What is psychological or emotional abuse?
Psychological or emotional abuse is conduct that has caused (or could reasonably have caused) a consumer psychological or emotional distress.
You must notify the Commission of any incident of psychological or emotional abuse that:
- happens in your service
- somebody has alleged happened at your service
- you suspect may have happened at your service.
What is psychological or emotional abuse?
Psychological or emotional abuse is conduct that has caused (or could reasonably have caused) a consumer psychological or emotional distress.
You must notify the Commission of any incident of psychological or emotional abuse that:
- happens in connection with care that your service provides
- somebody has alleged happened in connection with care
- you suspect may have happened in connection with care.
- taunting, bullying, harassment or intimidation
- yelling or name calling
- threats of maltreatment
- making threatening gestures towards a consumer
- punishing a consumer by withholding care or services
- making disparaging comments about a consumer’s gender, sexual orientation, cultural identity or religion
- humiliation
- unreasonably refusing to interact with a consumer
- unreasonably refusing to acknowledge a consumer’s presence
- unreasonable restrictions on a consumer’s social interaction
- repetitive conduct that is not unreasonable use of force, but which could cause a consumer psychological or emotional distress
- patterns of abuse which together cause a consumer psychological distress
- any other action that knowingly causes distress to a consumer, such as deliberately calling them by the wrong name
- moving items out of a consumer's reach or against a consumer's wishes to irritate or confuse them.
- raised voices to get the attention of a consumer with hearing difficulties
- minor disagreements between consumers
- making reasonable requests, such as asking a consumer to cooperate or encouraging them to eat their dinner.
- where a consumer is witnessed arguing with their spouse or family members.
Psychological or emotional abuse could be inflicted on the consumer by anybody at your service, including workers, visitors or other consumers.
What is 'in connection with care'?
You must manage and report all incidents (including alleged or suspected incidents) of psychological or emotional abuse in connection with care.
Incidents that occur in connection with care and that have (or could reasonably have been expected to have) caused harm to a consumer or another person, include incidents:
- that occur while care and services are provided
- that arise out of a failure to provide care and services
- where the harm (or potential harm) is connected to care and services provided, even if the harm did not occur during delivery of service.
Workers may witness incidents that are not in connection with care. This may include acts committed by members of a consumer’s household or community who are not affiliated with you. While incident management and prevention requirements do not apply to these incidents, it is part of your service’s broader responsibility to protect the safety, health and wellbeing of consumers. You must take protective steps when you become aware of neglect or abuse (including suspected or alleged incidents) of consumers.
You should also support consumers dealing with elder abuse or other issues by connecting them to further assistance, such as:
- OPAN (website) – the Older Persons Advocacy Network provides free, confidential, and independent support to older people seeking or receiving care and their families or representatives.
- 1800 ELDERHelp (1800 353 374) – a free and confidential National Elder Abuse phone line.
Workers may witness other workers interacting with consumers in a way they consider inappropriate or disrespectful. This could include giving abrupt or terse orders to a consumer or making inappropriate or cruel comments or jokes to a consumer or within earshot of a consumer. Where this occurs, workers must be encouraged to raise the incident with the worker directly or with service management and consider whether it should be reported to the Commission.
When your service is contacted by another service with concerns about a suspected or alleged incident, you should respond by assessing the incident or allegation. Where the incident meets the definition of a reportable incident, you must notify the Commission and manage the incident via your IMS.
Review About the SIRS for further detail on incidents in connection with care.
Work tool
The SIRS Decision Support Tool can help you explore what kinds of incidents are psychological or emotional abuse.
If an incident happens at your service, this tool can help you to decide whether it must be reported to the Commission, and if it is Priority 1 or Priority 2.
Patterns of abuse
Incidents of psychological or emotional abuse may consist of only one event or a series of incidents that form a pattern of abuse.
While the initial behaviour may not cause (or may not reasonably have been expected to have caused) psychological or emotional distress to a consumer, the repetitive nature of the behaviour over time can have a cumulative effect. This intensifies the level of potential harm to the consumer. Your IMS must allow for repeated minor incidents to be identified easily, so that any pattern of abuse can be recognised and reported to the Commission as a single reportable incident (and resolved by your service).
Warning signs
Incidents of psychological or emotional abuse are not always witnessed by workers at your service. There are other warning signs that might suggest that an incident has occurred. These include when a consumer:
- is unusually withdrawn, sad or emotional
- is secretive
- tries to hide information or belongings
- develops speech disorders
- has sudden weight gain or loss
- expresses feelings of worthlessness and low self-esteem
- is unusually disruptive or aggressive
- shows signs of self-harm, self-destructive behaviour or suicidal ideation
You should always investigate changes in behaviour or warning signs from your consumer.
Remember, if you suspect that a reportable incident has happened, you must notify the Commission. You should not wait for definitive proof.
Responding to psychological or emotional abuse
When an incident happens at your service, your first priority is always to ensure the safety and wellbeing of your consumer.
For incidents of psychological or emotional abuse, this could mean:
- providing mental health first aid
- actively listening to the consumer
- referring the consumer for medical or psychological treatment.
