Psychological abuse, also known as emotional abuse, is when a person endures abuse that results in psychological trauma. Examples of psychological abuse include: verbal abuse, intimidation, confinement, isolation, and humiliation.
Emotional distress is common in victims of psychological abuse, particularly if their abuser is someone they once trusted; this can include a family member, friend, or support worker (for example). Warning signs of emotional abuse include: the culprit speaking down to the person in a raised voice. A lack of interest in the person’s presence or needs may also be something to consider. Likewise, the individual may be fearful of raised voices and worry about being left alone.
Financial abuse occurs when an individual, usually one in a position of trust, abuses their position and spends money that doesn’t belong to them. Examples including: stealing cash, writing fake checks, and pressurising someone into making financial decisions.
Signs of financial abuse include: bills not being paid, unexpected debts, unusual financial transactions, and unexpected withdrawals from bank accounts.
Institutional abuse is the abuse and mistreatment of people by an organisation. Due to the various regulating bodies and the increasing number of laws/legislations regarding care, institutional abuse is not as common nowadays. However, it’s not to say that it doesn’t occur, because it does. A prime example is the Winterbourne View scandal of 2011. Winterbourne was a private hospital in the UK. Multiple cases of institutional abuse took place there, with a culture of abuse being viewed as the norm by its culprits. The abuse was eventually uncovered, with 11 care workers being charged in a court of law. Six admitted to charges of neglect and abuse.
(“Winterbourne View: Care workers jailed for abuse”, BBC News, published October 26th, 2012. Retrieved August 20th, 2018)
Possible signs of institutional abuse include: staff addressing individuals in an unacceptable manner. Other signs include: a lack of compassion, routine or care towards individuals. Individuals who look malnourished and lack physical care is something else to consider. Victims of institutional abuse may be withdrawn and isolated. They may be fearful in the presence of others and find certain people intimidating.
Self-neglect is defined as the neglect of yourself; not taking care of your own health. Self-neglect can occur because of a decline in mental health (such as dementia, Alzheimer’s, or depression) and due to a lack of understanding (e.g. learning disabilities). The main signs of self-neglect are a person’s failure to tend to their own essential needs. This can include: refusing to eat, refusing to wear adequate clothing, and self-harming.
(Definition of “Self-neglect”, Oxford Dictionary, 2018. Retrieved August 20th, 2018)
1.3: Describe factors that may contribute to an individual being more vulnerable to abuse
Individuals suffering from a physical disability or mental illness are at more risk of abuse; as are those with learning disabilities. This can be for different reasons. When thinking of the people I support, I’d have to say: it’s because – due to their learning disabilities – they have little understanding of what’s going on around them. Those with limited capacity are – in some cases – unable to speak. If a non-verbal person is being abused, there’s a high chance they’ll be unable to speak up and report the abuse themselves. In many cases, they have no comprehension of what’s happening. Likewise, even those who are verbal and with some degree of capacity, are at risk of abuse. This could be because they don’t know the signs of abuse and may not realise they are being taken advantage of.
If an individual is suffering from a mental illness, they may be unaware of their surroundings. If low in mood, they may yearn for the friendship of others. It’s easily possible for them to be coerced and manipulated into doing things they don’t want to do.
Isolation and seclusion can contribute to abuse. Vulnerable people sometimes want to stay alone and have little contact with others. Those with physical disabilities are less likely to be mobile. The less contact someone has with others, the more likely they are to be taken advantage of. Abuse is less likely to occur in the presence of others and more likely to occur behind closed doors.
An unlikely factor is the lack of understanding, training and experience of some care workers. Abuse isn’t necessarily thought through and premeditated. Some abuse occurs during spur of the moment. If a care worker is stressed and has multiple work-related issues; as well as family problems (for example), they could hit the person they’re caring for out of anger and frustration. Either way, any form of abuse is inexcusable. If a carer has an unknown history of abusing others, they may want to continue the culture of abuse they’ve become accustomed to giving. Within the care sector, vulnerable people could be easy targets.
(“Safeguarding adults” by Dr Colin Tidy, published August 24th, 2016. Retrieved August 21st, 2018) (“Abuse and neglect of vulnerable adults”, NHS, reviewed January 10th, 2018. Retrieved August 21st, 2018)
2.1: Explain the actions to take if there are suspicions that an individual is being abused
If I suspected abuse, my first step would be reporting any suspicions to my line manager. All my concerns would be recorded on relevant documents, and an internal investigation would follow. If the individual it concerns has capacity, they would be spoken to and asked if anyone has harmed them. Any proof of abuse having occurred would result in the police having to be called. This would be followed by an external investigation involving a team of multi-disciplinary people. In most cases, the victim’s next of kin would also have to be informed.
If I felt my concerns weren’t being taken seriously, the Priory has a whistleblowing line to report any cases of abuse. Despite this, I would contact the area manager (my manager’s manager) first, if I felt I wasn’t being listened to by my superiors. I would continue to go up the line of hierarchy until someone within the Priory took my concerns seriously.
I’m aware the CSSIW (‘Care and Social Services Inspectorate Wales’) has an anonymous whistleblowing line for care workers to report any cases of abuse or maltreatment within their workplace.
(“Raise a concern”, www.careinspectorate.wales. Publishing date unknown. Retrieved August 22nd, 2018)
2.2: Explain the actions to take if an individual alleges that they are being abused
Even if an individual has a history of making false allegations, any claims of abuse should be taken seriously and dealt with in a correct manner. I would ask the individual who they feel most comfortable talking with. If they said my manager, I would contact my manager straight away. She would find somewhere private to speak with them and would document any evidence, statements or concerns. However, if they said they would rather speak with myself, I would find somewhere quiet and private to speak with them. I would have to tell them that I have a duty of care, so I will need to pass on any information disclosed that involves any harm to themselves or others. I would proceed to take in what they have said, writing it down with their consent. I would pass on any concerns to my manager; along with any evidence. My manager would most likely want to speak with them. A formal investigation will then be conducted into the allegations that have arisen. If applicable, an incident report should be filled in and a body map completed. A full description of any injuries must be documented. Any notes filled in (e.g. statements, body maps, incident reports…) must be signed and dated. If the situation calls for it, the police should be called immediately; as should any other relevant authorities/multi-disciplinary teams.
Speaking in a calm and friendly manner is a must. Acting professional, but also showing empathy is important. Due to the individuals I work with having varying degrees of learning disabilities, I’d recommend not using highly technical terms, as it could be confusing for them. Individuals should be given reassurance that their allegations are being taken seriously. Staff shouldn’t tamper with any evidence if an alleged crime has taken place. If the situation calls for it, the crime scene should be closed off. Given how distraught the individual may be, it’s best to keep them out of contact with the alleged perpetrator until the police have arrived and the incident has been dealt with.
2.3: Identify ways to ensure that evidence of abuse is preserved
The area where the alleged abuse has taken place should be closed off. Minimal interference will ensure that DNA is preserved. This could be in the form of fingerprints, blood and other bodily fluids. If anything has been broken during the alleged abuse, this should likewise be left untouched.
Any statements should be signed and dated. A detailed record of any injuries should be kept in the form of body maps. All of this can be used as evidence and should be locked safely away until the authorities have arrived. These statements should then be handed over to the police. The police would presumably take and photocopy all forms of evidence, storing them along with the originals on an encrypted, secure database.