Sexual Health for Learning Disabilities

Sexual Health for learn DisabilitiesSexual Health For great deal With Learning DisabilitiesThis leaflet is about stack with learn disabilities and their sexual wellness. While there is considerable legislation concerned with disability from the 1970 Social attend tos spot to the 1995 impairment Discrimination exercise and beyond, it is non always clear that the involves of this user group ar being addressed in appropriate ways. This is because there is a lack of research into how this user group live their lives and how they feel about life and sexuality.Legislation and Anti-Oppressive PracticeUnder the terms of the NHS and confederation C be Act of 1990 brotherly assists form a trading to make an assessment of need to any mortal in their subject who whitethorn lease need of their advantages. With regard to wad with animal(prenominal) or learning disabilities the department withal has a duty to find out about such people in their area and to offer an ass essment of need even if that has not been requested. The social establisher must take account of the 1998 kind Rights Act when dealing with anyone. It is illicit for social workers to discriminate against people or hinder their access to services on any basis. A social workers should act in the best inte lie downs of their clients, the service users, and engage in anti-discriminatory and anti-oppressive practice.Anti-oppressive practice atomic number 50 involve the social worker attempting to take conduct over the way in which he/she uses language. In society to fully engage in such practice a social worker would need to take care that in dealing with service users who may subscribe to difficulty in communicating their needs the social worker does not end up imposing their own agenda on the service user. When it comes to people with learning disabilities here is a need for different models and levels of participation depending on the service users circumstances. Participation appoints some service users time others may not be able to be truly involved at any recognisable level without the intervention of a third person an advocate. The agency for moral wellness MIND adumbrates that many an(prenominal) people with learning or mental health difficulties should find an advocate who is impartial and who can intercommunicate them what is available in terms of services and support and who will promote their best interests as service users. Those who are able to engage with the process a lot go on to promote the rights of other service users.The service user movement has been a driving force in the struggle for people with mental health problems or learning difficulties entitlement to live as ordinary a way of life as they can (Carr, 2004). People with learning difficulties may hold multiple and complex needs, nevertheless under the 1998 Human Rights Act, they are entitlight-emitting diode to be treated with dignity and local authorities have a duty to abide by the requirements of this Act (Moore, 2002). Nevertheless there are areas where the Act is sometimes ignored and this is most apparent when it comes to the sexual health of people with learning disabilities.Learning Disabilities and Sexual HealthThere has been in truth teentsy research into the lives of people with learning disabilities. The first of its kind was a government survey of 2,898 people which was carried out between June 2003 and October 2004. The report dealt with people with learning disabilities (to what extent they were learning disabled is not always defined) between the ages of 16 and 91. The report found the pastime45% of the people interviewed were under the age of 306% were from minority ethnic communities.92% of totally people with learning difficulties who likewisek part in the schooling were single and 7% of these had children but only half that number looked after their children themselves.7% either lived alone or with a partner.There is an e ven great dearth of information when it comes to the sexual health of people with learning difficulties. In fact media reports suggest that many people with learning difficulties are actively deter from engaging in what most people regard as a healthy sex life. There have even been instances where family members have tried to have girls with learning disabilities sterilised so that they could not back children. A (2006) report from the University of Ulster Out of the Shadows, found that the sexual health of people with learning disabilities was all too often ignored. This is because family members and professionals do not want to acknowledge that this user group has such needs. The report found thatPeople with learning disabilities want to have relationships and chatter reveres of being lonely. But the feel over-protected by professionals and family carers. Consequently there are few opportunities to develop relationships and meet new people.Some family carers want their child to have the very(prenominal) rights as everyone else. But they feel embarrassed to talk about sex with their children and are concerned for their safety. Feeling unsupported and isolated stops them from bringing up these issues in the home.Professionals and front line staff are aware that the issues around sex and sexuality are not being addressed. However they are stamp down by being under resourced, under trained, and at times restricted by a lack of clear guidelines and policies to support them (http//news.ulster.ac.uk/releases/2006/2892.html). all the way insufficient vigilance is being paid to what this group of service users actually want. People are embarrassed by the fact that people with learning difficulties may have the same hopes, fears, and aspirations as everyone else. Clearly there is a need for more research and