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Reflections on the case of Ruby Knox

The Aotearoa New Zealand Association of Social Workers (ANZASW) believes that the review into the murder of Ruby Knox by her mother in 2016, published this month, raises serious issues that should be urgently addressed.

The case highlights the need for more services and quality respite to be made available to vulnerable adults, children with disabilities and their carers. Knox, who had been diagnosed with severe autism and an intellectual disability, was killed by her mother after she made repeated attempts to seek emergency help and expressed fears that she might harm her child, according to media reports.

ANZASW supports the report’s recommendation that an “early warning score system” be established through which risk factors can be monitored and interventions made before full-blown crises occur.

This move is important and necessary because abuse is so often hidden. In the event of an assault, disabled adults rarely make complaints to Police, typically because of limited or non-existent communication capacity or fear of retribution, and there is no equivalent to Oranga Tamariki to address care and protection issues for vulnerable adults.

With this in mind, ANZASW also backs the call for the government to create an "adult safeguarding service” similar to Oranga Tamariki, the Ministry for Vulnerable Children, as recommended in the review. Such a service could provide a much-needed boost to protection capacity especially in isolated regions.

The Knox case also highlights the need for more support to be made available to caregivers. Tragically, a large proportion of abuse experienced by vulnerable persons comes from those who assist them. While there is never any excuse for such behaviour, reductions in caregiver stress through respite and external support are essential in reducing the risk and prevalence of harmful behaviour.

We note that there is a shortage of adequately trained, well-paid and supported external carers available to the main caregivers of children with disabilities or vulnerable adults. The Carer Support Allowance, still only $75 a day, has to be carefully managed by families seeking respite. We regret that a review of Carer Support by the Ministry of Health in 2017, even after Knox’s case become public, did not result in an increase in the payment.

The Association also observes that Needs Assessment and Service Coordination (NASC) agencies, funded by the Ministry of Health to assess what financial supports can be allocated to families, are overwhelmed with large caseloads and have limited resources available to address a diverse and complex range of needs. Needs Assessors do not always have the capacity to follow up on the efficacy of the support they are providing, and some families cannot make full use of the support package they have been allocated.

ANZASW believes that there should be greater provision for the training of caregivers and that NASCs should be supported to significantly expand their workforce and analysis capacity.

Social workers across Aotearoa New Zealand do their best with limited resources to prevent abuse and facilitate change for children with disabilities, vulnerable adults and their carers. However, without an expansion of the services they can access, the needs of clients will not always be optimally met.

The Association envisions a future in which a system of respite for carers is developed that ultimately allows them to assist their dependents while living fulfilled lives. Carers should not have to wait until they are in crisis before they are provided with adequate support.

Without an expeditious expansion of the support available to children with disabilities, caregivers, healthcare staff, social workers and vulnerable adults we fear that another case similar to that of Ruby Knox could occur again in this country.

This must not be allowed to happen.

ends

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