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居住环境中智力障碍者遭受性虐待:向荷兰卫生和青年保健监察局报告的事件的 3 年分析。

Sexual abuse of people with intellectual disabilities in residential settings: a 3-year analysis of incidents reported to the Dutch Health and Youth Care Inspectorate.

机构信息

Legal affairs, Inspectie Gezondheidszorg en Jeugd, Heerlen, Netherlands

Erasmus School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands.

出版信息

BMJ Open. 2021 Dec 6;11(12):e053317. doi: 10.1136/bmjopen-2021-053317.

Abstract

OBJECTIVES

To explore characteristics of sexual abuse within residential settings for people with an intellectual disability and to map out measures undertaken and improvement plans made by healthcare organisations after sexual abuse.

DESIGN

Descriptive analysis of reports about sexual violence against persons with an intellectual disability submitted to the Dutch Health and Youth Care Inspectorate by healthcare organisations.

SETTING

Residential settings for people with an intellectual disability in The Netherlands.

SELECTION

186 incident reports submitted to the Inspectorate between January 2017 and December 2019 were included.

RESULTS

125 incident reports concerned sexual abuse by fellow clients and 61 reports concerned sexual abuse by professionals. Client perpetrators were predominantly male whereas almost 30% of the abusing professionals were female. The majority of the perpetrating professionals were unlicensed professionals. Clients who committed sexual abuse were mostly relocated to another residential setting. Most healthcare organisations invested in education and training for employees instead of improving the sexual education programme for clients after an incident of sexual abuse. If there was a strong suspicion of sexual abuse by a professional, resignation followed in most cases. In just two cases, the perpetrating professional was reported to a warning registry.

CONCLUSIONS

A small amount of the perpetrating professionals held a licensed profession, which makes it challenging to address this form of sexual abuse through healthcare regulation. It raises the question why warning registries are not engaged more often after alleged sexual abuse. Constantly relocating abusing clients might endanger the (sexual) safety of clients in these new environments. Previous literature suggests that adequate sexual education regarding social skills and sexual behaviour is very effective for the majority of clients who commit sexual abuse. Healthcare organisations could take up a more prominent role in this to ensure safety for their own clients and for clients residing elsewhere.

摘要

目的

探索居住环境中针对智障人士的性虐待特征,并制定医疗保健组织在性虐待事件后的应对措施和改进计划。

设计

对医疗保健组织向荷兰卫生和青年保健监察局提交的关于智障人士性暴力的报告进行描述性分析。

设置

荷兰智障人士居住环境。

选择

共纳入 2017 年 1 月至 2019 年 12 月监察局收到的 186 份事件报告。

结果

125 份报告涉及同屋客户的性虐待,61 份报告涉及专业人员的性虐待。施害者客户主要为男性,而近 30%的施害专业人员为女性。大多数施害专业人员为无照专业人员。实施性虐待的客户大多被转移到另一个居住环境。大多数医疗保健组织在性虐待事件后投资于员工教育和培训,而不是改善客户的性教育计划。如果有强烈怀疑专业人员有性虐待行为,大多数情况下会辞职。只有两起案件中,施害专业人员被报告给了警告登记处。

结论

一小部分施害专业人员持有执照,这使得通过医疗保健法规来解决这种形式的性虐待变得具有挑战性。这引发了一个问题,即为什么在涉嫌性虐待后,警告登记处没有被更多地利用。不断转移施虐客户可能会危及这些新环境中客户的(性)安全。先前的文献表明,对于大多数实施性虐待的客户,适当的社会技能和性行为性教育非常有效。医疗保健组织可以在这方面发挥更突出的作用,以确保其自身客户和其他地方客户的安全。

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