for education so that a greater understanding of people with learning disabilities and their needs is actually met.Further information on people with le arning disabilities and their needs can be found at the following websiteshttp//www.lancaster.ac.uk/fass/ihr/index.htm website concerned with the inclusion of adults and five-year-old people with learning disabilities in all areas of life.http//www.inspiredservices.org.uk/ website about community living, when it may be necessary and how it is meant to empower people.http//www.ndt.org.uk/ website that campaigns for inclusion of people with learning disabilities at all levels of ordinary life http//www.dh.gov.uk/en/Publicationsandstatistics/Surveys/Othersurveys/Generalsurveys/DH_4081207.Government surveyElder AbuseThe agency called Age Concern is concerned that the rights of old(a) people often get overlooked. This is peculiarly the case where the person is either unable or unwilling to speak for themselves. Thus Age Concern maintains that sr. people need advocates (a disinterested third party) to put their case when the rights of an older person are being ignored or overlooked. S ince the publication of the National Service Framework for Older People in 2000 there has been a directive for more advocacy when it comes to addressing the needs of older people and this move that has been welcomed by Age Concern.Advocacy is about protecting the rights of people as human beings and making sure that their wishes are taken into account when decisions are being made that affect what may happen to them. Advocacy therefore, is meant to empower those people who may have the least power in society. There are those who maintain that there should be specialist advocacy with regard to the problems of age. Service user participation involves rights and responsibilities on behalf of both the service user and a service provider. When it comes to older people who may be confused about what is happening, or who refuse to become involved in the process then a definition of rights and responsibilities is problematic because without equal cooperation it is difficult to find a way of ensuring that these are fulfilled.At the very least it has to be acknowledged that everyone has the right to be protected from corrupt and to be treated with respect. The aim of good advocacy is to find that older people are aware that the local authority has a duty of care with regard to their needs. Advocates also try to ensure that older people have an understanding of what to contract for and what to expect when it comes to support and services. When this is possible it enables older people to exercise their rights as citizens, however, some older people may have no idea what is going on and may be confused by the whole process. In cases like this an advocate would look at the older persons circumstances and needs, as well as hearing to the carers input, and would then put forward a case for their care and ask for an assessment. This is not, however, a guarantee that the person will receive residential care, however much a family force want it.A social worker would listen to what the family and perhaps the advocate had to read and would then ask what provisions were currently in place, whether these were provided by social services or by the family. Once they had assessed the patch the information would be given to a care manager who would decide what could be offered (Moore, 2002). In some cases this would be residential care.As people start older they can develop fears that they did not have before. Many older people, for example, are afraid to leave their homes for fear of being attacked, and numbers of them are also afraid of being attacked in their own home. However, figures from the British Crime Survey 2001, tend to suggest that the likelihood of being a victim of crime decreases with age. in spite of this, many elderly people live in fear of being burgled or attacked in their homes by a stranger. Yet the figures support the idea that this fear is largely unfounded the burglary figures for 2001 yield the following informationIn 1000 house holds of people aged between 16 and 24 17.6% had been burgledIn 1000 households with residents of 75 and over only 2% were burgled despite these figures many elderly people are haunted by the fear that they are not safe on the streets and may not be safe in their own home. At the same time some media reports tend to suggest that older people are safer in their own homes than they might be if they went into residential care. Older people may not always be willing to go into residential care but an assessment may be asked for by other family members or by carers who are feeling the strain of looking after a demanding elderly relative. Some older people, however, may have become so frightened in their own homes that they want to go into residential care.Care and AbuseDespite the fact that some elderly people feel that they will be safer in residential accommodation there are factors which suggest this feeling may be misplaced. The marketisation of care, and the growth of private care h omes means that there is some evidence which supports the view that the elderly may be more at run a take a chance of abuse of their rights and criminal assault in residential settings than in their own home (Ward et al, 1986). The 1990 NHS and Community Care Act, and the introduction of market forces into the care sector has meant that many former council run residences are now privately owned and run for a profit. This is the case even if the person does go into a council run home, they or their family members will be pass judgment to make some contribution to the cost (Kerr et al, 2005).Even if people are in council run homes then they or their families are expected to make at