Tjenestetilbudet til voldsutsatte personer med nedsatt funksjonsevne. En studie på oppdrag fra Barne-, ungdoms- og familiedirektoratet
Abstract
The Norwegian Directorate for Children, Youth and Family Affairs commissioned NOVA to do this study. The purpose of the study is to provide improved and updated knowledge about services to people with disabilities who are victims of violence and abuse in their close relationships. The main topic is whether services are suited for disabled victims of violence and abuse, and if there is a gap between their needs and the services offered. The study also provides information about the characteristics of people with disabilities who have been in a shelter, and new insight into factors that may preclude them from seeking assistance. We used multiple approaches to collect data: Semi-structured interviews were conducted with victims of violence and abuse, employees in municipalities, staff at incest and sexual abuse centers, assault centers, and the police. We carried out a nationwide survey in local communities and crises centers. We also analyzed available statistics about crisis center clients for the years 2009-2012.The main conclusions of the study are that services provided to disabled victims of violence and abuse have major shortcomings, and that very little seems to have improved in later years. Recommendations from a previous study were for example; to give staff guidance in order to raise their awareness and level of competence, organizational measures to coordinate services or clarify the division of responsibility between service areas. The CrisisCentre Act, effective from 01.01.10, states that municipalities are responsible for providing crisis center services to men, women and children subjected to domestic violence. The act does not seem to have led to major changes in services either. We expected that online information to victims of violence would have been adapted to make it available to people with different types of disabilities. Our results show that this type of distribution of information is inadequate or non-existent. The study has provided insight into people’s experience of violence and abuse that arise within the public service system’s structural framework. Research indicates that people with disabilities are at greater risk of being victims of violence and abuse, compared to people in general. Factors that pose risks are related to their dependence on assistance from others. Important risk factors are the way housing for disabled people is organized, lack of procedures and guidelines for the prevention of violence, and follow-up of reported incidents. Our study exemplifies how lack of registration and monitoring procedures in the service system affect victims of violence assessment of whether or not to report violence they experience. Consequences of such deficiencies are that victims of abuse and violence fear that they will not be believed, that they will be perceived as difficult, and that reporting such incidences can have negative consequences for future municipal services. Statistics about disabled persons at crisis centers The percentage of people with disabilities who used crisis centers remained relatively stable, about 6-7 per cent, in the years 2009–2012. There were fewer people with disabilities and an immigrant background compared to those without an immigrant background (4 and 12 percent respectively). There was an increase of men in crises centers, including men with disabilities, while the proportion of women with disabilities decreased over the same period. The most used category to describe the type of disability is “other disability”, which in most cases implies musculoskeletal disorders and psychological difficulties. The second most used category is “limited mobility”. Disabled persons who use crisis centers are more often than others reported to have been in a violent relationship for five years or longer. In average, they are also older than other users. Those who have been in long-lasting violent relationships, had more often than others experienced both physical and psychological harm. The majority of all people who use crisis centers report that the offender is their current or former spouse / partner. There is a tendency that disabled people more frequently than others report that the offender is their son or daughter. Shelter services for persons with disabilities The number of crises centers with accommodations for people with limited mobility has increased. While 18 out of 50 centers reported they had such accommodations in 2007, by 2013 the numbers had risen to 32 out of 47 centers. However, of these 32 centers only seven qualify to be accessible to all. The majority of centers have websites, but few use inclusive design technology. In general, the centers do not give information about the buildings’ physical accessibility. The general impression is that staff goes to great lengths to help everybody who seek their help, even though the lack of accessibility is challenging. One aspect was considered particularly unfortunate, and was related to security, especially fire and break-ins, when evacuation could be necessary. Although the staff are positive to teaching and informing about violence against disabled people to municipal employees, they experienced that their qualifications were not in demand. Municipal / Local authorities and services for disabled people The nationwide survey and interviews with representatives from 16 municipalities showed that there is little focus on, and knowledge about services for disabled victims of violence. The municipalities have little knowledge about the accommodations at