Abuse Of People With Disabilities

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Abuse of Peoplewith DisabilitiesInformation for Service ProvidersAbuse is a serious threat to many people with disabilities.This booklet pr ovides an overview of abuse, describesindicators of abuse, and suggests w ays in which you cansupport people with disabilities who may experience abuse.People with disabilities includepeople with physical, sensor y,mental health and intellectualdisabilities.The justice system identifiespeople who have experiencedabuse as victims. This bookletuses victim when describingjustice system responses.Having a disability may puta person at risk of abuse People often have negative attitudesabout disability. People with disabilities are oftensocially isolated. People with disabilities may need torely on others for the necessities of life,including intimate personal care. When abuse happens, people withdisabilies may not be believed, maynot know what their rights are, or maybe unable or afraid to complain. People with disabilities often havemuch lower incomes.What is abuse?Abuse is anything that causes harm to anindividual. Abuse can be physical, sexual,psychological/emotional, or economic/financial. Abuse of people withdisabilities, like all forms of abuse, is anabuse of power and control. People with disabilities are often inrelationships where another personcontrols the decision-making.Suite 150900 Howe StreetVancouver, B.C.V6Z 2M4TEL 604.331.5400FAX 604.331.5401

Physical abuse: intentionally causing aperson pain or injury. taking the money needed for food andshelter and gambling it away or using itto buy drugs, etc.Common examples: hitting, kicking or pinchingNeglect: this happens when caregivers donot meet the needs of people they serve. Acaregiver can be someone who is paid tohelp or a family member. handling someone roughly, slappingthem giving inappropriate medicationNeglect may involve not giving someonefood, care, or necessary medication. It isalso neglect when someone doesn’t stopanother person from being abused. confining people or using restraintsSexual abuse: forcing someone to havesex. It includes kissing or touching as wellas intercourse.Common examples not providing enough to eat or drinkPsychological/emotional abuse : behaviourthat takes away someone’s dignity and selfworth. not providing appropriate supervisionCommon examples: not providing appropriate personal care calling someone names or putting themdown removing dentures, glasses, hearing aids not providing enough heat/electricity isolating or ignoring them allowing the person to develop skinconditions or pressure sores threatening to remove benefits, services,medication, treatment etc. leaving the person’s medical problemsuntreated threatening to destroy pets or personalbelongingsSystemic abuse: Systemic abuse refers topractices that take away a person’sindependence and dignity. Systemic abusehappens in settings where other people aremaking decisions for the person who has adisability. Government bodies andbureaucrats can also be involved insystemic abuse. removing aids (such as a wheelchair orcommunication device) threatening to send the person to aninstitutionEconomic/financial abuse : controllinganother person’s finances withoutpermission.Institutional abuse : This is a form ofsystemic abuse. In institutional settings,power imbalances often exist betweenservice providers and people they serve.Research has shown that people withdisabilities who live in institutions aremore likely to experience abuse than thosewho live in the community.Common examples: withholding money for basic necessitiessuch as food, clothing, medication, andtransportation preventing someone from getting towork or denying access to employmentaltogether depriving someone of financial benefits2