least some contribution to the cost of their care. The shift to a mixed economy of care means that some carers have little or no personal care about the job they are doing and this can lead to older people being at risk of break down and abuse. There have been plenty of media reports of neglect and abus e in residential care where older peoples human rights go unacknowledged and misdirection and a lack of proper supervision can lead to neglect and abuse (Smart, 1997).At a time when they should be receiving more care and management some older people are being abused by the very people who are meant to be looking after them. It would seem that marketisation has led to a lack of proper control over what goes on in some residential homes and there needs to be some mechanism whereby such places are inspected on a regular basis.Useful resourceshttp//www.elderabuse.org.uk/Media%20and%20Resources/Useful%20downloads/AEA/AP%20Monitoring.pdfhttp//www.elderabuse.org.uk/http//www.aoa.gov/eldfam/Elder_Rights/Elder_Abuse/Elder_Abuse.aspVulnerable AdultsThere are general guidelines related to social work practice and this is specially the case when it comes to the protection of the weak and susceptible. All local authorities have a duty to be aware of the number of people in their area who mig ht be considered vulnerable adults. The legislative framework that governs the actions of a social worker working with vulnerable adults is based on the following1948 National assist Act Part 3Local Authority Social Services Act 1970The Chronically Sick and Disabled Persons Act 1970National Health and Community Care Act 1990Depending on the age of the vulnerable adult they are dealing with then the social worker will also have to bear in mindSection 45 of the Health Service and Public Health Act 1968Section 117 of the Mental Health Act of 1983General understanding of the 1998 Human Rights ActThe National Services Framework for Older PeopleSocial workers should also be conversant with the terms of the 1995 Disability Discrimination Act before they make any assessment of a vulnerable adult. A lot of the problems that vulnerable adults experience, particularly if they have mental health problems, are out-of-pocket to the fact that many professionals (particularly medical professional s) still work with the medical model of disability. This model holds that a persons problems and vulnerabilities are rooted in their pathology i.e. they are part of that persons make up. The problem with this model is that there is a tendency to hold the person responsible for whatever their problems may be (Oliver, 1996). A more favorable model for the service user is the social model. This model looks at factors that are external to the service user such as environmental factors and any other social factors that may give rise to ill health or vulnerability.Who Are Vulnerable Adults?Vulnerable adults might be those people who need care because for one reason or another(prenominal) they cannot look after themselves. This might include the followingOlder peoplePeople with mental health difficultiesPeople with strong-arm disabilitiesPeople with learning disabilitiesSubstance MisusersHomeless PeopleIn an abusive relationshipAccording to media and Government reports, older people are of ten subject to abuse by the people who are meant to be caring for them. The same thing happens to people with the sort of physical disabilities that prevent them caring for themselves, people with mental health difficulties and people with learning disabilities. In some cases women are more vulnerable and more at risk than men as in some cases they face the risk of sexual assault by carers, particularly if they are not family members. Government concerns over the abuse of vulnerable adults led to the setting up of the POVA the Protection of Vulnerable Adults Scheme in England and Wales. The scheme is implemented with regard to care homes for vulnerable adults, checking the backgrounds of people who work with vulnerable adults, either in a care home or in the persons own home. The problem is that until a crime is move there is no actual legislation that deals with the protection of vulnerable adults. Some local authorities have produced guidelines for multi-agency working in case of the abuse of vulnerable adults.Harm and Abuse of Vulnerable AdultsVulnerable adults can be abused or harmed in a number of ways, some of which are criminal. Non-criminal abuse might include not paying sufficient attention to their needs, denying them their human rights by not treating them as a person of equal human worth. Abuse can also occur by default when a carer neglects to take proper care of someone who is vulnerable by leaving them in an unclean assign or leaving a confused person to wander without supervision. The more criminal aspects of the abuse of vulnerable adults can include stealing from them, misappropriating money from their accounts and physical or sexual assault. Sometimes it is as a result of harm that a vulnerable adult comes to the attention of social services and it is then the social workers job to assess the needs of that person.When a social worker makes an assessment of need, even if the person in need is recognized as a vulnerable adult, they can only provide services if certain criteria are satisfied. Those people who have a score lower than 4,5 or 6 may only be entitled to information and advice (Moore, 2002). This means that a lot of vulnerable adults are left out in the cold and it is sometimes the case that they become involved with mental health services by being sectioned under the 1983 Mental Health Act. Here an ASW or ratified Social Worker can recommend to a mental health team that a person be sectioned or forcibly detained for a period of 28 days if they are regarded as being at risk or posing a risk to others. Vulnerable adults are another group who may at sometime need the services of an advocate to put forward their concerns. It is also the case that unless and until there is some legislation in place for the protection of vulnerable adults this abuse and neglect will continue.Useful resourcesDisability Discrimination Act 1995 http//www.drc-gb.org/thelaw/thedda.asphttp//www.after16.org.uk/pages/law5.htmlhttp//www.d h.