the crises centers. Although the municipalities are responsible for ensuring that the centers are accessible to all victims of violence, only a very few included the requirement of Universal Design in their contract with the centers. The centers are not always able to provide services to people with complex needs for assistance. The results show that 40 percent of municipalities do not have, or know if they have alternative safe shelters. Few municipalities have designed their information material according to the principles of Universal Design. Most say that disabled victims of violence will receive information after they have reported an incidence. The study shows that very few municipalities educate their staff about violence and abuse against vulnerable groups systematically. Almost none of the municipalities in the interview study said they had established procedures for how to follow-up cases of violence and abuse after they were exposed. The local authorities did not have written procedures about how to cooperate in cases where people with disabilities have been victims of violence. One reason they gave was that they had a good overview of the municipality's population and those who could be in a particularly vulnerable situation. They were confident that this "transparency" meant that violence and abuse against persons with disabilities would be discovered. Services provided by centers for victims of incest and sexual abuse, violence and sexual assault centers, and police Neither the centers nor the police keep records or statistics on victims of violence and abuse that have disabilities. The interviews revealed that they have limited experience with people with disabilities, particularly with persons with physical and sensory impairments. All agencies report that they have more experience with people with dementia, intellectual disabilities, and mental health and emotional disabilities. In general, there was little focus on the specific situation of people with disabilities, in regards to quidance of staff or development of services. There was a widespread assumption that people with disabilities do not have needs that require special expertise or facilitation beyond that all victims of violence need. Regarding cooperation with local authorities, a general view was that closer collaboration between the different services and the municipality is necessary. Recommendations The study shows that there still is great need to improve services for victims of violence who have disabilities. First, the municipalities have to fulfill their responsibility to ensure that their shelter services are accessible to all inhabitants, that the services and their content meet professional requirements and that the given information is available to everyone. Municipalities must also be able to offer acceptable alternatives to those who cannot use the crises centers. This means that municipalities must follow-up the responsibility they have towards all inhabitants in their community. Victims of violence with disabilities may need services from different agencies and according to various laws. This requires that the employees have referral skills and knowledge about the other public services. How municipalities choose to address such challenges may vary. Establishing procedures for cooperation or using coordinating units, may be relevant solutions. Establishing cooperative relations and routines could help address the challenges other agencies have with the municipalities when the users of their services have disabilities. Service practitioners in the community, whether they work in home care, in institutional or residential settings, must receive training and guidance regarding the ethical guidelines of their work. They should know what to be aware of in order to detect violence and abuse. They should also know how to respond when violence or abuse is detected. Management in the various units should anchor the guidance and training organizationally. The shelters have broad expertise about violence. Many of the employees do have experience from working with people with disabilities in other settings or with users of shelters that have disabilities. The shelters can be of use in the informational and educational efforts to raise municipal employees’ knowledge about violence and abuse against vulnerable groups. Furthermore, we recommend that municipalities, shelters and other agencies involve victims with disabilities in their work, both to improve their own competency and to find good models for cooperation. Otherwise, we recommend making updated information about available services that addresses the topic “Disabled people and violence in close relationships”. The information should include information about centers, how to reach them, their services and accessibility. The information should be available, both online and in printed versions, in formats that are suited for people with different types of disabilities. På oppdrag fra Bufdir har NOVA gjennomført en studie om tjenestetilbudet til voldsutsatte med funksjonsnedsettelser. Hovedkonklusjonen er at det er lite bevissthet om dette temaet i ulike hjelpeinstanser. Studien viser at det er store forbedringspotensialer i alle tjenestetilbudene når det gjelder tiltak for å forebygge og oppdage vold, og for å følge opp de som blir utsatt for vold. Tiltak som vil kunne avhjelpe situasjonen, er veiledning av ansatte for å heve bevissthets- og kompetansenivået, samt organisatoriske tiltak som etablering av prosedyrer for hva man skal gjøre for å forebygge vold og følge opp voldsutsatte. Det er også behov for etablering av samarbeidsrutiner mellom ulike tjenesteutøvere.