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Protect, Report, Preserve: Abuse Against Persons with Disabilities A training video and manual on reporting suspected abuse against persons with disabilities.

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Presentation on theme: "Protect, Report, Preserve: Abuse Against Persons with Disabilities A training video and manual on reporting suspected abuse against persons with disabilities."— Presentation transcript:

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2 Protect, Report, Preserve: Abuse Against Persons with Disabilities A training video and manual on reporting suspected abuse against persons with disabilities

3 Protect, Report, Preserve Manual Review Protect, Report, Preserve Manual Review  Prevalence of Violence  How is Violence Possible – Risk Factors  Recognizing Abuse – Types and Indicators  Structure and Role of Adult Protective Services  Reporting Abuse and Neglect  What TO DO and What NOT TO DO

4 Prevalence of Violence Against Persons with Disabilities  54 million Americans with disabilities (U.S. Department of Justice, 1998)  5 million crimes committed against persons with developmental disabilities each year in the U.S. compared with (Petersilia, Ph.D., UCD) : 1.4 million Child Abuse 1.4 million Child Abuse 1 million Spousal Abuse 1 million Spousal Abuse 1 million Elder Abuse 1 million Elder Abuse 800,000 Hate Crimes 800,000 Hate Crimes

5 Prevalence of Violence  Adults with developmental disabilities are at risk of being physically or sexually assaulted at rates four to ten times greater than other adults (Sobsey, Dick 1994).  A study of psychiatric inpatients found that 81 percent had been physically or sexually assaulted (Jacobson & Richardson, American Journal of Psychiatry, 1987)

6 Prevalence of Violence  62% of women with physical disabilities reported experiencing emotional, physical or sexual abuse (Nosek & Howland, 1998)  Only 3% of sexual abuse cases involving people with developmental disabilities will ever be reported (Valenti-Hein & Schwartz, 1995)

7 How is Violence Possible? Risk Factors – Page 10  Social isolation  Dependency on care  May feel powerless  Communication abilities  Physical capabilities  Poverty  May not understand the concept of strangers  May not have received sex education  May not be believed

8 Where Does Violence Occur? Private Homes Private Homes Community Residences Community Residences Long Term Care Facilities Long Term Care Facilities State Facilities State Facilities Work and Day Programs Work and Day Programs Transportation Vehicles Transportation Vehicles  Anywhere

9  Physical  Sexual  Neglect (Omission)  Emotional  Financial Exploitation Recognizing Crime, Abuse and Neglect Types of Abuse – Pages 11 – 13

10  Human bite marks  Unexplained internal injuries  Fracture to ribs, skull, arms and leg bones  Burns shaped like an object  Bruises in various stages of healing  Bilateral bruises  Extreme changes in behavior Indicators of Physical Abuse Pages 11 – 12

11 Indicators of Sexual Abuse Pages 11 – 12  Torn or stained clothing  Difficulty walking or sitting  Vaginal or rectal bleeding  Bruising in genital area or inner thighs  Incontinence  Extreme changes in behavior  Unexplained gifts from caregiver  Frequent bathing

12  Patient on patient abuse  Dehydration or malnutrition  Outdated/unmarked medications  Decubiti (bedsores), skin rashes, lice  Evidence of poor hygiene  Improperly dressed for weather conditions  Lacks needed dentures, eyeglasses, hearing aide, walker, wheelchair, TTY, communication board Indicators of Neglect Pages 12 – 13

13  Screaming, shouting, yelling, cursing  Threatening violence  Making discriminatory remarks  Mimicking, cruel teasing  Sexual harassment  Threatening withdrawal of food, shelter, care, clothes, possessions or necessary equipment  Using demeaning labels  Intimidating gestures Indicators of Emotional Abuse Page 13

14  Distrust of others  Emotional outbursts  Obsess, worry, anxious  Low self-esteem  Sudden loss of appetite  Fear of caregiver  Self-injurious behavior  Stress-related illness  Incontinent  Refuse assistance  Deteriorate physically Behavioral Indicators (Victim)

15  Fear of dark, isolation  Cry easily, frequently  Emotionally withdrawn  Startled responses  Feel hopelessness  Fearful of touch  Aggressive, disruptive  Guilt, shame, self- hate  Sexually promiscuous  Substance abuse Behavioral Indicators (Victim)

16 Structure and Role of Massachusetts Adult Protection and Human Services Agencies Structure and Role of Massachusetts Adult Protection and Human Services Agencies

17 Disabled Persons Protection Commission Disabled Persons Protection Commission  Created in 1987 as an independent state agency responsible for the investigation and remediation of instances of abuse against persons with disabilities within our Commonwealth (M.G.L.c.19C)

18 DSS Children DPPC Adults EOEA Elders DPH All Ages Child and Adult Protection Agencies Department of Social Services Disabled Persons Protection Commission Department of Public Health Executive Office of Elder Affairs

19 Adult Protective Service System Disabled Persons Protection Commission (DPPC) Department of Mental Retardation (DMR) Department of Mental Health (DMR) Massachusetts Rehabilitation Commission (MRC)

20  Operates a 24-hour Hotline,  Receives reports of suspected physical, emotional, sexual abuse, neglect and deaths of adults with disabilities  Evaluates reports to determine required response [emergency or non-emergency] and jurisdictional criteria  Provides information and referrals to callers DPPC INTAKE UNIT 24 HOUR HOTLINE

21 Disabled Persons Protection Commission State Police Detective Unit (617)

22 DPPC/SPDU Criminal Screening  District Attorney’s office notified  Designated Assistant District Attorney assigns criminal investigations to: Local Police Local Police DA’s SPDU DA’s SPDU DPPC’s SPDU DPPC’s SPDU  Human Service agency contacts notified  Civil Investigator proceeds with protective services

