.
"We thought she would die and we're just very lucky that she lived."
Ms Barker was in a coma for three weeks and remained unresponsive for nine months.
"Because all my vocal chords were severed because of the strangling, it took me five years to speak and eight years to walk with a walking frame," Anj, now 32, said.
"They said she'd be a vegetable for life," her mother added.
"I'm very proud of the way she gets through everything and has managed to keep going … I don't think I could have ever done that."
40% of family violence victims had brain injuryMs Barker's speech and mobility have been permanently impaired but her sense of justice remains razor-sharp.
While Ms Barker's case is at the extreme end of brain injuries inflicted by abusive partners, a report by Brain Injury Australia has revealed the extent of damage wrought by family violence.
Researchers from Victoria's Monash University examined data from hospital admissions between July 2006 and June 2017, and found that 40 per cent of 16,000 family violence victims had sustained a brain injury.
While the victims were most often women, the report found nearly one in three of the victims were children — and one in four of them had sustained a brain injury.
"They're shocking figures and yet the vast majority of women who experience family violence don't get medical attention," said Nick Rushworth, chief executive of Brain Injury Australia.
"So it's bound to be the tip of a very large iceberg.
"While around 1,800 victims of family violence go to Victorian hospitals each year, there are 26,000 cases referred to specialist family violence services and 37,000 intervention orders sought in the courts."
Brain Injury Australia has called for the creation of an integrated brain injury and family violence service to support diagnosis, rehabilitation and harm reduction, to bridge what it calls "significant gaps" in service responses and support.
"Australian state and federal governments need to develop a comprehensive system of services for women and children living with the consequences of brain injury from family violence … and that includes everything from screening through to therapeutic supports nationwide," Mr Rushworth said.
Brain injury not on victims' radar: expert
Mr Rushworth argues such a move would save money in the long run because the estimated cost of family violence-related brain injury in Victoria was $5.3 billion in 2015-2016 alone.
The report also drew on information from practitioners in the community and family violence sector, and the experiences of women and children who had suffered a brain injury.
"They'll talk about snapping, they'll talk about being incredibly tired and having memory problems — but they can attribute that to so many other things: being stressed … potentially mental health problems that may be happening, so brain injury is not on their radar," Monash University researcher Darshini Ayton said.
Many victims were also unaware of the cumulative impact of mild traumatic brain injuries "and the fact that multiple blows to the head over a long period of time can really lead to significant disability and brain injury", Dr Ayton said.
"The fact is that waiting lists to get assessed can sometimes take 18 months, so when you consider that along with the complexity and the chaos that might be happening in these situations, that's just not realistic in terms of being able to get accurate assessments and diagnoses."
She said the report also found that perpetrators were twice as likely to have sustained a brain injury themselves in the past — in some cases, inflicted during childhood — creating "a vicious cycle of inter-generational violence".
The study is the first of its type in Australia focusing on brain injury caused by family violence.
"A lot of the literature on concussion is done in sport and in military and people who are playing rugby and football and getting concussion and that's where the research has focused on the long-term impacts," Dr Ayton said.
"The practitioners all talked about the need for different agencies and the community and the sectors to come together to work to address this problem, it's not something that they can do in silos."
Anj Barker said the report was a wake-up call for care-givers and victims alike.
She has given talks to more than 38,000 schoolchildren, women and community groups in the hope that telling her story will save other victims from a similar fate.
"It makes me very happy that I'm able to give people the courage and the awareness to realise that they are in exactly the same situation and get out of it safely."
This article was written by Stephanie Ferrier and was copied from here.