ME/CFS Dependence on Social Institutions: Violence, Abuse, Neglect and Exploitation
- August 2021
- Conference: 2021 IACFS/ME Virtual Conference
Authors:
Geoffrey Hallmann
Abstract
Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) impacts up to 250,000 Australians, reducing capacity to work and live independently, resulting in dependence on multiple social institutions. This is the first study of experiences arising out of ME/CFS patient interactions with social institutions.
Objectives: To identify the types of interactions with social institutions experienced by persons with ME/CFS in Australia.
Methods: A literature review was conducted to examine the key issues that impact people with ME/CFS and guide potential points of interaction with social institutions. Ethics approval ECN-08-146 was obtained and addressed potential physical and psychological harms to the participants and researcher (an insider researcher) – noting many studies overlook physical and insider harms. A total of 19 participants with a diagnosis of ME, MFS or ME/CFS were selected (including severe patients) using a purposive and snowballing sampling strategy from volunteers along the east coast of Australia between Brisbane and Melbourne, and were interviewed.
A pilot study of 3 interviews was utilised to refine the questionnaire and generate more open-ended responses. Recordings were transcribed. Notes and memorandums were recoded between interviews and preliminary issues/themes and connections evolved. Interviews were conducted to the point of thematic saturation.
Open coding of the transcripts was conducted manually, then within NVivo, where axial coding was applied. Following establishment of the tentative core/sub-core codes, selective coding was applied. Using a grounded theory approach, identified and emerging themes and categories were verified by participants and matched against extant and evolving literature the assess validity. Rigor was maintained via reflexivity, regular peer debriefing and review of transcripts and coding, feedback and cross checking.
Results: The participants revealed a variety of stories across multiple social institutions including interactions with health and medical, educational, employers, businesses, insurers, families, churches, welfare and other institutions. Four key themes were identified within these experiences – violence, abuse, neglect and exploitation (‘VANE’).
The most prominent stories involved interactions with medical and health providers, including doctors, nurses, allied health, ambulance and hospitals, where disbelief of the condition or psychological attributions influenced occurrence of VANE. Insurers contested the condition, resulting in consistent occurrence of policy default and dispute, leading to neglect and abuse.
VANE occasioned by family, partners and carers was experienced on a regular basis among the majority of participants. Institutional dependence meant some participants were unable to escape such an environment due to poor health or financial incapacity. Welfare institutions demonstrated neglect through inflexibility in procedures, application processes, attendance requirements, examinations, and office spaces, with no account for the condition.
Conclusion: The issue of VANE within disability is a significant concern that is common throughout Australian society. This study identified that VANE was commonly experienced by participants with ME/CFS when they interacted with social institutions, including medical, educational, insurance, families, and welfare. Given the vulnerability of people with disabilities, this study demonstrates that the perpetrators of VANE are often individuals and institutions the person with ME/CFS relies on for care and support.
https://www.researchgate.net/public...tions_Violence_Abuse_Neglect_and_Exploitation