The abuse of adults must be addressed in the same way as for children to offer help where needed but also respecting individual autonomy, writes Colette Kelleher.
For some, abuse and neglect are unfortunately every day and ordinary.
Abuse comes in many forms and from many quarters — €50 pinched from the weekly pension, extra pills in the daily dose, chemical restraint to keep a person quiet. A fist to the face in the place of words.
Some of those who are abused have no voice of their own, and no one to voice their concerns. Some are physically unable to reach out for help, while others lack the capacity to do so.
A recent Red C poll, commissioned by the National Safeguarding Committee, found that one in three people believe that the abuse of vulnerable adults is widespread.
Some 80% of people are unclear about what constitutes psychological or financial abuse. This week the National Safeguarding Committee is kicking-off a national awareness campaign focussing on these issues.
While we don’t have comprehensive statistics on abuse and neglect, the data that we have paints a very bleak picture. Last year, the HSE received nearly 8,000 reports of adult abuse.
The National Study of Elder Abuse and Neglect from 2010 estimated that 10,000 older people are mistreated or neglected each year — with 6,000 cases of financial abuse.
The study also showed that, for many of the people who were financially abused, their only income was the state pension. Given that the State pays over €7bn in pension payments and over €3bn in illness, disability, and carers payments, the scale of financial abuse is potentially huge.
We know from international studies that people with dementia are particularly prone to abuse in the community with rates as high as 55%.
To begin to right this wrong, I introduced the Adult Safeguarding Bill 2017 in the Seanad in April. The goal of the bill is to put in place additional protections and supports for adults, in particular for those who may be unable to protect themselves. It can be thought of as Children First legislation for adults.
This, in many ways, is a green field site piece of legislation that if passed will become an important piece of architecture in our legislation of care.
The provisions of the bill are relevant to us all, because at some point in all of our lives, we may be the ones being harmed or abused.
It establishes the National Adult Safeguarding Authority which will be responsible for adequately investigating allegations of abuse, appointing independent advocates, running a national helpline, directing supports where needed, as well as seeking to prevent such cases through education, promotion, and standard setting.
This body will be independent and at arm’s length.
It requires reporting by certain professionals and others when they become aware that an adult has or is suffering abuse or harm, or is at risk of it.
The bill also provides a clear definition of adult abuse and neglect. The aim is to create a culture where we all recognise abuse and have zero tolerance for it.
It sets out clear pathways for action so that no one can say that they didn’t know what to do. This should act as a deterrent with sanctions for those who fail to act.
This is needed because the status quo isn’t working. In 2014, RTÉ’s Prime Time Investigates programme exposed high levels of abuse of adults in Áras Attracta in Swinford, Co Mayo.
The investigation heightened awareness of abuse nationally and clarified the need for comprehensive action and legislative reform. What followed were a set of guidelines that didn’t go far enough.
Staff working in the frontline as social workers or protection officers don’t have the powers they need or the legislative back-up to match the responsibilities they are given.
At present, there are also clear conflicts of interest. The HSE has too many roles. It acts as the commissioner, funder, and provider of services, as well as policer and protector. People with concerns often have nowhere to turn, often resorting to the Oireachtas Public Accounts Committee as whistleblowers.
The ‘Grace’ case exposed in recent months highlights more than ever why we need urgent action.
The Adult Safeguarding Bill has support from people with intellectual disabilities and dementia themselves, as well as cross-party support in the Seanad and from bodies such as the Irish Association of Social Workers, the National Safeguarding Committee, Hiqa, and Inclusion Ireland.
The Citizens’ Assembly is currently examining the opportunities and challenges of aging. In a submission, I called on them to recommend statutory safeguarding for adults.
Progressing and enacting this legislation will ensure that we make good on our commitment to Article 16 of the UN Convention on the Rights of Peoples with Disabilities.
Some critics might say that this bill sounds like a ‘nanny state’ instrument. In fact, it is the opposite.
It strikes a balance between the right to autonomy and the right to protection from harm. The principles it is built on include:
In light of the evidence regarding the significant levels of adult abuse, there is a clear need for statutory safeguarding. I believe this bill should be supported and progressed as a matter of urgency and not languish in the legislative ‘long grass’.
It must be priority for Taoiseach Leo Varadkar’s new cabinet to close this gap in social policy and make the world a safer place for adults experiencing abuse.
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