This is a solution of Safeguarding in Health and Social care Assignment, prepared after a research on effects of abusing of mental health

TASK 1: Article Review

Q1: Why particular individuals and groups may be vulnerable to abuse and/or harm to self and others

As per the case study, people who depend on others, particularly elder people are targeted by abusers the most since they are not able to stop someone else from hurting them or taking their advantage. Elderly lady couldn’t also do anything when she was being abused due to her powerlessness and dependency. But can dependant people be abused mentally or physically only? The next section of the answer explains it.

Many times, people learn to abuse others from their families or parents, in particular. They may have been abused themselves by their parents or seen their parents abusing someone else. Hence, the feeling stays in the mind and abuse becomes common condition for such people.

As per department of health, adults vulnerable to abuse are defined as the people who are either of 18 years or over, and who may in need of community care services by reason of mental or physical disability, age or illness or may be unable to take care of themselves against the harm or abuse. Vulnerable adults include people as victims of domestic violence, homeless people, drug addicts, or prostitutes (Michaud, 2007). People including those who have undergone traumatic pressure are also vulnerable to various kinds of abuses. Individuals and groups are vulnerable to such abuses due to many factors. These factors include learning disability, physical disability, sight or hearing loss, severe illness, mental health problems, old age and frailty. Individuals or groups considered weak by people are the key target of abusers.

People who are abused either verbally, sexually, physically or in any other way react differently to situations. In the case scenario of an elderly lady being abused by her care take, lady felt blamed and afraid the most. Other characteristics of such people are anxious, guilty, unworthy, undeserving, inadequate and incompetent (McArdle, 2008).

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Q2. Review of the risk factors associated with the incidence of abuse and harm to self and others

There are many types of abuses that can make the victim feel guilty and afraid. These abuses include physical, emotional, verbal, sexual, financial, neglect or any other kind of emotional abuse. These are represented below in a diagram:

In the case study, abuser targeted an elderly lady who was in distress due to a rare debilitating neurodegenerative disease and dependant on her care taker for help. Although there are no exact reasons that can lead to abuse or self-harm but experts feel there are multiple factors that places a person at high risk of abuse. These factors are usually called ‘Risk factors’. As per (Namie, 2000), risk factors are defined as the characteristics of individuals that increase the chances of worse results in future. When coupled with limited protective factors, it increases the probability of people experiencing abuse. Main risk factors of abuse include dependency, family conflict, career stress and other psychological problems. In the case study, the risk factors that led to abuse of elderly lady were dependency and her disease.

Risk factors associated with the incidences of abuse and self-harm are broadly classified into three categories. These are individual person factors, family factors and social or environmental factors. The individual risk factors include any kind of disability (physical/ cognitive/emotional), any physical or mental disorder, aggressive behaviour, temperaments and attention deficits. The family risk factors include abuse by family, involvement in criminal behaviour, family violence or regular conflicts, history of neglect, high family stress, poor interaction with family members, separation or divorce, low self-esteem and use of corporal punishment. The social or environmental risk factors include socio-economic disadvantage, unemployment, social isolation, inadequate housing, homelessness, lack of access to social support, discrimination or racism and stressful life events. Normally, elderly people suffer from abuse due to their dependency and illnesses (Donald, 2010). Dependency or disorders hinders the person from getting rid of abusive situations and take any action against it. In such cases, the dependant feels trapped and powerless due to fear and frustration.  In the situation described in The Daily Mail, an elderly woman suffers abuse at the hands of a caretaker on whom the lady the dependant for help. She couldn’t take action against her due to her helplessness.

These risk factors lead to different kinds of abuses and self-harm. Understanding of these risk factors is crucial to help professionals working to mitigate such abuses to look for ways to curb them and help the victims to cope with the abuses.

