A child is defined as “Any person under the age of 18, whether living with their families, in state care or living independently”. (The Children (Northern Ireland) Order 1995).

In Northern Ireland an adult at risk of harm is defined as a person over the age of 18:

‘Whose exposure to harm through abuse, exploitation or neglect may be increased by their personal  characteristics and/or life circumstances’. (HSCB Northern Ireland).

Personal characteristics may include, but are not limited to, age, disability, special educational needs, illness, mental or physical frailty or impairment of, or disturbance in the functioning of the mind or brain.

Life circumstances may include, but are not limited to, isolation, socio-economic factors and environmental living factors.

An Adult in Need of Protection is a person aged 18 or over, whose exposure to harm through abuse, exploitation or neglect may be increased by their:

  • personal characteristics and / or life circumstances and
  • who is unable to protect their well-being, property, rights, assets, or other interests
  • and where the action or inaction of another person or persons is causing or is likely to cause him/ her to be harmed.

What is abuse?


Institutional abuse – is the mistreatment or neglect of an adult by a regime or individuals in settings which adults who may be at risk reside in or use. This can occur in any organisation, within and outside Health and Social Care provision. Institutional abuse may occur when routines, systems, regimes result in poor standards of care, poor practice and behaviours, inflexible regimes and rigid routines which violate the dignity and human rights of the adults and place them at risk of harm. Insititutional abuse may occur within a culture that denies, restricts or curtails privacy, dignity, choice and independence. It involves the collective failure of a service provider or an organisation to provide safe and appropriate services, and includes a failure to ensure that the necessary preventative and/or protective measures are in place.

Physical abuse – Is the use of physical force or mistreatment of one person by another which may or may not result in actual physical injury. This may include hitting, pushing, rough handling, exposure to heat or cold, force feeding, improper administration of medication, denial of treatment, misuse or illegal use of restraint and deprivation of liberty. Female Genital Mutilation is considered a form of physical AND sexual abuse.

Emotional or psychological abuse – is behaviour that is psychologically harmful or inflicts mental distress by threat, humiliation, or other verbal/non-verbal conduct. This may include threats, humiliation or ridicule, provoking fear of violence, shouting, yelling and swearing, blaming, controlling, intimidation or coercion.

Sexual violence and abuse – is any behaviour (physical, psychological, verbal, virtual/online) perceived to be of a sexual nature which is controlling, coercive, exploitative, harmful, or unwanted that is inflicted on anyone (irrespective of age, ethnicity, religion, gender, gender identity, sexual orientation or any form of disability). Sexual violence and abuse can take many forms and may include non-contact sexual activities, such as indecent exposure, stalking, grooming, being made to look at or be involved in the production of sexually abusive material, or being made to watch sexual activities. It may involve physical contact, including but not limited to, non-consensual penetrative sexual activities or non-penetrative sexual activities, such as intentional touching (known as groping). Sexual violence can be found across all sections of society, irrelevant of gender, age, ability, religion, race, ethnicity, personal circumstances, financial background or sexual orientation.

Financial abuse – is actual or attempted theft, fraud, burglary. It is the misappropriation or misuse of money, property, benefits, material goods, or other asset transactions which the person did not or could not consent to, or which were invalidated by intimidation, coercion or deception. This may include exploitation, embezzlement, withholding pension or benefits or pressure exerted around wills, property or inheritance.

Neglect – occurs when a person deliberately withholds, or fails to provide, appropriate and adequate care and support which is required by another adult. It may be through a lack of knowledge or awareness, or through a failure to take reasonable action given the information and facts available to them at the time. It may include physical neglect to the extent that health or wellbeing is impaired, administering too much or too little medication, failure to provide access to appropriate health or social care, withholding the necessities of life, such as adequate nutrition, heating or clothing, or failure to intervene in situations that are dangerous to the person concerned or to others, particularly when the person lacks the capacity to assess risk.

The Safeguarding Adults: Prevention and Protection Partnership Policy does not include self-harm or self-neglect within the definition of an ‘adult in need of protection.’ Each individual set of circumstances will require a professional Health and Social Care assessment to determine the appropriate response and consider if any underlying factors require a protection response. For example, self-harm nay be the manifestation of harm which has been perpetrated by a third party and which the adult feels unable to disclose.

Exploitation – is the deliberate maltreatment, manipulation or abuse of power and control over another person; to take advantage of another person or situation usually, but not always, for personal gain from using them as a commodity. It may manifest itself in many forms including slavery, servitude, forced or compulsory labour, domestic violence and abuse, sexual violence and abuse or human trafficking.

Human Trafficking/Modern slavery – involves the acquisition and movement of people by improper means, such as force, threat or deception, for the purposes of exploiting them. It can take many forms, such as domestic servitude, forced criminality, forced labour, sexual exploitation, and organ harvesting. Victims of human trafficking/modern slavery can come from all walks of life; they can be male or female, children or adults, and they may come from migrant or indigenous communities. The response to adults at risk of experiencing human trafficking/modern slavery will always be to report the incident to the Police Service.

Domestic violence and abuse – is threatening, controlling, coercive behaviour, violence or abuse (psychological, virtual, physical, verbal, sexual, financial or emotional) inflicted on anyone (irrespective of age, ethnicity, religion, gender, gender identity, sexual orientation, or any form disability) by a current or former intimate partner or family member. Domestic violence and abuse is essentially a pattern of behaviour which is characterised by the exercise of control and the misuse of power by one person over another. It is usually frequent and persistent. It can include violence by a son, daughter, mother, father, husband, wife, life partner or any person who has close relationship with the victim. It occurs right across society, regardless of age, gender, race, ethnic or religious group, sexual orientation, wealth, disability or geography.

