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Abuse is any action or inaction that harms or injures another person and can present in many forms. While any one individual could experience abuse in their lifetime, it is important to identify vulnerable patient groups that are at greater risk of abuse than the general population.

These at-risk patient groups include, but are not limited to:

  • Children
  • Elderly
  • Women
  • Aboriginal and Torres Strait Islanders
  • People from Culturally and Linguistically Diverse backgrounds
  • People who identify as LGBTQIA+
  • People who are intellectually or physically impaired
  • People who suffer from mental illness
  • People who are homeless

Common categories of abuse include, but are not limited to:

  • Physical abuse: direct assault on the body. It can involve choking, strangulation, slapping, hitting, shaking, biting, kicking, hair pulling, pushing.
  • Psychological and emotional abuse: mental or emotional pain. It can involve creating fear, threatening harm, intimidation, coercion, harassment, humiliation, confinement, and isolation.
  • Sexual abuse: non-consensual sexual contact and / or sexual contact where the person was unduly coerced or could not provide consent. It can involve kissing, touching, sexual penetration, oral sex, exposure to sexual acts or pornographic materials.
  • Financial abuse: controlling an individual’s money and decisions around its use, taking or limiting money, stealing.
  • Technology-facilitated abuse: use of technology to monitor and stalk, send abusive text messages / emails, make harassing phone calls to share or threaten to share intimate images without consent.
  • Spiritual abuse: keeping someone away from places of worship or forcing them to participate in spiritual or religious practices that they do not want to be involved with.
  • Social isolation: keeping a person away from friends, family, work and / or other social opportunities.
  • Neglect: repeated failure to provide access to basic needs. It can include access to nutrition, hydration, clothing, housing and health care.

Family and domestic violence is a pattern of behaviour intended to coerce, control or create fear within a family or intimate relationship. It can take many forms with some abusive behaviours easily identifiable while others are more difficult to recognise. In intimate partner violence by men against women, research suggests that some risk factors (such as non-fatal strangulation) are associated with a higher likelihood of violence reoccurring, serious injury or death. You can read more about these risk factors here.

In cases of suspected family and domestic violence, St John WA staff and volunteers should provide reassurance and support to those involved. When discussing abuse with victims, always ensure that the perpetrator is not present. In some cases, adult and child victims living with perpetrators who use coercive patterns of control may not realise what they are experiencing is family and domestic violence.

If you have concerns that there is an immediate danger or a life–threatening situation, request WA Police attendance via the State Operation Centre or by dialling 000.

For victims with capacity, St John WA staff and volunteers can encourage victims to report their abuse to WA Police via 131 444.

Special circumstances:

  • If children or the elderly are the victims of family and domestic violence, please refer to the Child Abuse and Elder Abuse sections of this guideline for further information.
  • For victims who do not demonstrate capacity, St John WA staff and volunteers can report the details of abuse directly to WA Police via 131 444.   

In all cases, ensure information is handed over to either a registered nurse or doctor at the receiving care facility and all findings are documented on your ePCR. 


Child abuse refers to any kind of action or inaction that results in harm or possible harm to a child. A child who is being abused or neglected may feel fear, shame or confusion and may be afraid to tell anyone of the abuse. Abuse should always be considered as a potential differential diagnosis in children until proven otherwise. Under the Children and Community Services Act 2004, in Western Australia a child is a person under the age of 18 years.

There are four types of child abuse and neglect which can co-exist:

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Neglect

What to look out for:

  • Possible indicators of child abuse and neglect can be found here and should be considered in the context of the child’s age, capabilities, medical and developmental history.  

If a child tells you that they are being abused or neglected, the most important thing you can do is to believe the child and reassure them that telling you was the right thing to do. Allow the child to use their own words to tell you what happened. For more information see Responding to a child disclosing abuse (www.wa.gov.au).


Currently, it is not a mandatory requirement for St John WA staff and volunteers to report suspected child abuse or neglect. However, any person is lawfully entitled to make a voluntary (non-mandated) report if they are concerned for a child’s welfare.

Clinical Services believes that safeguarding is everyone’s responsibility and encourages staff and volunteers to report any suspected child abuse or neglect to the relevant authorities detailed below. It is also vital that this information is handed over to either a registered nurse or doctor at the receiving care facility and all findings are documented on your ePCR.

Department of Communities

You can contact the Department of Communities Statewide Referral and Response Service if you are concerned about a child’s wellbeing via the Central Intake Team on 1800 273 889 or by emailing cpduty@communities.wa.gov.au. To report your concerns outside of business hours, you can contact the Crisis Care Unit on 9223 1111. 

If you have concerns that the child is in immediate danger or a life – threatening situation, request WA Police attendance via the State Operation Centre or by dialling 000.

