In 2012 six care home workers were jailed for ‘cruel, callous and degrading’ treatment of disabled patients in the Winterbourne View care home after secret filming had demonstrated systematic abuse and neglect. The case revealed the importance of understanding the wider cultural and systemic problems which allow abuse to flourish unimpeded. Alongside this, academics and practitioners have begun to examine the myriad ways in which disabled people might experience abuse and what legislation and policy can do to counteract this. Sally Robinson’s monograph makes a valuable contribution to this debate by focusing on an area which is often overlooked – emotional abuse and neglect. Her starting point is to try and unpick the subtle nuances in the experiences of people with intellectual disability and to suggest that notions of abuse need to be examined through the lived experience of the disabled person. The constant theme throughout Preventing the Emotional Abuse and Neglect of People with Intellectual Disability is that abuse and neglect have a cumulative effect and we should be cautious in thinking that incidents which might appear unintentional or minor do not have longstanding consequences.
Part One of the book sets out the approach of the author, which is predicated on the notion that respondents are ‘more than victims of abuse’ (17). These early chapters are very well written because they prepare the reader for the detailed analysis of empirical findings that follow after. Robinson carefully examines the concept of harm at length by looking at relevant literature to draw out connections between policy and practice. She looks at notions of ‘othering’ and constructions of disabled people as less human to try and provide explanations for their experiences. This is important as it underpins the later chapters which are looking at the sometimes unintended environments that allow the abuse to occur unchallenged or ignored. Chapter Three connects experience to practice by further critiquing policy responses and the lack of legal redress that has often been available to disabled people.
Part Two presents the empirical research which utilised the narrative collage method and involves nine participants. At a very early stage in the book the reader is introduced to the narrators, and this serves to underpin Robinson’s ethos that ‘holders of expert knowledge about emotional and psychological abuse and neglect are people who have the lived experience of the issue under question’ (17). Her methodological approach is meticulous and what is clearly evident is the sensitive and respectful approach of the author. This sensitivity undoubtedly contributes to the richness of the accounts provided by the respondents, which are genuinely moving and insightful. It is relatively easy to write about the cumulative impact of so-called low-level incidents, but to read them first hand adds a new dimension for the reader. We see the respondents as people rather than victims or statistics. The reader is moved and quite exhausted by the end of Chapter Four, such is the ability of Robinson to evoke a response in her writing.
Robinson has also done well to organise the findings in a thematic manner which draws on the framework of abuse and neglect that was outlined earlier. Her findings connect the experiences on the systemic, structural and individual levels which point the reader towards a more macro understanding of what the findings mean. This is another important strength of the book. Chapter Five presents perspectives from practitioners and policy-makers in how abuse can be tackled and recognised. Perhaps understandably this section lacks the emotional intensity that the reader experienced in hearing from the narrators, but nonetheless it does highlight their viewpoint on impact, risk factors and what policy can do to change things.
The final part of the book looks at how changes could be made to reduce abuse and neglect and improve the lives of disabled people. Chapter Six draws out specific themes which had been highlighted by the narrators. This could have been expanded upon further because sometimes the sections are a little brief in their explanations. Chapter Seven looks at what the findings mean for policy and presents a list which is perhaps a little depressing in its length. The reader might not feel hopeful that such changes can be achieved – especially if reading in the United Kingdom, where so many support services are being cut under current austerity measures. That said, Chapter Nine provides some grounds for optimism by thinking more broadly than policy and looking at conceptual shifts that might aid a better understanding of disabled people and their experiences. This serves to bring the book full circle by again underlining the centrality of the lived experience and that ‘these lives matter’ (205).
Overall, Robinson’s book is an invaluable addition to knowledge about emotional abuse and neglect of people with intellectual ability. Her sensitive and respectful approach to her respondents is genuinely moving for the reader and allows for a nuanced insight into their everyday experiences. Furthermore, Robinson does well not to demonise the ‘perpetrators’ but to try and understand the social, systemic and structural conditions which allow abuse to occur.
Department of Sociology, University of Sussex, Falmer, UK
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© 2015, Hannah Mason-Bish
http://dx.doi.org/10.1080/09687599.2015.1062221