23 DPPC 19C Civil Investigations Conducts abuse/neglect investigations, assesses risk and recommends protective service actions DPPCDMHDMRMRC

24 DPPC Oversight Assesses victims risk, monitors civil and criminal investigation and ensures protective services are in place DPPCDMHDMRMRC

25 Reporting Abuse, Neglect and Mistreatment of Persons with Disabilities Pages 14 – 16

26 Mandated Reporters  A person, who as a result of their profession, is more likely to be aware of the abuse  Mandated Reporters are required by law to report instances of suspected abuse to the DPPC Hotline

27 Who are Mandated Reporters  Medical personnel  Medical Examiners  Social workers  Foster parents  Police Officers  Dentists  Public or private school teachers  Educational administrators  Psychologists  Guidance or family counselors  Day care workers  Employees of private agencies providing services to people with disabilities  Employees of state agencies within the Executive Office of Health and Human Services

28 What is Reportable?  The standard for reporting suspected abuse or neglect in Massachusetts is reasonable suspicion that abuse or neglect exists

29 What Makes Reporting Difficult for Victims  Unable to explain abuse due to the nature of disability  Uncomfortable sharing private, personal information  Having intense feelings of fear, shame and guilt  Dependent upon the caregiver

30 What Makes Reporting Difficult for Victims  Fearful of being blamed  Fearful of threats of further harm  Fearful of getting the caregiver in trouble  Fearful of being left without a home/family  Fearful of violating the caregiver’s orders  Fearful of rejection

31  Shocked, angered or embarrassed by information  Hearing information contrary to personal standards  Unclear of responsibility to report  Not exactly sure what abuse or neglect is  Reluctant to get involved  Fearful that reporting will exacerbate situation Reporting Difficulties - Professionals

32  Reluctant to break “Code of Silence” among employees  Fearful of being brought into legal matter  Fearful of retaliation  Fearful of alienating caregiver and losing services  Reluctant when caregiver is a colleague Reporting Difficulties - Professionals

33 Mandated Reporter Protection  Mandated Reporters are immune from civil or criminal liability as a result of making a report

34 Failure to Report  Failure to report can result in severe consequences for victims, other potential victims and Mandated Reporters  Mandated Reporters, who fail to report, are subject to a fine of up to $1,000

35 Recognizing and Reporting Abuse  Things are not always what they appear to be… sometimes we can be fooled by first impressions!  If you get that sick feeling in your stomach, and you suspect abuse or neglect, trust your feelings and address the situation immediately!

36 How to File an Abuse Report Call the DPPC 24-Hour Hotline at In Case of a Crime or an Emergency Call Local Police or 911 followed by a call to the DPPC

37 DPPC M.G.L. c. 19C Reporting Requirements  File ORAL REPORT immediately to DPPC’s 24 hour hotline at  File WRITTEN REPORT to the DPPC within 48 hours

38 Responding to Suspected Abuse Against Persons with Disabilities What TO DO What NOT TO DO Protect, Report, Preserve

39 Protect, Report, Preserve Protect, Report, Preserve REMEMBER Victims most often disclose to someone they trust IF THIS IS YOU…….…. Contain your emotions:  Stay calm and remain non-judgmental  Be supportive and ensure the individual’s safety  Explain the requirement to immediately report to DPPC or your local APS agency  Listen closely if the victim wants to talk

40 Protect, Report, Preserve Protect, Report, Preserve Do gather essential information, by asking:  What happened? - Only enough to establish that abuse or a crime has occurred  Where did it happen? - Important to know for notifying appropriate police department  When did it happen? - If within 120 hours of sexual assault, go to an emergency room for a sexual assault exam  Who is alleged abuser? – If appropriate, ask obvious questions of the alleged abuser about what happened

41 Protect, Report, Preserve Protect, Report, Preserve  Gather and document basic information on the alleged victim and alleged abuser  If possible, collect relevant logs, schedules, and correspondence etc.  Prevent loss or destruction of known evidence  Contain & control the situation  Ensure allegations are not repeated to others  Speak directly with the original source of the report  Ensure all contact with the alleged abuser/suspect is by one person

42 Protect, Report, Preserve Protect, Report, Preserve DO NOT:  Try to conduct an investigation  Re-interview the individual  Interpret or edit the information  Interrogate the alleged abuser/suspect  Involve other persons  Interview other individuals or staff  Go looking for evidence  Touch physical evidence

43 Protect, Report, Preserve File an Abuse Report Protect, Report, Preserve File an Abuse Report  In an emergency or if you suspect a crime has been committed Call 911  Report abuse and neglect to the DPPC Hotline V/TTY immediately

44 Multidisciplinary Agency Response Joint Investigations  No one person or agency possesses all of the skill, knowledge, and resources necessary to respond to the complex problems of mistreatment and abuse. Each agency brings a different perspective and different information to the table Each agency brings a different perspective and different information to the table

45 Benefits to Building Partnerships  Improved communication and coordination  Less trauma for victims and families  Improved civil and criminal investigations  Increased reporting, criminal investigations and prosecutions  Enhanced access to the criminal justice system for victims with disabilities  Institutionalized systemic improvements  Improved data collection and documentation  Common goal: Increased protection for victims with disabilities

46 The Partners In Protection VICTIMS TOWN SELECTMEN What Went Wrong A System Failure DPPC NEIGHBORS LOCAL POLICE BUSINESS OWNERS DMR FAMILY BOARD OF HEALTH STATE POLICE SOCIAL SECURITY VICTIMS DPPC LOCAL POLICE STATE POLICE FORENSIC INTERVIEWER SANE VICTIM WITNESS ADVOCATE COURTS MRC DMH DMR DISTRICT ATTORNEY


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