Conclusions

The causes of abuse are both complex and concealed. There are although not many causes of abuse but experts feel that two or three factors can place a person at the verge of high abuse. Key causes of abuse are carer stress, dependency on others, family conflicts, addictive behaviour and psychological problems.  As per the case study, dependency is one of the key risk factors. People dependant on others for their livelihood or well-being can suffer abuse at the hands of their caretakers. The abusers can include family members, volunteers, staff at hospitals etc. The people dependant on others feels trapped or powerless which hinders the person to save him from abusive situations. The perpetrators can be dependent on the victims for their physical, psychological and financial needs (Donald, 2010).

Other risk factors are:

Family conflicts: One of the major risk factor associated to abuse or self-harm is family conflict. For instance, a child being subjected to abuse all his life may repeat the same situation on the dependent parent. In such cases, the abuse becomes normal and passed on from generation to generation.

Isolation: The client may be socially isolated and lacks support from society. In such cases, the level of abuse is high. The factors increasing the probability of abuse are physical isolation, social isolation, and emotional isolation, absence of adequate of the support or relief.

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Psychological conditions: In most cases, the mental health of the abuser is the major contributing factor to abuse others. Abuses are common in condition when perpetrator has long history of mental illness, difficulty in controlling anger and suffers from low self-esteem.

These are some of the risk factors leading to abuse and self-harm. These risk factors are crucial to understand by the professionals to look for ways to mitigate the abuses.

TASK 2: Case Study

CASE SCENARIOS

To handle a patient with previous history of physical/verbal abuse towards staff member, a mental health nurse must first take the patient to a calm and quiet environment. Calm and peaceful environment helps a person to become positive towards various things and change his perspectives. It will help the nurse in giving medications to the patient calmly. Additionally, nurse must remove all the harmful objects from the room which can be used by the patient to harm him. During such situations, the best method to give medications is by showing sympathetic concern and support towards patient (Rodriguez, 2000).

If a child with autism who faces problems to communicate with others claims that others are bullying him then a school nurse must show supportive towards him. At this point of time, child particularly needs support and sympathy. Besides this, school nurse can encourage the child to talk about what happened. It helps to let the student know that someone is concerned for him. School nurse must always the procedures for reporting and addressing the bullying behaviour.

If a teenager aged 15 tells you about the sexual abuse then social worker must show concern towards him to let teenager know that someone care for him. At this point of time, teenager needs support so that he can tell social worker everything about what all happened. Additionally, social worker can create an environment for him where he feels safe. Responding in a supportive and sensitive manner is crucial during such situation (Rodriguez, 2000).

If a woman who is a victim of domestic abuse by her husband reports this to a social worker then responding in a sensitively and supportively is crucial. It is important to encourage her to talk about her problems so that social worker can take necessary measures to help her. They can create a safer environment for her so that she feels someone understands and care for her (Bancroft, 2002). Social worker can offer her the help to find resources in the community for protection, advocacy and support. Finally, it is very report the abuse to report authorities like police to take strict actions.

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Q3. Minimising abuse with reference to existing working practices and strategies health care professionals employ, and the effectiveness of the suggested policies and practices

Abuses can have negative impacts on the lives of people and the severity of the negative impacts depends on several factors such as how much the victim has been abused, how well the victim is associated with the abuser and what are the actions of the friends and family to dismiss those abuses. Survivors of the abuse can result in difficult experiences to maintain relationships at personal and professional front (Shaw, 2008). In the case study, abused elderly lady lost trust in people and it became hard for her to accept her helplessness. Here are two different scenarios discussed where victims have been abused at different places and different conditions. Also, the working policies and strategies meant to minimize the effects of abuses have been evaluated.

The first scenario taken here is of an autistic kid who claims of being bullied by other kids in class. Generally, autistic kids are common target of bullying due to their inability to communicate their thoughts and feelings with other people (Rodriguez, 2000). They find it difficult to understand the facial expressions and body language of others. Since child abuse is increasing day by day so there is high need to minimize the abuse by taking certain steps and measures. The working practices and strategies that can be used to minimize such abuses are:

• Following the school procedures to report and address bullying behaviour
• Encouraging the bullied student to talk about what happened in detail. It helps the student to know you believe them and are supportive.
• You can use writing or drawing methods to help students verbalize about the bullying student.
• Reassuring the student that reporting the conditions is not tattling on another student.

