Standards of care: vital to safeguarding the rights of disabled people
(* This article is co-authored with Charles O’Mahony, PhD fellow, Centre for Disability Law and Policy, NUI Galway)
According to an article in the Irish Times today, more than 500 official complaints (approx three a week) over the past two and a half years have been made regarding abuse and mistreatment of disabled people in residential settings. The most serious incidents included allegations of abuse or physical assault by a staff member at a number of residential centres.
Currently Ireland has no mandatory standards or independent inspections for assessing care provided by residential services to disabled people. Health Research Board statistics for 2008 show that there are more than 8,000 adults with an intellectual disability in receipt of full-time residential services. The majority of these services are provided through voluntary service providers at an approximate cost of €1.5bn to the Irish government. Despite this volume of state funding, these services remain uninspected and unregulated.
Disability advocates such as Inclusion Ireland have been petitioning for standards and an independent inspection for residential services for over a decade. As part of the 2010 budget announcements, standards were introduced on a ‘voluntary basis’ due to the pressure on public finances. The Irish Times article quotes that ‘officials privately say it would of cost between €5 million and €10 million’.
Article 16(1) of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) (2006) requires the state to ‘take all appropriate legislative, administrative, social, educational and other measures to protect persons with disabilities, both within and outside the home, from all forms of exploitation, violence and abuse, including their gender-based aspects.’ 16(3) of the Convention provides ‘[i]n order to prevent the occurrence of all forms of exploitation, violence and abuse, States Parties shall ensure that all facilities and programmes designed to serve persons with disabilities are effectively monitored by independent authorities.’ The lack of independently monitored facilities’ and programmes preventing the perpetration of abuse and violence against persons with disabilities means that the state is not complying with the standards set out in the UNCRPD, of which Ireland is a signatory. There is a legal and moral urgency in challenging abuse and violence perpetrated against persons with disabilities. The scandal of abuse in other contexts demonstrates the danger in failing to protect vulnerable persons from abuse and exploitation. A system of voluntary standards (despite the best intentions of service providers) leaves the state open to legal liability for abuse perpetrated. (Potentially amounting to more than the funding required to enforce the appropriate standards.)
There is a significant research gap in Ireland in relation to the prevalence of abuse perpetrated against persons with disabilities. The NDA is aiming to fill this gap and last year called for tenders to establish a methodology for a national study on the experiences of people with disabilities of physical, financial, sexual or emotional abuse or neglect. The difficulties in defining and disclosing abuse, the reliability of existing reports and records of abuse and the invisibility of people with disabilities within the available mainstream data make research on this topic difficult according to the Council of Europe. (See Council of Europe 2003)
The debate about standards in disability services is not a new one, yet it remains a low priority for our government. Recent reports showing abuse of vulnerable people, (Ryan Report, Murphy Report & Leas Cross Review) send warning signals to policy makers and legislators that those most vulnerable, those living in closed spaces away from public scrutiny should be adequately safeguarded. This Report in the Irish Times is also not surprising as there is a substantial body of research on the abuse of persons with disabilities. There is evidence that suggests that children with disabilities are at an increased risk of abuse when compared to non-disabled children. Another leading American study indicated that children with disabilities are at greater risk of sexual and physical abuse and neglect when compared to non-disabled children. A considerable amount of research indicates that people with disabilities are at increased risk of different forms of abuse. Much of the research has focused on abuse of women with disabilities indicating that women with disabilities experience higher rates of abuse than non-disabled women and men with disabilities. The research indicates that women are vulnerable to sexual and emotional abuse by health care workers and personal care attendants, in addition to husbands and partners. The research has not explored abuse against men to the same extent, and it has been suggested that the rates of abuse may be much higher than perceived.
 Temkin (1994) “Disability, Child Abuse and Criminal Justice” 57 Modern Law Review 402-418.
 Sullivan, Knutson, Scanlan, & Cork (1997) “Maltreatment of Children with Disabilities: Family risk factors and prevention implications” Journal of Child Centred Practice, 4 (1): 33-46.
 Sobsey, & Doe (1991) “Patterns of sexual abuse and assault” Journal of Sexuality and Disability, 9, 243-259.
 Goldson (1997) “Commentary: Gender, disability, and abuse” Child Abuse & Neglect, 21(8), 703-705.
 Saxton, Powers, McNeff, & Curry (2004) Violence against men with disabilities (Portland, OR: Oregon Health & Science University Center on Self- Determination).