Domestic Violence and People with Disabilities

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Domestic Violence and People with Disabilities

• Jewish Women International
• With
• Nora J. Baladerian, Ph.D., BC.F.E
• May 8, 2008

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Overview of the Problem

• Domestic Violence effects people with and without
  disabilities
• Domestic Violence causes disability, particularly
  traumatic brain injuries, many of which go
  unrecognized
• Domestic Violence shelters often do not offer
  accessible shelters or services

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Who are domestic violence survivors with
disabilities?

• Adults with developmental disabilities (mental
  retardation, cerebral palsy, epilepsy, autism
  spectrum disorders (includes Aspergers) other
  neurological disabilities that began before the
  age of 22.
• Adults with ABI, acquired brain injury
• Adults with mental illnesses

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Who are domestic violence survivors with
disabilities?

• Adults with physical disabilities that inhibit
  motor movement (plegias, amputations, injuries)
• Adults with sensory disabilities
• Blind and vision impaired
• Deaf
• Hard of hearing or deaf
• Adults with medical conditions that compromise
  their independence

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How extensive is the problem of abuse of adults
with disabilities?

• There have been no national studies on the
  incidence or prevalence of abuse in the lives of
  men and women with disabilities.
• A very few studies have been conducted focusing
  on various aspects of this problem
• Baylor University in Texas adult women with
  physical disabilities
• OHSE in Oregon Adult women and men with
  developmental disabilities adult women with
  physical disabilities.

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The Domestic Violence Risk for People with
Disabilities

• Up to 85 of women with disabilities are victims
  of domestic abuse (Colorado Department of Health)
• Approximately 223,000 in NYC
• Children with Disabilities are at 4-10 times the
  risk of abuse (National Resource Center for
  Crisis Nurseries and Respite Care Centers, 1994
  Report)
• 1993 Study documented twice the rate of abuse
  among children with disabilities (National
  Resource Center on Child Abuse and Neglect)
• 2001 Study documented 3.4 times the rate of abuse
  among children with disabilities (Boystown,
  Sullivan Knutson)

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Domestic Violence Leads to Disability

• The Incidence of disabilities caused by
  maltreatment is 147 per 1,000 maltreated children
• Maltreatment related injuries contributed or led
  to disabilities for 62 of sexually abused
  children 48 of emotionally abused children and
  55 of children experiencing neglect (National
  Resource Center on Child Abuse and Neglect,
  August, 1995 Report)

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Personal Assistance Services Providers Abuse of
Women with Disabilities Project

• Oregon Health Science University
• Center on Self-Determination
• In partnership with
• World Institute on Disability
• Berkeley Planning Associates
• Laurie Powers
• Mary Ann Curry
• Mary Oschwald
• Elizabeth McNeff

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Incidence of Abuse Towards Women with
Disabilities

• In the U.S. about 20 of women experience some
  form of physical disability (U.S. Census 1992).
• Of these women, about 25 use some form of
  Personal Assistance Services (Litvak et. al.
  1987), including
• Paid or unpaid / Formal or informal
• family members, intimate partners, friends,
  strangers
• Therefore, women with disabilities have
  additional risk of abuse by people who give them
  assistance

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Incidence of Abuse Towards Women with
Disabilities (cont).

• Nosek, Young Rintala (1995) study found women
  with physical disabilities
• 62 experienced some form of abuse in their
  lifetime
• The abuse was longer lasting and more insidious,
  using the disability factors to abuse, neglect,
  verbally/emotionally abuse.
• Powers et. al. (2002) study found women with
  physical and physical and cognitive disabilities
• 67 experienced physical abuse in their lifetime
• 53 experienced sexual abuse in their lifetime

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People with Disabilities stay in Dangerous
conditions significantly longer

• 11.3 years vs. 7.1 years in situations of
  physical abuse
• 8.3 years vs. 4.1 years in situations of sexual
  abuse (Baylor University Study)

