Identifying vulnerable and at-risk situations

How do you identify vulnerability and establish the degree of risk, neglect or harm?

People who are vulnerable and at significant risk in a crisis may be:

  • people with a developmental disability
  • people with acquired brain injury
  • people with mental health issues
  • children and young people
  • people affected by domestic violence
  • people who are addicted to alcohol or other drugs
  • people who are homeless.

People with a developmental disability

This can include a multiplicity of disabilities, including difficulty with learning, thinking, reasoning, retaining information and forming relationships.

It is vital to recognise the individuality of people with developmental disabilities and their right to age-appropriate consultation and self-determination. Their needs, which often arise from social isolation, need to be recognised and addressed.

The critical importance of primary caregivers in the lives of people with developmental disability needs to be recognised in any support given to the client.

Developmental Disability
The Queensland Centre for Intellectual and Developmental Disability (QCIDD), supports people with intellectual disability. Information on developmental disability can be accessed via their website

The Queensland Government website has information on working with people with a disability

People with acquired brain injury

Acquired brain injury is not something people are born with. Acquired brain injury relates to injury to a person’s brain received through:

  • accident, e.g. motor vehicle, sport-related, horse riding, work
  • surgery relating to tumours, etc.
  • violence
  • drug overdose
  • alcohol addiction
  • chroming, etc.

Some major considerations include:

  • understanding and recognising the impact of cognitive impairment on individuals and their families
  • being aware of associated grief and loss issues
  • challenging behaviours
  • support groups and services.

Acquired Brain Injury (external)
The Better Health Channel provides health and medical information for consumers, quality assured by the Victorian Government. You can access information on acquired brain injury via their website www.betterhealth.vic.gov.au (external)

People with mental health issues

Supporting people with mental health issues requires workers to be able to:

  • recognise the basic signs and symptoms of anxiety, depression and suicide impulses
  • recognise other indicators of mental illness such as hallucinations or delusion
  • know the appropriate intervention and referral services in the community.

Suicide Prevention
Suicide Prevention Australia provides information on the complex and wide-ranging issues around suicide prevention. You can access information and organisations dealing with suicide prevention via their website.


Children and young people

The mission for child protection is to protect children and young people from risk of harm. This can mean employing a range of strategies, including:

  • Notification
  • Mandatory reporting
  • Working with the Department of Child Safety to protect, plan and strengthen families within their networks and communities to develop their capacities in order to sustain and/or restore their child care role. Or where this is not possible, to enhance the child’s relationships with their family where the plan is for the child/young person to remain in care
  • Supporting people through the court process
  • Engaging and networking with a range of support services

We discussed identification of harm and assessing risk in Child Protection earlier in this resource.


Child Protection – Tips for Kids (external)
Kids Help Line provides counselling services for young people between the ages of 5 and 25. You can access information on child protection on their website www.kidshelp.com.au (external)

Parenting – Coping with Stress (external)
The Better Health Channel provides health and medical information for consumers, quality assured by the Victorian government. You can access information on parenting via their website www.betterhealth.vic.gov.au (external)

People affected by domestic violence

Many clients have been, or are being, affected by domestic violence. Domestic violence relates to an abuse of power and can take a number of forms, such as:

  • physical and sexual violence
  • emotional and psychological abuse
  • economic and social deprivation
  • forcing cultural, religious and/or ritualistic requirements on someone else.

Relationship Violence (external)
Child and Youth Health promotes the health, wellbeing and development of children, young people and families. You can access information on relationship violence via their website www.cyh.com (external)

People who are addicted to alcohol or other drugs

It is important to recognise the vulnerability of those affected by alcohol and other drug addiction. Chroming is also a major problem with disempowered and disengaged youth.

Harm minimisation is the major focus of workers attempting to support those affected by alcohol and other drug addiction. Many support agencies have been developed for counselling, treatment, detoxification and rehabilitation of affected clients.

Homelessness

It is recognised in psychology and illustrated by Abraham Maslow that safety and security are two of the most crucial basic needs for human beings: that having a safe and comfortable place to live is a vital aspect of meeting that need for safety and security.

However, many of the people workers are attempting to support are young homeless or in inadequate or unsafe accommodation arrangements.

Mission Australia provides counselling and support in a range of areas. You can access information on homelessness their website.

Risk Assessment

One method of risk assessment, after you have analysed all the information, is to categorise the possibility/probability of risk along a continuum between ‘minimal risk’ and ‘imminent risk’, as indicated below.

Minimal risk indicates favourable demographics, positive family, school and social interaction, and limited psychological and environmental stressors.
Remote risk indicates negative demographics, family, school, and social interaction, and some stressors.
High risk indicates negative demographics, negative family, school and social interaction, numerous stressors, negative attitudes, emotions and skill deficiencies.
Imminent risk indicates negative demographics, negative family, school and social interaction, numerous stressors, negative attitudes, emotions and skill deficiencies and development of self destructive and deviant behaviours.
Adapted from McWhirter, EJ, McWhirter, BT, McWhirter, AM & McWhirter, EH, 1988, At-Risk Youth – A Comprehensive Response, 2nd edn, Brooks/Cole Publishing Co.

Other issues you need to be aware of in risk assessment include:

  • age and maturity (developmental factors)
  • personal characteristics (positive/negative outlook on life, health, mental health, etc.)
  • environmental resources available (transport, community support, etc.)

Some families can harbour secrets – alcoholism, incest, depression – that can stem from long-term and ongoing dysfunction.

Minimal risk

Minimal risk indicates favourable demographics, positive family, school and social interaction, and limited psychological and environmental stressors.

Remote risk

People in all circumstances must cope with such factors as death, divorce, incapacity, loss of home or bankruptcy in their families. The level of risk can be increased when such crises occur and other combinations add up.

High-risk characteristics

High-risk characteristics include depression, anxiety, aggression, and hopelessness, as well as deficits in social skills and coping behaviours. The authors explain that these characteristics can set the stage for more self-destructive and deviant behaviours.

Imminent risk

Expression of self-destructive and deviant behaviours (often linked with many of the above characteristics) poses imminent risk to youth in particular. For other clients it may be related to others' behaviours towards them or serious health or mental health conditions posing imminent risk.

When a client is considered to be at imminent risk, it is imperative that you take action by using one or a number of the following processes:

  • contacting appropriate authorities (e.g. Dept. of Child Safety, SCAN Teams, Mental Health Response Teams, police, and ambulance)
  • crisis intervention (e.g. meeting immediate needs, referral to specialist teams and agencies)
  • medical referral
  • special observation
  • case management.

Activity: Risk assessment

This activity relates to risk assessment.

This task requires you to choose a scenario from your workplace. (Please do not use real names.)

Use:

Task

  • Indicate on the continuum below the level of risk you believe your client is presenting.
  • Explain your assessment of the level of risk to that client.
  • Check the services your organisation delivers against the range of client needs to be dealt with.
  • Examine all client information to determine the degree to which other issues may impact on the possible services that can be provided by your organisation.
  • Create a table which reflects the above information.

the continuum ranges from minimal risk to remote risk to high risk to imminent risk.

Last modified: Thursday, 20 July 2017, 12:12 PM