In 1988 pressure groups initiated the first Danish debates about occurrence and prevention of violence at institutions for people with learning disabilities.
The debate was raised by The Danish Disability Council and resulted in negotiations and discussions between the Danish Ministry of Social Affairs, The LEV National Association, The Danish Regions Handicap Group, The National Federation of Social Educators, and the research unit of the Social Educators University.
Violence as a Form of Expression was launched in 1992 at a national conference. The purpose of this project was to stimulate violence prevention work in the county councils’ residential care services. Because of the good results and experiences gained it was decided to make the project permanent from 1999.
Aims and Points of Departure
There were three distinctive points of departure throughout the project’s undertaking:
- Persons, who have a special need for support and care, are not typically violent. Violence is often an expression of helplessness, frustration and despair.
- Violence is not purely a work environmental related problem, in which the staff needs protection against the ‘inmates’. It is about creating better conditions and quality of life for the users and better working conditions for the staff.
- It is not only the co-workers who are exposed to violence. Users, residents and their relatives are also affected. They are also in need of support and care.
The purpose of Violence as a Form of Expression has from the start, through nation-wide development work, been to contribute to:
- shedding light on and describing the causes of why violence occurs and how violence develops describing, what can be done to prevent violence occurring
- gathering and disseminating available knowledge and experience on violence and the prevention of violence
- equipping co-workers and relatives, who could be exposed to incidents of violence to understand the reasons for the violence, and to reach methods that can reduce or eliminate violence
- contributing to the general recognition that violence should not be considered a problem in itself, but as an inappropriate reaction or a form of communication, with a deeper cause
- making working with users who have marked inappropriate behaviour, prestigious
From the beginning the intention was to work towards the creation of a framework for mutual exchange of experience and inspiration concerning common problems between the county councils’ co-workers and the relatives, the main focus being dissemination of solutions and results in relation to prevention and reducing violence.
To begin with, Violence as a Form of Expression featured persons with intellectual disabilities as the primary group. It was among the co-workers and relatives within this group that the need for special violence prevention work was formulated, and this was strongly supported by their respective organisations. However, attention was quickly drawn to other working areas within the county councils, where similar problems of violent incidents could be recorded. First, the area of children and youth was involved, then welfare homes were brought into focus as were persons with mental illness in social psychiatry – and in some counties also the area of hospitals. Finally, attention was drawn to persons affected by dementia in the counties’ residential care services.
In the project’s main activities, the co-workers’ situation and problems were primarily brought into focus with regard to violence and threats. However, more and more questions arose within the nation-wide framework as to how one can deal with problems of residents who live in a residential environment, and who, in a greater or lesser degree are exposed to violent incidents as part of their everyday lives.
Areas of focus
Many varied activities have been carried out, on a nation-wide basis as well as in all the co-operating counties. Listing them all here would be too lengthy, but they can be summarised in some main areas, which are:
- Developing a violence policy, with the intention of creating visibility, uniformity and continuity in the work with prevention of violence.
- Registering and analysing specific incidents of violence has been a suitable tool for the prevention of violence
- Education – not only about violence but also, just as importantly, about a long list of special professional specific themes, which have contributed to increasing insight and greater professionalism. This has also led to the development of professional methods and focuses on values and attitudes, and strives to develop ‘keeping in step’ in the work.
- Emergency plans – such as crisis plan checklists and crisis help have found their ways to many work places and today, good procedures are available for supporting co-workers in connection with incidents of violence.
- Physical conditions has been in focus, partly with the intention of creating a proper working environment and partly to secure a dignified framework for the users of residential care services.
- Technical conditions have also been part of the discussion – sometimes under the headline of ‘rearmament or disarmament’, i.e. how much technical alarm equipment should be used in relation to the professional methods for prevention or reduction of the violence.
- Special evaluation of the workplace has also recently gained a footing as a tool to tackle and prevent violence.
Violence as a Form of Expression is a form of network organisation, which comprises of the following components:
- Steering group
The steering group consists of representatives from organisations, who are actively involved in the nation-wide project, and who financially contribute towards the project’s activities. These are: The Danish Ministry of Social Affairs, the Danish Ministry of Labour, The Danish Regions, The LEV National Association, SIND, the Danish Federation for Mental Health, The Danish Council of Organisations of Disabled People, The National Federation of Social Educators, The Danish Trade Union of Public Sector Employees, The Danish Nurses Association, Social Development Centre, SUS. In the steering group overall guidelines and objectives for the project are discussed.
- County council groups
It is the intention of the nation-wide project that in all the participating county councils, a county council group will be established, which will have the responsibility for developing and carrying out their activities. As it has been an unavoidable starting point that each particular county council ultimately decides which specific activities they want to carry out within the framework of the project, there has also been a great diversity in how these county council groups are organised. In some counties, the groups have been separated for the particular work areas. In others, all the thematic areas have been assembled in one group, and yet in other places, there are no groups at all, but they have organised themselves through other co-operative agencies such as the central liaison committee/security committee.Representatives of the county council groups meet 3-4 times annually, with the view to exchange experiences of new activities in the particular counties, make contacts and discuss common development possibilities concerning prevention of violence.
- Thematically based network groups
Nation-wide network groups have been established covering following five themes: people with mental disabilities, people with learning disabilities, children and youth, persons affected with dementia, homeless and substance abusers at welfare homes.The idea of the network groups is to create an inspirational platform for co-workers from the respective fields, as well as the opportunity for a specific and a ‘hands on’ exchange of experiences. SUS functions as the initiators and the facilitators for the groups’ work as required.The network groups have been a very active element in Violence as a Form of Expression. A great deal of knowledge have been generated and disseminated from these, and both on a regional and a nation-wide basis the groups have been strong actors at arrangements such as at theme days and national conferences.The members themselves determine the specific contents of the work. At most meetings they visit each other’s work place and are introduced to the violence prevention work there.
- The secretariat and co-ordination
Social Development Centre SUS manages tasks in connection with the nation-wide co-ordination and dissemination of the activities. SUS supervises the running of the secretariat and provides guidance, counselling and consultancy to county councils, staff at residential care services, and students, among others.
- Ad hoc groups
In connection with the decision to implement specific activities, ad hoc groups are established with the participation of representatives from county councils and organisations. This has been done in connection with the development of a so-called inspiration file, which has been sent to all educational institutions in the social and health field, as well as to institutions in the pedagogical field. Also a group has been established, which works on the publication of a theory book on the themes of the project.
The nation-wide activities of the Violence as a Form of Expression project is funded by annual contributions from all the said county councils, organisations and governmental ministries. For specific dissemination activities, further funding is applied for from funding bodies, such as the State Pools Fund.