The second scenario discussed here is handling a patient with previous verbal/physical abuse. Normally, such patients get frustrated or angry soon and even create problems for the mental health nurses in taking food and medications. Hence, they have to be handled sensitively and supportively so that they don’t harm themselves or other people in the hospital (Rodriguez, 2000). Close monitoring is required and constant observation of patients is required by a trained sitter. Some of the effective working practices and strategies for such patients are:

• Taking them to a calm, peaceful and quite environment
• Removing harmful objects from the patient’s room so that he doesn’t harm him or others
• Showing sympathetic concern towards such patients and their complaints
• Responding in a sensitive and supportive manner
• Inquiring what can be done to mitigate the cause of anger or frustrating behaviour

These working strategies help the health professionals to show complete support towards victims and provide them safer environment. Victims feel positive with the supportive response from the health professionals.

Q4. Recommendations for minimising abuse

In UK, there are about 1.2 million women who suffered from domestic abuse and about 333,000 women who were sexually assaulted (McArdle, 2008). In order to control the situation and minimize the abuse against people, particularly women, UK government has planned to protect the victims of any kind of abuse by introducing local support services and help lines. The government has re-launched a campaign named ‘This is Abuse Campaign’ with a focus on reaching young male perpetrators. Similarly, there are many other policies and legislations introduced by governments all over globe to minimize the abuses effectively. Specialized meetings are held every year where health professionals from around the world recommend steps to improve the existing working practices. As per the case study, there has to be a check on the caretakers appointed to take care of the elderly people to monitor their day to day activities.

There are numerous working practices and strategies but these can be effectively improved to minimize different kind of abuses happening to people. Hence, health care professionals take numerous steps like following the proper procedures to report the abuses and encouraging such students to talk about what happened in detail. Besides these steps, some of the recommendations are:

• Conducting respite care programs for autistic kids
• Parent education programs and support groups for autistic kids
• Conducting public awareness programs to inform citizens how and where to report the bullying
• Public  service announcements on TV or radio to encourage people about treating kids properly
• Adding skill based curricula in the learning for children

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The second case evaluated is handling the person with previous history of verbal and physical abuse. Such people are vulnerable to abuses since they are dependent on others for their day to day activities. As per (Welsh, 2008), when they are victimized to different kind of abuses, such people become powerless and trapped to hinder the abuse against them. Health professionals adopt different strategies to mitigate the abuses and handle such people properly like showing sympathetic concern and support towards such patients and their complaints. Besides these steps, some of the recommendations are:

• Conduct rehabilitation programs for victims of abuse to give them peaceful and quite environment
• Engaging those people in different activities like drawing or writing to divert their attention towards other things
• By providing them supportive and encouraging environment through seminars and workshops
• Conducting events where health professionals listen to victims of different abuses

These are some of the recommendations that can help already existing working practices and strategies to help the victims recover faster and lead a healthy life (Michaud, 2007).

CONCLUSION

To conclude, it is indeed crucial to take necessary steps to minimize different kinds of abuses. A person can turn abuser due to numerous factors but it adversely affects the person getting abused. In the case study, the victim is traumatized by abusing elderly lady mentally. Figures suggest that the elderly or dependant is abused increasingly in countries since they are dependent on others for their day to day activities. It makes them powerless and trapped and stops them from acting against the abuse done on them. Hence, there are many working practices and strategies recommended by health professionals that are constantly followed to reduce the trauma of the victims and help them recover faster.

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REFERENCES

Bancroft, L. (2002). “Why does he do that? Inside the minds of angry and controlling men.” Berkley Books, pp. 56 Donald, C. (2010). “Psychology: The Science of Behaviour.” Pearson Canada Inc., pp. 572. Michaud, P. (2007). "Alcohol misuse in adolescents – a challenge for general practitioners.” TherUmsch 64 (2), pp. 476 McArdle, P. (2008). "Alcohol abuse in adolescents.” British Medical Journal 93 (6), pp. 56-58

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