How widespread is abuseof people with disabilities?Contributing factors to abuseCaregiver stress : Caregiver or familystress may precipitate the abuse of aperson with a disability. Often the abuserwill blame the person with the disabilityfor the abuse, saying that the disabilityitself “provokes” the abuse. Most people with disabilities will experiencesome form of sexual assault or abuse (Sobsey& Varnhagen, 1989). People who have somelevel of intellectual impairment are at thehighest risk of abuse (Sobsey & Doe, 1991). Between 39 to 68% of girls and 16 to 30% ofboys will be sexually abused before theireighteenth birthday (Sobsey, 1994).Negative role models: The abuser mayhave learned that abusive behaviour isacceptable, usually through their ownexperiences of abuse. A survey of 245 women with disabilitiesconducted by DisAbled Women’s NetworkCanada found that 40% had been abused and12% had been raped (DAWN, 1989).Negative stereotypes : People with disabilities may be seen as a burden orpassive or worthless. These stereotypesoften contribute to abusive behaviour. Males with disabilities are twice as likely thanmales without disabilities to be sexuallyabused in their lifetime (Statistics Canada,1994). Among adults who have developmentaldisabilities, as many as 83% of the femalesand 32% of the males are the victims ofsexual assault (Johnson & Sigler, 2000).Who are the abusers?Often the abusers are friends, familymembers, caregivers, or serviceproviders. For individuals with psychiatric disabilities,the rate of violent criminal victimizationincluding sexual assault was two times greaterthan in the general population (8.2% vs.3.1%) (Hidday, Swartz, Swanson, Borum, &Wagner, H.R. 1999). 33% of abusers are acquaintances,33% are natural or foster familymembers, and 25% are caregiversor service providers (Sobsey, 1998). It is estimated that approximately 67%of perpetrators who abused individualswith severe developmental disabilitiesaccessed them through their work indisability services (Sobsey, 1991). The abuse of people with disabilities is ofteninvisible. When identified, it is underreported.Reports are usually limited to serious instancesof physical and sexual abuse. Verbal andpsychological abuse, and cases of restraintand control, are almost never reported(Sobsey, 1994; Rindfleish & Bean, 1988).Barriers to disclosure People with disabilities have to live ininstitutional or residential settings away frompublic scrutiny and with little or no access topolice, support services, or advocates. Moreabuse occurs “behind locked doors”(Crossmaker, 1991).People with disabilities face many barriers to disclosing the abuse. Examplesinclude:3

Fear: The person may be unable to escapethe abuser’s control. The abuser may bethreatening to withdraw services, removethe person’s children, or hurt the person’sfamily members or pets.with ongoing threats, result in intimidating the person they are abusing. In many situations, abusers know thatthey can get away with this behaviourbecause the person they are abusing isisolated from social supports or isdependent upon them for economic,social, or physical support.Economic dependence: Economicdependence or poverty can keep peoplewith a disability trapped in an abusiverelationship. They may lack financialresources, educational qualifications, oremployment skills or experience.Indicators of abusePhysical signs include:Isolation: Some people with disabilitieshave had little or no contact with anyoneother than their caregivers. They may nothave people who can act as advocates ontheir behalf. unexplained injuries, pain, or bruising delay in seeking treatment over-sedation stained, torn or missing clothesLack of access. People with disabilitiesoften do not have access to appropriatesupport services. change in sexual behaviourCredibility issues : People with disabilitiesare often considered to be less credible.For example, they may be seen as unreliable witnesses in court simply becausethey have a disability.Behavioural signs include: unexplained pregnancy sexually transmitted diseases behavioral extremes, like hyperactivityand/or mood swings unusual fear of a particular person avoidance of specific settingsCharacteristics of abuse fear of intervention depression Abuse usually occurs when abusershave a need to impose power or toabuse the power that they already hold,and the person with the disability feelspowerless to stop the abuse fromoccurring. sleep disturbance eating disturbance withdrawal excessive crying spells It may involve multiple forms of abuse. excessive weight loss/gain It may involve a variety of tactics andstrategies that on their own do notappear abusive but in combination poor self-esteem self-destructive behavior4

