GRAND RAPIDS, Mich. (WOOD) — October is domestic violence awareness month, and the YWCA is focused on increasing awareness about what they say is the most deadly form of domestic violence: strangulation.

The YWCA reports it is the strongest predictor of domestic homicide. But strangulation is often minimized by the perpetrator, by the victim and by the law. Until 2013 it was only a misdemeanor charge in Michigan.

YWCA Nurse Examiner Program Director Stephanie Solis says screening for strangulation is critical, because many victims don’t report it. She asks questions about symptoms of strangulation, including hoarse voice, sore neck and trouble swallowing.

There is a misconception that there will be obvious signs of injury, but 85% of strangulation cases have no marks or signs of violence.

It takes very little pressure to render someone unconscious.

Anyone looking for help can reach out to the YWCA helpline at 616.454.9922.