If you make a report or disclose relevant information to the Department of Communities, the following legislative protection will be provided to you.

  • Protection of identity - with some exceptions, your identity must not be disclosed without your consent. For further information, refer to section 240 of the Children and Community Services Act 2004.
  • Legal protection – you are not subject to legal liability under State law providing the information is provided in good faith.
  • Professional protection – authorised disclosure of information cannot be held to constitute unprofessional conduct or a breach of professional ethics. As a result, you cannot be disciplined by your professional body or incur any formal professional negative consequences at your workplace.

When you contact the Department, the Duty Officer will gather and record information that you provide and decide how best to respond. The type of information that the officer will gather includes:

  • details about the child / young person and family
  • the reasons you are concerned
  • the immediate risk to the child 
  • whether or not the child or family has support  
  • what may need to happen to make the child safe
  • your contact details, so that the officer can call you to obtain further information if required or to provide feedback

Elder abuse is defined as a single or repeated act, or lack of appropriate action, that occurs in a relationship with an older person where there is an expectation of trust and where that action causes harm or distress to the older person. It is largely underreported and can happen anywhere, in private homes, with families and in residential aged care facilities. More information can be found here.

Types of Elder Abuse:

  • Financial
  • Neglect
  • Psychological
  • Sexual
  • Social
  • Physical

What to look out for:

  • Acting fearfully or withdrawn
  • Signs of stress, anxiety or depression
  • Bruising or other physical injuries
  • An inability to pay normal bills or having an unpaid bill
  • Marked weight loss
  • Changes in sleeping patterns

Currently, it is not a mandatory requirement for St John WA staff and volunteers to report suspected elder abuse or neglect. However, Clinical Services believes that safeguarding is everyone's responsibility and encourages staff and volunteers to report any suspected elder abuse or neglect to the relevant authorities detailed below.

In these cases, you may need to share the patient’s confidential information and so it is important to explain this to the patient and obtain their consent, provided the patient demonstrates capacity. For victims who do not demonstrate capacity, St John WA staff and volunteers can report the details of abuse directly.

If you suspect that elder abuse is occurring, you can report it to police by calling 131 444.

It is also vital that this information is handed over to either a registered nurse or doctor at the receiving care facility and all findings are documented on your ePCR.

If you have concerns that the older person is in immediate danger or a life–threatening situation, request WA Police attendance via the State Operation Centre or by dialling 000.


  • Advocare: assists older people to understand their rights and provides free confidential information and support to older people who are at risk of or experiencing elder abuse. Call the Elder Abuse Helpline on 1300 724 679 during business hours Monday to Friday 8:30am – 4:30pm.
  • Crisis Careprovides Western Australia’s after-hours response to reported concerns for a child’s safety and wellbeing and information and referrals for people experiencing crisis. Phone: 1800 199 008.
  • Men’s Domestic Violence Helpline: provides telephone information and referrals for men who are concerned about their violent and abusive behaviours, and for male victims of family and domestic violence in Western Australia. Phone: 1800 000 599.
  • MensLine Australia: 24/7 support for men and boys dealing with family and relationship difficulties. Support for men who are concerned that their behaviour is hurting the people they care about. Phone: 1300 78 99 78.
  • Sexual Assault Resource Centre: provides a range of free services to people affected by sexual violence. Phone: (08) 6458 1828 or free call 1800 199 888.
  • Women’s Domestic Violence Helpline: provides support for women, with or without children, who are experiencing family and domestic violence in Western Australia (including referrals to women’s refuges). Phone: 1800 007 339.

References

Government of Western Australia. (2020). Explanation of High Risk Factors in Family and Domestic Violence. Retrieved from Flyer Consumer Template (health.wa.gov.au)

Government of Western Australia. (2021). Identifying child abuse and neglect. Retrieved from Identifying child abuse and neglect (www.wa.gov.au)

Government of Western Australia. (2021). Responding to a child disclosing abuse. Retrieved from Responding to a child disclosing abuse (www.wa.gov.au)

Government of Western Australia. (n.d). WA Strategy to Respond to the Abuse of Older People (Elder Abuse) 2019 – 2029. Retrieved from WA Strategy to Respond to the Abuse of Older People (Elder Abuse) (www.wa.gov.au)

Government of Western Australia. (2021). What is Family and Domestic Violence? Retrieved from What is Family and Domestic Violence? (www.wa.gov.au)

Western Australia Police Force. (2021). Family Violence. Retrieved from  Family Violence | Western Australia Police Force

Western Australia Police Force. (2019). Seniors and Elder Abuse. Retrieved from Seniors and Elder Abuse | Western Australia Police Force

World Health Organization. (2021). Elder Abuse. Retrieved from Elder abuse (who.int)

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