People with an intellectual disability: under-reporting sexual violence

Date21 February 2020
Publication Date21 February 2020
AuthorSara Willott,Wendy Badger,Vicky Evans
SubjectHealth & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse
People with an intellectual disability:
under-reporting sexual violence
Sara Willott, Wendy Badger and Vicky Evans
Purpose People with an intellectual disability are much more likely to be sexually violated and the
violation is less likely to be reported. Despite this being high-lighted at least 3 decades ago and
improvements in both safeguarding and national reporting processes, under-reporting remains a
problem. This paper explored under-reporting alongside prevention possibilities using safeguarding
alerts raisedin a Community Learning DisabilityTeam within a UK NHS trust.
Design/methodology/approach Using a combination of authentic but anonymised case vignettes
and descriptivedata drawn from the safeguarding team,under-reporting was examined throughthe lens
of an ecological model. Safeguarding alerts raised in a particularyear were compared with the number
expectedif all (estimated) cases of abuse were disclosed and reported.
Findings Only 4.4 per cent of expectedabuse cases were reported to the team, which is lower than the
reporting level the authors had expected from the literature. There is evidence in the literature of the
under-reportingof sexual assault for all kinds of people. Arguably, the implicationsof under-reporting for
PwID are even moretraumatic.
Research limitations/implications Constraints includedthe lack of standardisation in data collection
within the statutory services that report to the Birmingham Safeguarding Adults Board. One key
recommendation is thatthe national provider of data for the NHS in the UK requiresmore complex and
standardisedaudit information that would allow eachlocal authority to benchmark their practiceagainst a
higher protectionstandard. Another recommendationis that compliance to quality standards sits withina
Originality/value This paper explored the extentto which the previously documented under-reporting
concern remains an issue.Certainly eye-balling safeguarding compliancedata in the NHS organisation
we worked in led us to a concern that reportingmight be even lower than implied in the literature. This
together with a renewed spot-lighton sexual violence (e.g, NHS England,2018) led us to decide that it
was timelyto re-examine the problem.
Keywords Learning/intellectual disabilities, Safeguarding, Abuse, Mental health, Under-reporting,
Sexual violence, Sexual assault
Paper type Case study
Introduction and overview
Under-reporting of sexual violence towards people with an intellectual disability (PwID) is
not a new problem. It is shocking however that the level of this violence remains so high,
while the level of under-reporting remainsso low despite repeated attempts to highlight this
issue since 1980s. PwIDs are aroundfour times more likely than other groups to be sexually
violated[1]. Sexual abuse is however one of the least likely forms of abuse to be reported,
although this landscape may be changing (Bunting et al. (2010). Certainly, eyeballing
safeguarding compliance data in the NHS organisation in which we work, led us to a
concern that reporting was even lower than implied in the literature. This together with a
renewed spotlight on sexual violence (NHS England, 2018) led us to decide that it was
timely to re-examine the problem. We will start by summarising both prevalence rates
and studies of under-reporting cited in existing literature and then estimate the level of
Sara Willott is based in the
Department of Learning
Disabilities, Birmingham
Community Healthcare
NHS Foundation Trust,
Aston, UK. Wendy Badger
is based at the Heart of
England NHS Foundation
Trust, Birmingham, UK.
Vicky Evans is based in the
Birmingham Community
Healthcare NHS
Foundation Trust, Aston,
Received 6 May 2019
Revised 9 November 2019
9 December 2019
Accepted 20 December 2019
The authors would like to thank
Jenny Riley (Senior Intelligence
Officer) Public Health
Information and Intelligence
Team, Birmingham City
Council, for checking the data.
DOI 10.1108/JAP-05-2019-0016 VOL. 22 NO. 2 2020, pp. 75-86, ©Emerald Publishing Limited, ISSN 1466-8203 jTHE JOURNAL OF ADULT PROTECTION jPAGE 75

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