From the 1980s, health professionals began drawing attention to the sexual abuse of girls and women with learning difficulties. Estimates of the proportion who would be sexually assaulted in their lifetime ranged from 30 to 80 per cent. Girls and women with intellectual disabilities are a particularly vulnerable cohort of people: the lack of sex education means that many are unaware that they are being molested; they are often bribed or told that the abuse makes them ‘special’; they are conditioned to be over-compliant; and dependency on offenders for day-to-day care makes complaining risky. Impairments of speech and poor communication skills also prevent many of them from informing others about their experiences. These challenges are multiplied when legal remedies are sought. Justice systems are notoriously unsympathetic to people (of all types) who claim to have been sexually assaulted: intellectually impaired victims are some of the most powerless complainants.
This was the situation that psychotherapists Tamsin Cottis and Steve Morris sought to change when, in 1991, they established RESPOND, the first UK-based charity supporting people with learning disabilities and/or autism who have experienced sexual abuse, violence, or other traumas. Then, as now, RESPOND believes in the power of trauma-informed psychoanalytic and systemic therapies. They also provide information and advocacy about how to negotiate health, welfare, and justice systems. They have a special project addressing issues of forced marriages. They provide vulnerable young people who might be at risk of dangerous sexual behavior with support circles. They also help family members who share the lives of people with learning disabilities and conduct training for medical and other professionals. Crucially, RESPOND is driven by their service users, who are uniquely placed to know what they need and are capable of devising ways of achieving their goals.
One of their most important innovations was introduced only 3 years after they were established. This was offering help to abusers, in the belief that offenders often have a history of personal traumas, too. All have learning disabilities and/or autism. It was a daring initiative at the time. As Noelle Blackman (CEO of RESPOND since 2012) told me, in order to create ‘a safer place’, perpetrators of abuse have to be listened to and healed.
Covid-19 has made the lives of people with learning disabilities in domestic or sexually vulnerable situations even more difficult. Many do not have access to useable online technologies. Routines have been broken; visits from family, friends, and other carers, suspended. Even worse, at the start of the lockdown some doctors were issuing ‘Do Not Resuscitate’ (DNR) orders for entire care-homes for people with learning disabilities. Others had ‘Do Not Escalate’ orders applied to them, meaning that if they became seriously ill with Covid-19, they would not be automatically admitted to Intensive Therapy Units (ITUs). Some lives were not deemed worthy of saving.
I asked Noelle Blackman and Lynne Tooze (Independent Sexual Violence Adviser Coordinator at RESPOND) what we can do to improve the lives of people with learning disabilities and/or autism who have experienced sexual assault. Their response was clear:
- make others aware of the special challenges facing people with intellectual disabilities;
- ask disabled people who seem unhappy if they are okay;
- ensure that all pamphlets, online materials, and other information are presented in accessible ways.
But also, remember that everyone can learn from those who live their lives with learning disabilities.
We need to listen more.
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