DOMESTIC ABUSE INVOLVING PEOPLE WITH DISABILITIES

Compiled by Ann Hubbard, Professor of Disability Law, UNC-Chapel Hill Law School

1. Disability is relevant to domestic abuse in several ways.

a. Persons with pre-existing disabilities are more vulnerable to abuse and less able (physically, financially, mentally or emotionally) to escape it.

b. Severe or sustained abuse may inflict disabling conditions, including physical or mental impairments.

c. Disability may put a strain on family members, especially caregivers, and lead to conflicts, which in turn may produce violent situations. This risk is exacerbated if the disability is one that interferes with impulse control or increases aggressivity.

2. Disability makes a person more vulnerable to abuse. The reasons include:

a. Increased dependency on others for long-term care

b. Denial of human rights that result from perceptions of powerlessness

c. Perpetrators' perception of less risk of discovery

d. Greater difficulty being believed

e. Less education about appropriate and inappropriate sexuality.

f. Greater economic independence. (13% of women with disabilities work full-time.)

g. There are fewer personal boundaries respected, especially if the care taking family member provides personal care (dressing, bathing, toileting), handles the disabled person's finances, controls all social arrangements, and makes routine household decisions (what and when to eat, etc.)

h. Abuse often involves control, and there are many ways to control a person who is physically dependent: deny transportation for access to friends and family, leave her on the toilet for an hour, leave the cordless phone out of her reach, etc.

3. People with disabilities face additional obstacles to leaving abusive relationships.

These include:

a. Inability to escape a situation due to architectural inaccessibility; difficulty financing and obtaining adaptive equipment to provide the mobility and independence to leave

b. Cognitive impairments (resulting from disabilities including brain injury, mental illness or mental retardation) that make it difficult to recognize abuse and seek help.

c. A history of prejudice or abuse producing internalized stigma, guilt, shame or low self-esteem.

d. Disability-related fatigue making it harder to pursue treatment or to escape.

e. Isolation, with few chances to form a support network or meet with persons who might provide legal, psychological, financial or logistical assistance.

4. Domestic abuse may cause or exacerbate disabilities.

a. Domestic abuse has been shown to lead to debilitating conditions, including brain injury, suicide, temporary or permanent physical disability, mental and emotional disorders, self-mutilation, eating disorders and substance abuse. These conditions may be masked or explained away by the disability (e.g. she "bruises" easily, she is clumsy, her speech impairment is simply getting worse).

b. Physical or emotional abuse also are known to produce a range of common medical complaints, including depression, chronic anxiety, pelvic pain, headaches, backaches, skin disorders. Because these conditions are more prevalent among people with disabilities, they, too, are likely to be attributed to the disability, not to abuse.

c. Abuse or neglect of a family member with a disability - including withholding of food or medicine - can exacerbate existing conditions and produce new disorders.

5. Disability and dependence may lead to situations that produce violence.

1. Some persons with mental or emotional disorders, such as bipolar disorder or schizophrenia, may be more impulsive or angry or less able to control their actions, and therefore more likely to resort to violence. Therefore, a psychiatric assessment and evaluation of the person's treatment and condition may identify interventions to reduce or eliminate future risks of violence.

b. Unfortunately, when a person with a mental disability threatens or assaults a family member, many law enforcement officers and mental health professionals are quick to assume that the person with the disability is "violent," without asking whether the person was provoked or acting in self-defense.

c. UNC Professor Sue Estroff has challenged the "largely unexamined assumption" that "diagnosed persons engage in and incite violence primarily because they are mentally ill, independent of the actions of others who are not diagnosed, and of social context and interpersonal situation." Instead, "violence seldom happens unilaterally, and hostility and violence from others is not uncommon in the personal histories and current social networks" of persons who have mental disorders.

d. Estroff concludes: "Abuse experienced by individuals with psychiatric disorders ... is grossly underinvestigated, mirroring and contributing to a disproportionate and misleading focus on violent persons solely as perpetrators. Equally little is known about and equally little attention is paid to their versions of how and why violence occurs. Their fears and perceptions are too often considered to be symptoms rather than legitimate concerns."