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What dont we know?
Under-reporting we know to be a problem, but we
do not know the rate of under reporting. We do
not know the of men AND women victims We do not
know all of the reasons for not reporting
abuse. We do not know the extent of abuse in the
many situations in which people with disabilities
could be chronic victims of abuse work, day
program, transportation services, medical
services, social services, in-home services,
counseling therapy, among others.
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Redefining DV for People with Disabilities
Domestic Violence usually is defined by where the
violence occurs (in the home) and by whom (a
spouse or unrelated life partner) However, as
this crime effects persons with disabilities,
this definition must be expanded to match their
actual life style. That is, to include anyone
living in the same household. Including anyone
who is providing personal care services including
medical care.
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Redefining DV (contd)
Domestic Violence would then include any living
setting gt Group homes gt Supported living gt
Congregate living (assisted living) Domestic
violence would then include any perpetrator
within the household. Staff, relatives and
friends of staff who come into the home with
their permission and even provide services to
those living there authorized service providers
such as medical, psychological, personal care,
communication, among others.
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Who are these people?
People with developmental disabilities Usually
living with their parents or in group homes or
supported living programs. Some live in larger
institutions. Others may have acquired the
disability in young adulthood through accident or
illness. Many with physical disabilities may be
connected to their local Center for Independent
Living, and even may have acquired their in-home
support person through this resource. Some may
have very recently acquired their disability and
were not aware that their care provider was
exploiting and abusing them.
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Reporting

• Most do not believe they are able to report the
  abuse, do not know to whom to report, and believe
  their situation would worsen significantly if
  they did report.
• They fear that if they try to report, there will
  be serious repercussions by the perpetrator
• Many are never left alone with another (for
  example with the physician).
• Many are not allowed to receive visitors in the
  home or to make telephone calls out.

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Who are the perpetrators?

• Most are those closest in relationship to the
  victim
• Family members, household members
• Neighbors, social circle members
• Service providers (services such as housing,
  therapy, personal attending, transportation, day
  program)
• Both men and women are identified as perpetrators

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Types of abuse

• This includes your usual list. However, because
  of the disability, additional methods of abuse
  are employed
• Withholding of SSI Checks
• Restricting access to transportation
• Withholding wheelchairs transferring services
• Refusal to assist with personal needs (toileting,
  food)
• Restricting access to friends
• Restricting access to outside the house
• Manipulation of medications

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Types of abuse

• It is relatively easy to prey on adults with
  disabilities because
• Their access for reporting maltreatment is within
  the control of the perpetrator
• Their knowledge of abuse and the abuse-response
  system is usually absent or poor
• Their understanding is that finding others to
  help them would be difficult (they are told this
  by the perpetrator and there is truth in it).
• It is likely that upon reporting their abuse, the
  report would not be taken seriously.

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LACK OF SERVICES

• Social Service System
• NOVA survey of 150 victims agency 6 interested
  in disability access
• Lack of access in shelters for victims who are
  mobility impaired
• Lack of services for victims who are hearing
  impaired
• Disability system
• Denial of Problem
• Ignorance about problem

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Reporting of DV and the response from social
services and law enforcement

• The primary barrier to effective intervention is
  negative attitudes towards persons with
  disabilities by those in a position to help.
• Our culture so values verbal fluency and correct
  vocabulary, syntax and grammar, that callers with
  communication difficulties are often ignored.

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Reporting of DV and the response from social
services and law enforcement

• If a person OTHER THAN the victim with a
  disability files the report, it is likely to
  receive proper attentionat the beginning.
• Devalue
• Dismiss
• Dehumanize
• Distance

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Reporting of DV and the response from social
services and law enforcement

• The initial response to a report should be to
  triage and response as quickly as possible,
  interviewing the victim and others in the
  household.
• HOWEVER, when the victim has a disability,
  response time may be delayed, all in the
  household are interviewed except the victim,
  those without disabilities are given more
  credibility than the victim.
• Often standard protocols are abandoned when the
  victim has a disability, such as private
  interviews, extensive interviews, note taking and
  documentation.