If the incident may be unlawful or if there is any ongoing danger to any person, you should also contact the police.
While managing the incident, you must continue to give the consumer support and practice open disclosure by letting the consumer, or their representative, know the steps you are taking to respond.
Responding to psychological or emotional abuse
When an incident happens in connection with the care your service provides, your first priority is always to ensure the safety and wellbeing of your consumer.
For incidents of psychological or emotional abuse, this could mean:
- providing mental health first aid
- actively listening to the consumer
- referring the consumer for medical or psychological treatment.
If the incident may be unlawful or if there is any ongoing danger to any person, you should also contact the police.
While managing the incident, you must continue to give the consumer support and practice open disclosure by letting the consumer, or their representative, know the steps you are taking to respond.
Reporting psychological or emotional abuse
Psychological or emotional abuse, like any reportable incident, must be recorded into your IMS and the Commission must be notified.
If there were reasonable grounds to contact the police, or if there was harm to a consumer that needed medical or psychological treatment to resolve, it is a Priority 1 reportable incident and you must notify the Commission within 24 hours of becoming aware.
If there were no reasonable grounds to contact the police and no harm to a consumer that needed medical or psychological treatment to resolve, it is a Priority 2 reportable incident and you must notify the Commission within 30 days of becoming aware.
A quality incident notification requires more than simply transcribing the details from progress notes about the incident or copying text from your IMS. It is important that the person making the notification is familiar with:
- what happened
- when the incident happened
- where the incident happened
- who was involved including the affected consumer, workers involved with the incident, and other affected people
- what actions were taken after the incident
- what caused the incident (if known)
- what changes will be made as a result of the incident (if known).
If you become aware of further information after submitting your initial notification, you should update the Commission.
When you provide clear and comprehensive information early on, it is less likely that the Commission will need to:
- ask for further details
- require you to conduct an investigation
- directly investigate the matter itself.
Multiple providers delivering care
Where you are one of multiple providers delivering aged care services to a consumer, you (or your worker) may become aware that an incident may have occurred, been alleged, or been suspected in connection with the care and services delivered by another provider.
For example, two services are delivering care and services to the same consumer, where your service is provider A, and another service is provider B:
- the consumer informs a worker from your service (provider A) that another worker from provider B hurt them during the provision of care and services, or
- the consumer shows signs of being involved in a reportable incident related to the care and services being delivered by another service, provider B. The consumer does not tell your service (provider A) what happened, or
- a worker of Provider A witnesses a worker of Provider B verbally abuse the consumer while delivering services in the consumer’s home.
As Provider A, you are not required to notify the Commission of such incidents through the SIRS, given you are unlikely to know the details and have limited ability to investigate such incidents further.
In such circumstances, you are expected to raise your concerns directly with Provider B so that Provider B can assess the incident, submit a SIRS notification where required and manage the incident. This will ensure that Provider B can act to prevent similar incidents from occurring in connection with their provision of care and services in the future.
In providing quality care and services, you should also provide support to the consumer to ensure their safety, health and wellbeing. You may also consider engaging with the consumer’s representative/s, a consumer advocacy service and/or making a complaint to the Commission, particularly where you have concerns about Provider B’s management of the incident.
Contracting or engaging organisations to deliver care
When you contract or engage another organisation or non-employee to deliver services on your behalf, this is not considered ‘multiple providers’. When this occurs, your service remains responsible for the delivery of safe and quality care and services and meeting your provider responsibilities.
It is your responsibility to ensure those delivering care understand their SIRS responsibilities; are trained to respond to incidents; and can escalate incidents so that they can be appropriately managed via your IMS and reportable incidents can be notified to the Commission.
Tip
It is easier to make a good quality notification to the Commission if you have the information you need at hand.
Educating workers to report incidents correctly within your IMS will make it easier to notify the Commission when a reportable incident happens.
Work tools
The fact sheet, Reportable incidents: psychological or emotional abuse, provides more detailed guidance for reporting of incidents in a residential service relating to this incident type.
The example Psychological or emotional abuse shows the level of detail the Commission expects when receiving a notification about this incident type.
You can use the Practical tips guide to ensure your notification contains all the required information.
Work tools
The fact sheet, Reportable incidents: psychological or emotional abuse, provides more detailed guidance for reporting of incidents in a home or community setting relating to this type of reportable incident.
Contact us
If you have a question about the SIRS, you can call us on 1800 081 549.
This phone line is open 9 am to 5 pm (AEST) Monday to Friday and 8 am to 6 pm (AEST) Saturday to Sunday.
You can also email us at sirs@agedcarequality.gov.au.
Facilitated workshops
The Commission provides facilitated workshops to those working in the sector. All current workshops are available on the Commission’s Workshop page.
Online learning
The Commission’s Aged Care Learning Information Solution, Alis provides free online education for employees of Commonwealth-funded aged care providers, including a module covering psychological or emotional abuse.
You can access Alis at learning.agedcarequality.gov.au.
Disclaimer
The information contained on this page is intended to provide you with general guidance; however, it is your responsibility to be aware of your legislative requirements.
