Preventing abuse and exploitation
A tiered approach
Preventing abuse, neglect and exploitation of people with disability requires the promotion of positive cultures, safe environments and relationships based on mutual respect.
There are three levels of prevention work:
- Primary prevention — targets the broad community; strategies are directed to the general public, families, workplaces, community networks and people with a disability who may or may not be using support services.
- Secondary prevention — targets people with disability; strategies include reducing risks, building up protection and strengthening abuse recognition and response systems.
- Tertiary prevention — targets known incidents of abuse; strategies provide support to victims of abuse and may include recovery support and links to the criminal justice system, where appropriate.
Primary prevention
The most effective strategies for preventing abuse are those that promote positive roles and valued status for people with disability throughout the community.
Community inclusion
Support that enables people with disability to live in the community is a key way to increase inclusion and minimise risk of abuse.
Interaction with community visitors and programs that build connections and relationships beyond the service environment are essential for people who live in a specialist accommodation service and have an intellectual or psychiatric disability, acquired brain injury, dementia or other condition that affects decision making.
A community visitor is someone appointed by the Office of the Public Guardian to visit accommodation and respite services that care for people with disability. Community visitors try to resolve issues or complaints with staff to ensure adequate support and service standards are provided.
Enhancing valued status
Changing attitudes about people with disability is a necessary step in reducing their risk of abuse. Attitudes that devalue people with disability, deny them common rights and freedoms, or downplay or ignore disadvantage and discrimination may lead to unacceptable tolerance of abuse.
Enhancing the valued status of people with disability is achieved through giving them opportunities to form relationships, demonstrate competence, exercise citizenship rights and meet social responsibilities. Removing barriers and providing coordinated and customised support enhances these opportunities.
Raising awareness
Community education campaigns are a significant feature of abuse prevention. Increased awareness of the problem encourages those who have experienced abuse to seek assistance while creating a sense of community responsibility.
Secondary prevention
Supporting families and carers
Most families that have a member with disability enjoy positive relationships. They are committed to promoting their family member's welfare and happiness and providing physical and emotional support.
Families and friends provide support with daily living or care to about 80 per cent of people with disability who require assistance. Carers are often under considerable stress and may experience stress-related illness or health problems.
High levels of carer stress can be both a cause and a symptom of abuse. Providing effective support to both carers and people with disability in families can build resilience to stress and reduce the risk of abuse. Strategies that services can implement include:
- improving access to more flexible and appropriate respite care
- improving service coordination to minimise caregiver frustration
- identifying barriers to social participation (e.g. transport, costs, physical access) and advocating for their removal
- increasing risk assessment and providing intensive support to families at risk
- creating mechanisms to ensure that family concerns are heard.
Family support programs are provided by mainstream family services as well as specialist disability services.
Creating safer services
The Queensland Government is committed to ensuring high-quality services are provided to people with disability. The Department of Child Safety, Seniors and Disability Services supports the assessment of services against the Human Service Quality Standards.
Implementing all six standards is vital for developing high-quality service delivery. Quality Standard 4 is specifically directed at maintaining and protecting the safety, wellbeing and rights of people using services.
Through the service agreement funded disability services sign with the department, providers are required to have, maintain, implement and act in accordance with policies consistent with the department's Abuse, Neglect and Exploitation Policy Abuse, Neglect and Exploitation Policy .
The culture within a service and the environment in which services are provided are significant factors in preventing abuse. Abuse is less likely to occur in:
- workplaces that are positive towards people with disability and support valued status
- services that integrate with the community and do not segregate or isolate people with disability
- services that encourage risk awareness, take steps to prevent harm, and report all incidents as early as possible.
Meeting individual needs is another key to abuse prevention. Good practice includes:
- individual assessment of needs and priorities
- providing tailored support and flexible options
- capacity to change supports in response to changing needs
- monitoring individual outcomes and satisfaction.
The recruitment and professional development of support workers is another important part of creating safer disability services. Due to the high vulnerability of people with disability in service systems, staff should be appropriately trained and equipped with relevant knowledge and strategies.
A code of practice and policies that clearly prohibit all forms of abuse and overly restrictive behaviour management are essential.
Building a person's confidence
A person's characteristics can increase the likelihood that they will act against abuse and may reduce the likelihood they will be victimised. However, this is not effective on its own; the environment and culture must provide the right context for self-empowerment and protection against abuse.
Training programs, information packages, learning and communication technology can be used to:
- educate people about their rights as citizens and service users
- encourage self-advocacy and increase individual independence and decision making
- provide support to improve mobility and freedom of movement
- increase choice and opportunities
- build knowledge and skills.
Tertiary prevention
Most abuse of people with disability is not reported. Barriers to reporting include:
- failure to recognise abuse, neglect and exploitation
- lack of knowledge about how or where to make a report
- concern that the report will not be believed
- fear of retribution or repercussions
- concern or empathy for the perpetrator (e.g. when they are a family member or housemate)
- privacy and confidentiality concerns.
Abuse is more likely to be reported if there are mechanisms in place for responding to the situation. These include:
- a clear commitment to treating all reports seriously and undertaking appropriate investigation
- mechanisms to protect the safety of victims and whistle-blowers
- collaboration with other relevant agencies across sectors, including victim support services and criminal justice responses
- mandatory training in abuse recognition, reporting and response, covered as part of staff inductions and completed before any customer contact.