Abuse and neglect of people in institutional and residential settings

A Senate inquiry has issued a report into violence, abuse and neglect towards people with a disability in institutions and in-home care.


In the executive summary to the long titled report, Violence, abuse and neglect against people with disability in institutional and residential settings, including the gender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people with disability, and culturally and linguistically diverse people with disability, the report said:


The committee finds that violence, abuse and neglect of people with disability is both widespread and takes many forms. This inquiry has not shied away from the fact that the causes, the impacts and the solutions to this issue are complex and there is no easy fix. As one submitter wrote, these issues make people feel uncomfortable and most would prefer to take the easy option and pretend that nothing is wrong. But the reality is far different - the situation for people with disability is unacceptable.


Throughout this inquiry, the evidence presented from people with disability, their families and advocates, showed that a root cause of violence, abuse and neglect of people with disability begins with the de-valuing of people with disability. This devaluing permeates the attitudes of individual disability workers, service delivery organisations and most disturbingly, government systems designed to protect the rights of individuals.


This de-valuing takes many forms. People with disability are often communicated about, not communicated to and are frequently denied the right to make the most basic of decisions about their lives. They miss out ... often though a patronising prism of 'protection.' Their choices about day to day living are taken away: sometimes in more benign ways by people trying to 'help', sometimes by service providers in the guise of efficiency, but all too often by people exerting malicious control.


In many cases people with disability have their legal capacity taken away, the very status in law that defines the rights of individuals. From this legal disregard of them as a person in their own right can flow serious and far-reaching repercussions. They lose the right to make decisions about their life, where they live, who they live with, what they eat, who they can see, and even decisions about their own bodies.


Under the guise of 'therapeutic treatment', people with disability can be subjected to forcible actions that could be considered assault in any other context. They are often detained arbitrarily and indefinitely, sometimes being held in prisons without being convicted of any offence.


This inquiry heard highly distressing personal accounts from many people with disability. The inquiry also heard from dedicated family members and advocates speaking on behalf of loved ones, some of whom died as a result of violence or neglect. Much of the evidence was received in camera, largely due to the personal nature of the evidence, but in some cases because of the possibility of repercussions for speaking out.


Witnesses told of their fear of speaking out about abusers who had continued daily access to their homes as disability service workers. Evidence was also presented that showed a propensity for reports to service providers about violence and abuse to be ignored, swept under the carpet or treated as a 'workplace issue' rather than a crime.


In fixing the disability service sector, and the legal frameworks that should protect all people regardless of disability status, people with disability must be put at the centre. This entails going beyond considering the rights of people with disability, it means putting people with disability at the centre of decision making not just in their own lives, but also in amending policies and laws.


The Senate Committee's report contained recommendations which included:

10.10 The committee recommends that a Royal Commission into violence, abuse and neglect of people with disability be called, with terms of reference to be determined in consultation with people with disability, their families and supporters, and disability organisations.


10.16 The committee recommends the Australian Government consider the establishment of a national system for reporting and investigating and eliminating violence, abuse and neglect of people with a disability...


10.29 The committee recommends the Australian Government consider establishing a national approach to modify state and territory and Commonwealth service delivery accreditation programs...


10.32 The committee recommends the Australian Government work with state and territory governments on the implementation of initiatives to improve access to justice for people with disability contained in the reports by the Law Reform Commission, Equality, Capacity and Disability in Commonwealth Laws...


10.41 The committee recommends that the Australian Government consider driving a nationally consistent move away from substitute decision-making towards supported decision-making models.


10.45 The committee recommends the Australian Government work with state and territory governments to create national consistency in the administration of guardianship laws to ensure:

  • public advocate and guardianship functions are separate to ensure independent oversight;

  • mandatory training on supported decision-making for guardians.

10.48 The committee recommends state and territory and Commonwealth service delivery accreditation programs should be modified to impose additional requirements for positive life outcomes [the right to risk] for individual people with disability, rather than a singular focus on the avoidance of negative outcomes.


10.52 The committee recommends all levels of government acknowledge the vital role that formal and informal advocacy plays in addressing violence, abuse and neglect of people with disability, by considering:

  • increased training for people with disability to recognise violence, abuse and neglect so they can self-report;

  • government service contracts to include provisions to enforce access to facilities for advocates, requirement for self-advocacy programs...

Read the report at http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Violence_abuse_neglect/Report


25 November 2015.