Circumstantial signs include: Know about, and network with, victimserving resources Alcohol or drug abuse by caregiver Devaluing attitudes by caregiverWhat can you do if an adultmay be experiencing abuse?Although no one should jump to conclusions, do take all of these indicatorsseriously.Provide information, support, andpractical assistanceAdapted from Violence and Abuse in theLives of People with Disabilities (1994),D. SobseyIf you suspect that someone is beingabused, speak to them in private. You canask: Are you having trouble? Can I help you?Preventing Abuse Can I contact a friend for you? How would you like to be assisted?The best way to prevent abuse is to makesure that anyone who has a disability:If someone discloses abuse to you, allowsufficient time for him or her to tell thestory. The full scope of the abuse is usuallyrevealed over time. It involves a relationship of trust and a space for the person toassess the impact and extent of the abuse. is involved in the community has control over their life and makestheir own decisions can do as much on their own aspossible Create an environment of safety andsupport and prepare for the person’sspecific needs e.g. a very quiet space,time to rest, etc. can get information about their rightsThere are actions that service providerscan take to help prevent the abuse ofpeople with disabilities: Encourage them to contact a trustedfamily member or friend for support. Explain the options available. Appreciate the serious dimension ofabuse of people with disabilities Learn to recognize the signs of abuse. Discuss the advantages and disadvantages of each option or contact someone who can. Listen to, believe, and act on accountsof abuse. Let the person make his/her owndecision. Recognize and respect the fact thatmany persons with disabilities are ableto exercise independent decisionmaking If the person’s safety is at risk, tell thepolice and Victim Services. Help stop abuse and neglect. Report it! Provide information on abuse, as wellas options, and resources5

What if the adult can’tget help on their own?Criminal Code specifically prohibits aperson in a position of trust or authorityover, or in a relationship of dependencywith a disabled person from counselingor inciting any kind of sexual touching inrelation to the disabled person withouthis or her consent.If you know or suspect that someone is abused, neglected or self-neglected,and is refusing support and assistance, and appears to be mentally incapable orphysically unable to get help on theirown Guardianship legislation is designed toprotect vulnerable adults from abuse. TheBC Adult Guardianship Act offers practical tools for intervention, including acourt order to get past a suspected abuserto talk to the person about the abuse. Seethe pamphlet, Protecting Adults fromAbuse, Neglect and Self-Neglect, onlineat ltsreport the situation.In BC, contact: your regional health authority or your local community living service ofthe Ministry of Children and FamilyDevelopment (for adults with a developmental disability) Under Canada Evidence Act if a witnesshas difficulty communicating because ofa physical or mental disability, the witness may be able to give evidence by anymeans that allows the evidence to beunderstood.Community numbers for reporting abuseand neglect are on the Internet at:www.trustee.bc.ca/report%20phone.htmKnow what legal protectionsare available Provincial human rights legislation protects people with disabilities from discrimination. If the abuse does not comeunder the Criminal Code, the abused person may wish to use human rights protections. In BC, they can make a complaint under the Human Rights Act .A proactive approach to reporting abuseand prosecuting abusers has been shown toreduce victimization (Russell, 2002). All Canadian provinces have mandatoryreporting requirements for child abuse.Under the BC Child, Family andCommunity Services Act, any suspectedabuse or neglect of a child must bereported. Protection orders : These are orders madeby a judge in court that contain a condition designed to provide safety and security to one or more people. There are twokinds of protection orders: peace bonds(for anyone), and restraining orders (forpartners only). A range of Criminal Code offences relateto abuse. These include assault andsexual assault provisions, as well asfraud, theft, mischief, criminal harassment (also known as “stalking”), utteringthreats, intimidation, and extortion. TheSee For Your Protection: Peace Bonds andRestraining Orders,www.gov.bc.ca/pssg/victim EB.pdf6

