19 Abuse Cases Found by Investigators at N.S. Residence for Mentally Disabled

By Michael Tutton (CP) –
September 9, 2009

HALIFAX, N.S. — Residents of an aging centre in Nova Scotia for mentally handicapped and mentally ill adults suffered 19 cases of physical, emotional or sexual abuse over the past two years, say government documents obtained by The Canadian Press under provincial access to information legislation.

The 19 cases at the Riverview adult residential centre in Riverton, just south of New Glasgow, represent almost half of the 43 cases across the province that were classified as “founded” by investigators between Oct. 2, 2007, and July 31, 2009.

The cases have prompted advocacy groups to call for a full investigation into what’s behind abuse of the developmentally disabled and renewed a debate about whether harm is more likely to occur at larger institutions than smaller homes.

The list of founded abuse cases at Riverview – which means an incident is accepted as having happened – includes four instances where staff physically harmed residents.

The 89-year-old centre houses about 100 residents with varying mental disabilities, including Down syndrome and long-term mental illness, with some residents sharing rooms and living in what’s called “secure units.” It also includes several smaller detached homes.

Across the province, 1,625 residents with developmental disabilities are housed at licensed group homes and residential centres that are covered by the act.

The cases of abuse were investigated under the Protection of Persons in Care Act, which defines physical abuse as actions “resulting in pain, discomfort or injury, including slapping, hitting, beating, burning, rough handling, tying up or binding.”

At Riverview, there were two founded cases of neglect by staff, defined as failure to provide adequate care.

In addition, there were two cases of emotional abuse by staff, defined as “causing emotional harm,” by actions such as intimidation or humiliation.

The remaining 11 cases were of residents abusing other residents, with 10 of those listed as instances of “non-consensual” sexual contact and one of physical abuse.

The chief executive officer of Riverview said the cases have been taken seriously and the centre has responded to ensure residents are protected.

But advocates for the disabled argue the cases at Riverview show larger institutions for the developmentally disabled – which have been closed in Ontario and British Columbia – are more prone to abuse than smaller homes.

“One case is too many,” said John Cox, the executive director of People First of Nova Scotia.

“In publicly funded buildings, why is this going on? Why is even one occurring?”

Mary Rothman, the director of the Nova Scotia Association for Community Living, said she wasn’t surprised at the results of the investigations as research shows larger institutions are “less safe” than smaller group homes.

“There should be a massive investigation, there should be immediate updated training for the staff. We as an association believe plans should be in place to close the place down over the next couple of years and plans should be created for the residents to live in a home, in a more normalized situation,” she said in an interview.

People First of Nova Scotia says the province has one of the highest rates per capita of institutionalization of adults with various disabilities, though Cox notes that Alberta, Manitoba, Quebec and Saskatchewan also continue to have large, decades-old centres.
The overall results for Nova Scotia show that by March 2009, the bulk of the complaints and abuse cases that were determined to be founded were at larger institutions in the province, with 24 abuse cases happening at adult residential centres, and 10 in regional rehabilitation centres. There were two abuse cases in smaller group homes.

The Department of Community Services only agreed to provide details for Riverview, saying it won’t discuss the nature of abuse at other facilities because of privacy concerns as those homes have five or fewer founded cases of abuse.

Nancy Clarke, the CEO of the non-profit Riverview centre, said the response of her staff and the province to the abuse was thorough and has protected the residents.

“We have taken these stats very seriously and we put measures in that monitor things very seriously, and the fact you are seeing statistics indicates the act is working and we are doing our part to report,” she said in a telephone interview.

Asked why the latest case of staff physically abusing a resident happened this year, Clarke responded, “this is extremely, extremely stressful work. It’s probably always going to be an issue.”

“The other stat that isn’t there (in the act) is the number of times that staff are physically assaulted. … We have staff that are assaulted on a daily basis. … When you’re dealing with people who have profound disabilities and they are extremely, extremely aggressive, it’s a very stressful situation.”

Over the past year, Clarke said the level of stress was higher because the sprinkler system in the building failed, resulting in flooding, which caused tighter living conditions during the repairs.

She said staff also strictly interprets the act when complaints about non-consensual sexual contact between residents are made because there are “a great number of clients who are unable to give consent” to sexual activity.

“We have to be very, very careful. If it’s somebody who isn’t able to give consent and you have somebody come up to them and put their arms around them, or give them a kiss, as a society we may not think that’s a big deal, but to a client with intellectual disabilities … it can really be a trigger to them.”

She said residents involved in sexual abuse have in some cases been moved to other facilities, there has been increased supervision of a resident involved and some residents have received courses on appropriate behaviour.

Clarke said staff who work with residents have been trained in conflict management, and have taken courses in dealing with difficult behaviour. There are 170 people working in the facility, including nurses, licensed practical nurses and residential rehabilitation workers, as well as maintenance staff and managers.

In addition, the Department of Community Services provided a course on abuse in mid-August, a government spokesman said.

A $19-million renovation is underway at the centre, Clarke said, with plans to build three more buildings on the grounds and a 24-room addition to the main building.

She declined to comment on the precise nature of the abuse or to confirm whether staff were disciplined.

“We have taken very stringent action,” she said.

According to the documents obtained by The Canadian Press under the Access to Information Act, there have been four staff suspended as a result of abuse at residences across the province, though the documents don’t define where or what happened. There were also seven cases referred for police investigation, but the province says no charges were laid.

Lorna MacPherson, the director of the services for people with disabilities at the Department of Community Services, said a review of the operations, finances and administration of Riverview is underway, and it will include a look at abuse rates.

“We can’t derive any basis for why it (abuse) is continuing. The review we are undertaking will help inform some answers to that,” she said in an interview.

She also said there has been a steady decline across the province in the number of complaints reported under the act over the past two years, partly due to changes in the definition of abuse to exclude instances where a patient’s mental condition may lead them to abuse others.

Copyright © 2009 The Canadian Press. All rights reserved.

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