More than 500,000 incidents of adult maltreatment are estimated to occur in the United States each year. While only a small percentage are formally reported to adult protective services (APS) agencies responsible for investigating them, the number of reported incidents is steadily increasing. The number of maltreatment or self-neglect reports will continue to grow as more states require mandatory reporting by social workers and medical service providers, and the US population ages. Increases in population size and number of mandated reporters are likely to result in a dramatic increase in the demand for the services provided by APS agencies.
States created APS agencies to provide social services and legal aid to adults who may need assistance to defend or care for themselves. A primary task of these agencies is to respond to allegations of maltreatment, including abuse (physical, emotional, and sexual), financial exploitation, neglect by another person, and self-neglect. State APS agencies vary in terms of the extent of service provision beyond initial investigation, which is more often than not defined by state law. But while APS policies and procedures may differ, all APS agencies face very similar case management decisions. For example, as part of their investigations, APS workers must evaluate the current safety of their clients as well as the risk to their clients’ future well-being.
NCCD helps APS agencies use research as the basis for APS service decisions through the implementation of research-based and structured assessments. Identifying adults who are at high risk of subsequent maltreatment or self-neglect may help workers target engagement efforts more effectively toward those adults most in need of long-term services.
Selected APS publications:
In 2008, the New Hampshire Department of Health and Human Services Bureau of Elderly and Adult Services (BEAS) and the National Council on Crime and Delinquency (NCCD), with funding provided by the National Institute of Justice (NIJ), collaborated to construct an actuarial risk assessment to classify BEAS clients by their likelihood of elder maltreatment and/or self-neglect in the future. Studies in adult and juvenile corrections and child welfare have demonstrated that active service intervention with high risk clients can reduce criminal recidivism and the recurrence of child maltreatment (Wagner, Hull, & Luttrell, 1995; Eisenberg & Markley, 1987; Baird, Heinz, & Bemus, 1981). The purpose of this research was to examine a large set of individual and referral characteristics, determine their relationship to subsequent elder self-neglect and/or maltreatment, and develop an actuarial risk assessment for BEAS workers to complete at the end of an investigation to inform their case decisions. BEAS and NCCD pursued development of an actuarial risk assessment with the goal of reducing subsequent maltreatment of elderly and vulnerable adults who have been involved in an incident of self-neglect or maltreatment by another person (i.e., abuse, exploitation, or neglect). The actuarial risk assessment described in this report provides BEAS workers with a method to more accurately identify high risk clients and therefore more effectively target service interventions in an effort to protect their most vulnerable clients.
A new NCCD Focus article, "Structuring Decisions in Adult Protective Services," describes the value of structured decision frameworks in the growing field of adult protective services (APS). The article highlights findings on risk factors for future adult maltreatment from research literature as well as NCCD's efforts to develop an actuarial-based risk assessment for APS in partnership with the New Hampshire Bureau of Elderly and Adult Services under a grant from the National Institute of Justice.