Vern av risikoutsatte voksne. Kommunenes varslingssystemer for avdekking av vold og overgrep
Abstract
This report concerns the municipalities' work against violence and abuse against vulnerable adults. NOVA prepared this report as commissioned by The Norwegian Directorate for Children, Youth and Family Affairs (Bufdir). The overarching theme of the report is how the municipalities are working to deal with violence and abuse against vulnerable adults when such cases are disclosed or suspected, and how this work is organized. In the report we provide an overview of the tools used by municipalities when disclosing or suspecting violence, abuse or neglect. Bufdir has developed guidelines on sexual abuse of adults with intellectual disability, a guide to the guidelines, and a website with information about the material. The report also presents the experiences of the municipalities that are familiar with and have adopted this material. We conducted telephone interviews with a random sample of 100 municipalities, with a geographical and quantity representative spread. Extended interviews were done with 20 municipalities that had experiences with the materials developed by Bufdir. Based on the data, the following research questions were posed: How do the municipalities organize their work to safeguard adults at risk of abuse and neglect? Do they have a working system in the form of action plans and procedures for notification and reporting when such issues arise? What kind of tools are municipalities using to handle violence and abuse against adults at risk? Which vulnerable groups and forms of violence and abuse are covered by the plans and procedures, and which need more attention? Are the municipalities familiar with the guidelines regarding sexual abuse of adults with intellectual disability, the guide to these guidelines, as well as the website “vernmotovergrep.no”? Have the guidelines been adopted? Moreover, what are the experiences of the municipalities that have put this material to use? One third of the municipalities have notification and reporting systems Work against violence and abuse against vulnerable adults and how such matters are discovered and handled varies from one municipality to another. The study shows that nearly half of the municipalities have action plans against domestic violence in general, while just under one quarter have action plans against domestic violence for adults at risk. A main finding is that one third of the municipalities have notification and reporting procedures that specifically target high-risk adults. 13 municipalities have notification and reporting procedures that are more general, they do not specify vulnerable group or form of violence. More than half of the municipalities have no notification and reporting systems. The findings of this study indicates that the work these municipalities do is arbitrary and related to when actual cases occur. We find that municipalities with notification and reporting systems that specifically target adults at risk are often large and medium-sized municipalities where shelters are located in the same municipality. This may indicate that municipalities that host shelters have better access to resources such as expertise, and that larger municipalities tend to have more specialized positions that make it easier to develop and implement tools and systems. The study indicates that although a municipality may have warning and reporting systems it is not a given that the system is established and used. The work on implementation of routines seem somewhat variable from one municipality to another, and tools appear in some cases as "dead documents". Most of the municipalities reported, however, that the procedures are well known on both management and service level. However, they are often introduced in only one line of service, and as such are not holistic systems. Tools for certain forms of violence and certain vylnerable adults The study indicates that the tools used mostly covers sexual offenses committed against the disabled. The tool that most municipalities employ is "Guidelines. Cases involving sexual abuse of adults with learning disabilities." Other than this, the municipalities mostly develop their own tools. We find few tools involving people with mental illness and people with substance abuse problems. Furthermore, financial abuse and neglect are both forms of violence that most notification and reporting systems and tools seem to exclude. A main conclusion of the study is that notification and reporting tools that target other forms of violence than sexual abuse are lacking. Moreover, they seldom target other groups at risk than those with learning disabilities. There is a need for more focus, knowledge and tools related to multiple forms of violence and several groups of adults at risk to ensure equal and legal protection. Tools may increase disclosure Municipalities that have experiences with the Bufdir material are very pleased with it. Only a few municipalities have taken advantage of the website «vernmotovergrep.no", and it is mostly known at management level. Of municipalities that have adopted the guidelines, we find that it is largely known to both manage and service level. The main impression is that the tool provides security when situations arise. The recommended handling is perceived as correct, and to be of good help. Municipalities that have used the tool in specific cases, points out that several cases are reported to the police and that several forms of abuse has been uncovered as a result of the introduction of the guidelines. Tools like "Guidelines. Cases involving sexual abuse of adults with intellectual disabilities" may be a driving force in raising the quality of services in the municipalities, ensuring that adults at risk are safeguarded in a good way and protecting their rights. A procedure for handling the disclosure of violence or abuse is, however, of little worth if it is not implemented well in the services rendered. Nor is it of much use if the services lack expertise and knowledge on how to recognize and detect violence and abuse. Recommendations Based on the results that emerge in the study we give some recommendations. We recommend the development of a more comprehensive tool for handling violence and abuse cases, involving multiple forms of violence, abuse and neglect, as well as several groups of at-risk adults. Knowledge and skills are prerequisites to be able to disclose violence and abuse. We therefore recommend that both service providers and managers receive adequate training in the use of these tools, and to develop comprehensive implementation strategies. Equally important is knowledge on violence and abuse against adults at risk, including knowledge of the different expressions violence may take. Municipalities should furthermore make use of shelters and RVTSs to build up expertise on violence and abuse in their services. Our last recommendation is for each municipality to establish a system to ensure that all services have notification and reporting procedures so that the individual service provider know how she / he will handle a situation when it arises. The routines that the system are based on should also be revised regularly to ensure they are based on new knowledge and current legislation. Furthermore, the system should involve instruction routines for new appointees, as well as for the notification and reporting procedures. To uphold knowledge about violence and abuse against adults at risk the municipalities ought to give the topic attention on regularly yearly basis. Eldre, psykisk syke og rusmisbrukere samt personer med fysisk funksjonsnedsettelse eller utviklingshemming har økt risiko for å bli utsatt for omsorgssvikt, fysisk, psykisk, seksuell eller økonomisk vold. Når vold mistenkes eller oppdages av ansatte i kommunale eller statlige hjelpetjenester, kan det å ha prosedyrer for hvordan man skal håndtere situasjonen, være avgjørende for et godt videre forløp i saken. I studien av hvordan 100 norske kommuner arbeider for å verne risikoutsatte voksne mot vold og overgrep, finner forskerne ved NOVA at 35 prosent av kommunene har varslingssystemer for avdekking av vold og overgrep, og at disse stort sett omhandler seksuelle overgrep mot utviklingshemmede. Et annet hovedfunn er at kommuner som har innført slike systemer, har økt avdekkingen av vold og overgrep mot gruppen.