Safeguarding information In this article we cover some of the ways in which brain injury survivors can be at risk of harm or abuse.

The effects of brain injury can unfortunately make brain injury survivors vulnerable to being exploited or mistreated by others and may even impair the survivor’s ability to recognise when they are in danger. In some cases, it may be family and friends who suspect that something is wrong.

On the other hand, a brain injury survivor might recognise themselves that they are in a bad situation but struggle to identify how to get support.

If you are concerned about your or someone else’s safety, but it is not an emergency situation, ring 101 to speak to the non-emergency local police force. If someone is at immediate risk of harm or there is an emergency, ring 999 to speak to the police. If you are a member of staff supporting someone, you will also need to do the above and alert your designated safeguarding lead. If you are the victim of abuse or think you know someone who is being/ has been abused, contact their local Adult Safeguarding Team; details are available on local council websites.

Explore the sections below to find out more information on safeguarding.

Cuckooing

Cuckooing is a technique whereby criminals pretend to befriend a vulnerable person and gradually inhabit and take over their home. They may start forcefully using the home as their own or using it as a space for criminal activity such as drugs distribution or storing firearms.

Once a ‘cuckoo’ has inhabited someone’s home, it can be impossible to make them leave without police involvement, as they may use life-threatening tactics to stay where they are.

A brain injury survivor may not recognise that they are the victim of cuckooing and may genuinely believe that the ‘cuckoo’ is a new friend. Cognitive impairment may affect their ability to understand that they are in a vulnerable position or may interfere with their ability to get help. Survivors who are isolated or have limited support may be particularly vulnerable.

Relatives and friends of a vulnerable brain injury survivor should be cautious of new people or groups of people in the survivor’s life who are spending a lot of time ‘hanging around’ the survivor’s home, especially if the survivor seems uncomfortable or nervous around them or there are illegal substances or firearms around.

  • Cuckooing is a criminal activity and should be reported to the police or local council.

County lines

County lines refers to a type of drug dealing in which organised criminal groups target a vulnerable person and use them to move illegal drugs around the country. Criminals running county lines will often also use ‘cuckooing’ techniques (see above) as a base for their drug distribution activity.

A brain injury survivor may not recognise that they are being groomed for a county line operation and may genuinely believe that the ‘criminal’ is a new friend or offering them an opportunity to make money. Cognitive impairment may affect their ability to understand that they are becoming involved in criminal activity or may interfere with their ability to get help. They might be unable to reflect on or assess the risk of handling illegal drugs.

Relatives and friends of a brain injury survivor should be cautious of new people or groups of people in the survivor’s life who are spending a lot of time ‘hanging around’ the survivor or their home, especially if the survivor seems uncomfortable or nervous around them or there are illegal substances or firearms around the home. Frequently travelling or being absent without having a good explanation for this, or having new possessions or money that the survivor cannot account for might also be warning signs of county lines involvement.

Once recruited, it can be impossible to leave without police involvement, as the groups may use life-threatening tactics to keep the vulnerable person involved in their operation.

Financial abuse

A brain injury survivor may meet someone who takes control over their money, goods or property without the survivor’s genuine agreement or consent - this is known as financial abuse and it is a form of domestic abuse.

Financial abuse can also include someone forcing a brain injury survivor to pay for goods for them, stealing from a survivor, or forcing a survivor to make changes to their will in order to financially benefit. It may also be the case that a survivor gives someone money to pay for goods, such as asking a relative to do their shopping, but the person uses the money for something else instead, or does not give an accurate account of where the money has been spent.

Brain injury survivors who lack capacity or have cognitive problems may not realise that they are being financially exploited in these instances. They might also find it difficult to handle money themselves and struggle to account for or keep track of missing money.

Controlling what a brain injury survivor spends their money on is also a form of financial abuse if the survivor has the capacity to make their own decisions about finances, even if their decision is considered to be ‘unwise’ by others. It is important to note that someone who is a legally appointed deputy for a brain injury survivor can manage their money on their behalf if they hold the correct form of deputyship and fulfil their legal obligations as a deputy. 

A brain injury survivor with a significant compensation payout might be at particular risk of financial abuse if details of their case come to be known by others.

Financial abuse can take place both in person and virtually through scam friendships or relationships formed online, for instance through social media.

Domestic abuse/ intimate partner violence

Domestic abuse is a pattern of abusive behaviour directed towards someone that the abuser has a relationship with, whether this is an intimate or family relationship. It can include physical abuse (such as hitting, biting, strangling, and sexual abuse) as well as other non-physical forms of abuse (such as controlling behaviour, bullying, verbal abuse, financial abuse and controlling of money, emotional abuse, among others). 

Behaviours such as making regular threats, being disrespectful and harassment also count as abuse.

A brain injury survivor might be at risk of domestic abuse if the effects of brain injury cause them to rely on others for care or support. The survivor may be unable to defend or protect themselves from domestic abuse due to emotional, psychological, or physical effects of brain injury. They might fail to recognise that behaviour directed towards them is abusive, or not think that their situation is ‘serious enough’ to be considered as abusive.

If the brain injury survivor is known to have experienced domestic abuse and is receiving support from the police and/or other professionals (such as an Independent Domestic Violence Assessor or IDVA), the effects of a brain injury (for example memory) may also impact on their ability to follow their ‘safety plan’. 

A brain injury survivor who relies on a relative or partner to care for them may feel like they are trapped and unable to report the abuse if it means losing their support.

In some cases, brain injury survivors themselves might become abusers if, for example, they have difficulties with managing their anger or judging social situations.

Signs that someone may be being domestically abused can include frequent physical injuries or marks on their body, attempting to cover up injuries with makeup or clothing, showing anxiety or fear around a particular person, being withdrawn or not having access to one’s own money even though they have the capacity to manage it themselves.

Changes in personality, behaviour or habits are common after brain injury however they may also indicate a cause for concern of abuse, and it can be helpful to check in with the survivor more regularly.

Mate crime

Mate crime is a form of abuse in which a vulnerable person is exploited or abused by someone whom the person considers to be their friend.

Mate crime can take any of the forms described in the previous section, such as a ‘cuckoo’ pretending to be a friend or someone who is considered to be a friend financially abusing the vulnerable person.

Mate crime can take place both in person and virtually through friendships made online, for instance through social media.

Acknowledgements: Thank you to Laura Thorpe, Safeguarding Adults Manager at Ann Craft Trust for her assistance with producing this content.

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