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Reporting of DV and the response from social
services and law enforcement

• The victim may require assistance in
  communication in the form of an interpreter or
  other specialist, a role usually played by the
  perpetrator. Although a Certified Interpreter is
  required, often the handy person with ability to
  communicate with the victim is used as an
  interpreter, nullifying the statement.
• When the victim has a mental disability such as
  mental retardation or a mental illness, the
  statement of the victim is not given the same
  importance.

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Resources

• Shelters
• Over 80 of calls for service include requests
  for shelter
• Most shelters are not in compliance with ADA,
  either for physical accessibility into or inside
  the shelter
• Most shelters do not permit service dogs
• Most shelters do not provide 24-hour interpreter
  services for Deaf, deaf or Hard of Hearing
  persons.

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Resources

• Services
• Most DV service agencies and providers are not
  yet in full compliance with the spirit or letter
  of the law of the Americans with Disabilities
  Act.
• Most do not provide all of their materials in
  accessible formats.
• Most are not familiar with how to use TDDs,
  Relay or VRS services
• Most are not attitudinally equipped nor
  knowledgeable about designing and implementing
  accessible services for DV victims.

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The Law Disability

• Americans with Disabilities Act
• Title II for State and Local Governments
• Title III for Public Accommodations
• Basically, according to the ADA, all services
  rendered to the public must be in compliance with
  the ADA, beginning July 1991.
• When was your last self-review for ADA compliance?

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Other Legal Protections

• Section 504 of the Rehabilitation Act of 1973
• Architectural Barriers Act of 1968

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How do we look at relationships?

• When the person has a disability, usually our
  myths and stereotypes kick in FAST, and we do not
  perceive the person in the same way as others who
  do not (yet) have a disability
• Marriage
• Parenthood
• Responsible careers and jobs
• Income levels and achievements
• Educational achievements

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How do we look at relationships?

• When the person has a disability, one may think
  that having a spouse or domestic partner they are
• Extremely lucky
• They should be grateful!
• Because they have parents who care for them, we
  may mistakenly assume household peace rather than
  the hell they may be living
• When someone has a disability, overall, it is
  assumed that their careprovider is good and we
  tend not to look upon them with suspicion.

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Barriers to Intervention

• Lack of interest on the part of our
  agencyusually it is ONE PERSON within an agency
  or organization who takes an interestthen they
  leave and the services for DV victims with
  disabilities leaves with them.
• Lack of know-how
• Belief that money is a barrier to ensuring access

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Barriers to Intervention

• Feeling that to include people with disabilities
  in the centers services would be too much
  trouble, meaning too high a learning curve,
  eventually expensive (we cant add interpreters
  to our budget) and not that many people request
  the services anyhow.
• Prejudice against persons with disabilities.
• Fear of persons with disabilities
• Reluctance to do anything newfeeling that people
  with disabilities is a new or heretofore
  unrecognized part of the community.

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Facilitators to Intervention

• Undertaking innovative programming!
• Being the first in your community/area to create
  a fully accessible program for DV survivors
• Begin slowly, with doing a self-survey of ADA
  accessibility of the physical building, functions
  within the building (alarms, for example),
  wheelchair accessibility in bathrooms, elevators,
  alarms.
• Conduct a self-survey of accessibility of
  services.
• Invite someone from your local CIL to assist in
  your self-survey (at the outset and in reviewing
  findings).
• Adopt nothing about us without us as your motto.

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People with Disabilities are in every family,
community and nation.

• Serving all DV survivors in the community makes
  sensehow can you justify not them practices?
• Those in the Disability Services field are happy
  to help increase accessibilityjust ask!
• As we learn from people with disabilities,
  services are improved for all.

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Time for YOUR Questions and Comments
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Nora J. Baladerian, Ph.D., B.C.F.E., A .A.E.T.S.

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