Provinces and territories have legislationspecifically for victims. In BC, theVictims of Crime Act provides rights tovictims of crime, including the right tobe treated with courtesy, respect, andwithout discrimination by all justicepersonnel. The BC Crime VictimAssistance Act provides eligible victimsinjured as a result of certain crimes withfinancial assistance and/or benefits.Systemic changes Institutions need to support and promoteresidents’ councils and independentadvocates to prevent the abuse and tofacilitate disclosure. Programs that provide services to peoplewith disabilities need to carefully screen,train, and supervise staff. Providing positive role models and working conditionsmay be as important as confronting abusive caregivers.See Your Rights as a Victim of Crime:www.pssg.gov.bc.ca/victim able in eight languages)Abuse PreventionInformation Sitesplease call the Telus Relay Service at 711.VictimLINK is operated by the Victim ServicesDivision of the BC Ministry of Pubic Safety andSolicitor General. Victim Services Division fundsa network of victim service programs. Go to theVictim Services Division Directory:www.pssg.gov.bc.ca/victim services/directory/index.htmCanadian Health ence.htmlInformation about resources on different formsof abuse, and links to agencies that producedthe information.DISABILITY SITESCanadian National Clearinghouse on Famil e/Information on violence prevention resources,including violence against people with disabilitiesBC Institute Against Famil y Violencehttp:www.bcifv.orgLinks to resources on different forms of abuse.VICTIM SERVICESVictimLINKTelephone: BC Toll Free 1 800 563-0808, 24hours a day, seven days a week. Deaf and hardof hearing people can contact VictimLINK viathe TTY service at 604 875-0885; to call collect,7BC Coalition of People with Disabilitieshttp://www.bccpd.caBC umbrella disability rights group. They candirect you to other disability resources in theprovince#204 - 456 West BroadwayVancouver BC V5Y 1R3Tel: 604-875-0188; TTY: 604-875-8835;Fax: 604-875-9227DisAbled Women’s Network (DAWN)http://www.dawncanada.netDeals with violence and abuse against womenwith disabilities. Will link you with provincialDAWN groups.Disability Weblinkshttp://www.disabilityweblinks.ca/

Enablelinkhttp://www.enablelink.org/BC Coalition to Eliminate Abuse of Seniorshttp://www/bcceas.caFocuses on the elimination of abuse ofseniors. Provides information, advocacy, andresources.#304 – 5050 KingswayBurnaby, BC V5H 4C2Phone: 604-437-1940; Fax: 604-437-1929;Toll Free 1-866-437-1940Council of Canadians with Disabilities(CCD)http://www.pcs.mb.ca/ ccd/The Roeher Institutehttp://www.roeher.ca/ADVOCACY RESOURCESARCH: A Legal Resource Center for Personswith Disabilitieshttp://www.ar ch-online.orgAn Ontario-based legal clinic and legalresource centre.425 Bloor Street East, Suite 110Toronto, Ontario M4W 3R5Phone 416-482-8255; Fax 416- 482-2981;TTY 416- 482-1254Office of the Public Guardian and Trusteeof British Columbiawww.trustee.bc.caThe Public Guardian and Trustee upholds anadult’s right to self-determination andprovides support and protection for thosevulnerable to abuse.#700-808 West Hastings StreetVancouver, British Columbia V6C 3L3For services to adults, contact:Phone: 604-775-0202; Fax: 604-660-4493BC Association for Community Livinghttp:www.bcacl.orgFocuses on the rights of adults and childrenwho have a developmental disability.#300 - 30 East 6th AvenueVancouver, B.C. V5T 4P4Phone: 604-875-1119; Fax: 604-875-6744Shelternethttp:www.shelternet.caAn online Canada-wide resource to helpabused women and children find shelter,safety, and information about their options.The People's Law School would like to thank Justice Canada for funding this booklet.Produced by: The People's Law School 2004Reviewers:Coordinator: Jennifer FudgePat Feindel - BC Association for CommunityLivingWriter:Gayla ReidPenny Bain - BC Institute Against Family ViolenceDesigner:Tamara MacKenzieAndrea Rolls - Victim Services DivisionEditor:Bernice De WittJennifer FudgeJane Dyson - BC Coalition of People withDisabilitiesKathy Doerksen - Community Response NetworkJennifer Fudge - People's Law SchoolNahid Roboubi - Justice CanadaSuite 150900 Howe StreetVancouver, B.C.V6Z 2M4TEL 604.331.5400FAX 604.331.5401This booklet contains public legal information andeducation only. It is not legal advice. If you needlegal advice, please consult a lawyer.8

Abuse of People with Disabilities People with disabilities include people with physical, sensory, mental health and intellectual disabilities. The justice system identifies people who have experienced abuse as victims.This booklet uses victim when describing justice system responses. Abuse is a serious

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