Safeguarding in mental health: towards a rights‐based approach

Pages30-42
Publication Date11 Dec 2009
DOIhttps://doi.org/10.1108/14668203200900026
AuthorAmy Whitelock
SubjectHealth & social care,Sociology
 © Pier Professional Ltd The Journal of Adult Protection 6OLUME)SSUEs.OVEMBER
Introduction
People with mental health problems are not the bread and
butter clients of the adult safeguarding system. This is despite
the fact that many people with mental health problems fall
easily within the def‌inition of ‘vulnerable adult’¹. In part, this is
because adult protection is still primarily seen as the preserve of
social services – hospitals and community mental health teams,
being NHS-led, tend to rely on internal investigations and
complaints systems to deal with incidents of abuse. Police are
seldom called to inpatient settings and adult protection referrals
for mental health service users are a very rare occurrence, even
in the community2. Risk assessment is seen as the mechanism
for keeping patients safe in the NHS – people with mental
health problems are supervised, treated and sometimes detained
for their own (and others’) safety and in return, so the theory
goes, professionals will ensure that they are not at risk of abuse.
The NHS approach ref‌lects the other fundamental problem
with the adult safeguarding system as a whole, namely that it
disempowers the very people it seeks to protect. Until now,
adult safeguarding procedures have been based on a paternalistic
intervention model – adult protection is something that is
done to ‘vulnerable adults’ by everybody else, namely health,
social care and criminal justice professionals. This principle
underpins the current authoritative voice on adult safeguarding,
the Department of Health’s No Secrets guidance (Department
of Health, 2000). Yet this traditional model of safeguarding,
built around inter-agency crisis intervention, is clearly failing.
Despite the introduction of No Secrets in 2000, abuse is still
widespread in private homes, the community, and in health and
social care settings3.
3AFEGUARDINGINMENTAL
HEALTHTOWARDSARIGHTS
BASEDAPPROACH
!MY7HITELOCK
0OLICYAND#AMPAIGNS/FlCER-IND
P
E
E
R
·
R
E
V
I
E
W
E
D
Research paper
key words
!DULTSAFEGUARDINGMENTAL
HEALTHABUSEHUMANRIGHTSUSER
INVOLVEMENTPREVENTION
abstract
4HECURRENTADULTSAFEGUARDINGSYSTEMIS
FAILINGPEOPLEWITHMENTALHEALTHPROBLEMS
Despite the introduction of the Department
OF(EALTHS
.O3ECRETS
GUIDANCEIN
ABUSEISSTILLWIDESPREADINPRIVATEHOMES
THECOMMUNITYANDHEALTHANDSOCIALCARE
SETTINGS.EWRESEARCHFROM-INDDEMONSTRATES
THEURGENTNEEDFORASHIFTINFOCUSTOWARDSA
PREVENTIONMODELOFSAFEGUARDINGWITHSERVICE
USERINVOLVEMENTATITSCORE#URRENTLYPEOPLE
FEELDISEMPOWEREDBYANDFRUSTRATEDWITHA
PATERNALISTICSYSTEMTHATLABELSTHEM@VULNERABLE
and fails to take account of their preferences in
MAKINGDECISIONSABOUTTHEIRSAFETY4HISHAS
LEDTOAREALLACKOFFAITHAMONGPEOPLEWITH
MENTALHEALTHPROBLEMSINCURRENTPROCEDURES
TOENSURETHEIRSAFETYWHICHUNDERMINESTHE
ENTIRESAFEGUARDINGPROJECT-INDCONDUCTED
SURVEYANDFOCUSGROUPRESEARCHTHATHIGHLIGHTS
THREEKEYAREASWHEREADULTSAFEGUARDINGIS
FAILINGPEOPLEWITHMENTALHEALTHPROBLEMSTHE
SYSTEMDISEMPOWERSINDIVIDUALSANDEXCLUDES
THEMFROMPARTICIPATINGINDECISIONSABOUT
THEIRLEVELOFRISKTHEREISASYSTEMICLACKOF
ENGAGEMENTWITHSAFEGUARDINGBYTHE.(3
MEANINGINSTITUTIONALABUSEISWIDESPREADAND
unchecked; and discrimination at the heart of
THECRIMINALJUSTICESYSTEMMEANSTHATPEOPLE
WITHMENTALHEALTHPROBLEMSAREBEINGDENIED
EQUALACCESSTOJUSTICEWHICHPOSESARISKTOTHEIR
HUMANRIGHTS)NLIGHTOFTHESElNDINGS-IND
ISCALLINGFORAWHOLESALEREVISIONOFTHECURRENT
APPROACHTOADULTSAFEGUARDINGTOWARDSARIGHTS
BASEDAPPROACHWHICHISUNDERPINNEDBYUSER
INVOLVEMENT

To continue reading

Request your trial

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT