Self-neglect at a glance

Pexels: Claspsed hands

Self-neglect in adults, is an extreme lack of self-care, it is sometimes associated with hoarding and may be a result of other issues such as addictions.

Practitioners in the community, from housing officers to social workers, police and health professionals can find working with people who self-neglect extremely challenging. The important thing is to try to engage with people, to offer all the support we are able to without causing distress, and to understand the limitations to our interventions if the person does not wish to engage.

What is self-neglect?

  • Lack of self-care to an extent that it threatens personal health and safety
  • Neglecting to care for one’s personal hygiene, health or surroundings
  • Inability to avoid harm as a result of self-neglect
  • Failure to seek help or access services to meet health and social care needs
  • Inability or unwillingness to manage one’s personal affairs

What causes self-neglect?

It is not always possible to establish a root cause for self-neglecting behaviours. Self-neglect can be a result of: 

  • a person’s brain injury, dementia or other mental disorder
  • obsessive compulsive disorder or hoarding disorder
  • physical illness which has an effect on abilities, energy levels, attention span, organisational skills or motivation
  • reduced motivation as a side effect of medication
  • addictions
  • traumatic life change.

SPOC Referrals

If an adult has no care and support needs, then a referral will go to GP. If they have care and support needs, a referral for self- neglect should go to adult care services (not safeguarding) to ensure appropriate long term support. A safeguarding referral for self neglect will only be made if the person has care and support needs AND the self neglect is immediately life threatening or they are hoarding with a clutter scale of 7-9.

Any concerns over hoarding that are not a safeguarding, can be reported directly to the fire service rather than SPOC. The fire service will visit and monitor cases of hoarding.

SELF HARMING – ADULTS

This should not be referred through SPOC as self neglect.

Self harming has complex causes based in difficult experiences or emotions, the most appropriate route for adult self harming or overdoses is a GP referral so that mental health interventions can be considered, there is no role for adult social care with the issue of self harming, unless the person has a package of care, in which case, ASC may want to review the care package as part of their duty of care.

Neglect – Children

Child neglect is a form of child abuse, and is a deficit in meeting a child's basic needs, including the failure to provide adequate health care, supervision, clothing, nutrition, as well as their physical, emotional, social, educational and safety needs. This would be a SPOC child safeguarding referral.

A young person/child, who presents with symptoms of self-harming, attempted suicide, under the influence of drugs or alcohol is neither categorised as neglect nor self-neglect. Self-harm and attempted suicide in a young people/child indicates concerns for the child/young person’s emotional wellbeing, with an assessment/ intervention required through CAMH by the child/young person being conveyed to hospital or a referral by a G.P.

A young person who presents with symptoms associated with use of alcohol or drugs will meet the safeguarding threshold IF there are additional concerns, attributed to child exploitation. If not this will generally be a GP referral.

The fore mentioned will only be considered as neglect if parents fail to pursue medical attention or support for the child/young person or to put in place boundaries; in addition to the presenting concerns having an impact on other children in the family. This will be a child in need referral

Parents and children who are living in a property which is damp, and this has been brought to the attention of their Landlord or Housing Officer, will not be a safeguarding concern as the appropriate routes of support or action have been undertaken. It is the responsibility of parents to pursue appropriate housing remedies, this is not a role for Children’s Services.

 

Published 1st February 2020

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