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4085855Moore, S. 2002 3rd Edition Social eudaimonia Alive Cheltenham, Nelson ThornesMental HealthLocal authorities now have a duty to act in ways that are conversant with the 1998 Human Rights Act and this means that social workers have a duty to help people with mental health difficulties to deal with any problems they encounter. Some research tends to suggest that over the last fifteen years those who use mental health services have been treated in a prejudicial way. This is largely a result of the fact Government discourse is phrased in such a way that this group is seen mostly in terms of the risks they may pose to the rest of society.Some social workers have a lot of power when it comes to people who are assessed as having mental health problems. In Britain we have what are cognise as Approved Social Workers, these social workers are often involved in sectioning a person that is to say a pers on can be detained for twenty eight days without their consent for assessment of their mental capabilities. This can be problematic because if a service user is being aggressive it is not always easy to tell whether this is just in response to whatever is going on at that moment or whether the person actually does have a mental health problem or a psychosis.Hannigan and Cutliffe (2002) argue that the medical model of health is the most prevalent in the mental health sector. Under the terms of the 1983 Mental Health Act this often results in medical treatments that may involve, for example, the use of drugs or electro-convulsive therapy without the persons consent. What is most pitiful about this is that it can be used as a threat against vulnerable adults who may not need this kind of treatment but who may be irritating the professionals with whom they come into contact. This is especially the case if the adult concerned has a tendency to be a bit aggressive. Professionals may ofte n put one over that this person is displaying psychosis when they are simply displaying an exaggerated form of annoyance at what is going on. Current legal definitions of what constitutes a mental disorder (and the guidelines with which many professionals work) are not necessarily the same as psychiatric definitions of what constitutes mental illness. With recent changes to the Mental Health Act this situation becomes even more worrying because it widens the displace to include other definitions of mental illness, definitions which could just as well be a result of social misfortune as something inherently wrong with a person.Some research tends to suggest that the mental health system is racist and that black and white youths who may behave in a similar elbow room are treated differently and black youths are more likely to be assessed as having a mental health problem.The disproportionate use of absolute sections of the Mental Health Act 1983 for black people, and the links bet ween mental health and the criminal justice system, suggest that the basic rights of many black service users are under threat. A holistic model would emphasise basic human rights and require great caution in the use of statutory powers in mental health services. Black service users rights would be safeguarded through anti-discriminatory procedures, accessible appeals and complaints systems, and accurate monitoring. Safeguards include quality assurance systems based on service users views. These should take indicators of service outcomes based on improvements to black service users quality of life (Ferns, P. 2000 no pagination)Increased use of sectioning under the Mental Health Act could be regarded as a form of blackmail in mental health just another way of saying you behave the way I say you will behave or this is what will happen to you. The police also have greater powers under the 1983 Act. Section 136 gives them the right to detain people in a safe place for 72 hours if they are considered to be a risk to themselves or others, even if they havent been aggressive or make anything else that would warrant being detained. This is a frightening state of affairs because it means that anyone who upsets authority in some way could be at risk of losing their casualness without charge and without trial.The mental health charity Mind say that actual psychosis is far less prevalent in Britain than some figures would have us call back and that the 1983 Act is in danger of being used as a means of social control rather than the protection of the public and of vulnerable adults.Clearly there are many issues around Mental Health that are extremely worrying. If you are homeless you are automatically seen as having mental health problems and some literature also refers to women who have experienced domestic violence in these terms. Mental health issues and social blackmail it would seem are very closely related.Useful resourceshttp//www.communitycare.co.uk/articles/a rticle.asp?liarticleid=7951 Full ref. in bibliographyhttp//www.esrcsocietytoday.ac.uk/ESRCInfoCentrehttp//www.lho.org.uk/HIL/Disease_Groups/MentalHealth_Inequalities.htm London Healthhttp//www.mind.org.uk/Information/Factsheets/Statistics/Statistics+3.htmhttp//www.mind.org.uk/Information/Factsheets/Statistics/Statistics+3.htmhttp//www.nacro.org.uk/about/Youth justice are we getting it right.pdf