The response to any adult facing this situation will usually require a referral to specialist services such as Women’s Aid or the Men’s Advisory Project. In high risk cases a referral will also be made to the Multi-Agency Risk Assessment (MARAC) process. Specialist services will them decide if the case needs to be referred to a Health and Social Care Trust for action under the safeguarding procedures. If in doubt, anyone with a concern can ring the Domestic and Sexual Violence helpline (0808 802 1414) to receive advice and guidance about how best to proceed.

Hate Crime – is any incident which constitutes a criminal offence perceived by the victim or any other person as being motivated by prejudice, discrimination or hate towards a person’s actual or perceived race, religious belief, sexual orientation, disability, political opinion or gender identity.

Cyber bullying – Cyber bullying occurs when someone repeatedly makes fun of another person online, or repeatedly picks on another person through emails or text messages. It can also involve using online forums with the intention of harming, damaging, humiliating, or isolating another person. It includes various types of bullying, including racist bullying, homophobic bullying, or bullying related to special education needs and disabilities. The main difference is that, instead of the perpetrator carrying out the bullying face-to-face, they use technology as a means to do it.

Forced marriage – This is a term used to describe a marriage in which one or both of the parties are married without their consent or against their will. A forced marriage differs from an arranged marriage, in which both parties’ consent to the assistance of a third party in identifying a spouse. The Anti-Social Behaviour, Crime and Policing Act 2014 make it a criminal offence to force someone to marry.

Radicalisation – The aim of radicalisation is to inspire new recruits, embed extreme views and persuade vulnerable individuals to the legitimacy of a cause. This may be direct through a relationship, or through social media.


Physical abuse is the deliberate physical injury to a child, or the wilful or neglectful failure to prevent physical injury or suffering. This may include hitting, shaking, throwing, poisoning, burning, or scalding, drowning, suffocating, confinement to a room or cot, or inappropriately giving drugs to control behaviour.

Emotional abuse is the persistent emotional ill-treatment of a child. It is also sometimes called psychological abuse and it can have  severe and persistent adverse effects on the child’s emotional development. It may involve conveying to children that they are worthless or unloved, inadequate. It may include not giving a child opportunities to express their views, deliberately silencing them, or ‘making fun’ of what they say or how they communicate. Emotional abuse may involve bulling – including online bullying through social networks, online games or mobile phones – by a child’s peers.

Sexual abuse occurs when others use and exploit children sexually for their own gratification or gain or the gratification of others. Sexual abuse may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing, and touching outside clothing. It may include non-contact activities, such as involving children in the production of sexual images, forcing children to look at sexual images or watch sexual activities, encouraging children to behave in sexually inappropriate ways or grooming a child in preparation for abuse (including via e-technology). Sexual abuse is not solely perpetrated by adult males. Women can commits acts of sexual abuse, as can other children, known as Sexually Harmful Behaviour.

Neglect is the persistent failure to provide for a child’s basic needs, whether it be adequate food, clothing, hygiene, supervision, or shelter that is likely to result in the serious impairment of a child’s health or development. Children who are neglected often also suffer from other types of abuse. It may also include neglect of, or unresponsiveness to a child’s basic emotional, social and educational needs.

Exploitation is the intentional ill-treatment, manipulation or abuse of power and control over a child; to take selfish or unfair advantage of a child or situation, for personal gain. It may manifest itself in many forms such as child labour, slavery, servitude, engagement in criminal behaviour, begging, benefit or financial fraud or child trafficking. It extends to the recruitment, transportation, transfer, harbouring or receipt of a child for the purpose of exploitation. Exploitation can also be sexual in nature.

Although exploitation is not included in the categories of registration on the Child Protection Register, staff should recognise that the abuse resulting from or caused by the exploitation of children can be categorised within the existing Child Protection register categories as children who have been exploited will have suffered from physical abuse, neglect, emotional abuse, sexual abuse or a combination of these forms of abuse. (Cooperating to Safeguarding Children and Young People in NI, 2017)

Threat to Life is defined by the National Chief Police Officers (NCPO) as perceived or potential, when considering all the circumstances relating to an individual, their involvement with, or knowledge of a crime or criminal behaviour or any other relevant information – a risk is identified that they may be exposed to a fatal attack or serious injury. Such threat and potential harm to a child is deemed to be an extreme form of child abuse, potentially falling within the definitions of harm contained in Co-operating to Safeguard Children and Young People in NI i.e. Potential/Actual Physical Abuse, Emotional Abuse.

Harmful Sexual Behaviour is developmentally inappropriate sexual behaviour which is displayed by children and which may be harmful or abusive. It encompasses a range of behaviour which can be displayed towards other children, peers and adults. It is harmful to the children who display it as well as to the people subjected to it. A child who engages in harmful sexual behaviour may be suffering, or be at risk of significant harm and may be in need of protection. Harmful Sexual Behaviour, when identified in children, must be taken seriously by all agencies. It is important to distinguish between behaviours that are experimental and those that are exploitative and harmful.

Runaway or Missing From Home or Care; Missing Children’s Protocol, 2015 – A Looked After Child who is not at their placement or the place where they are expected to be and their whereabouts are not known, is Missing from Care. A Runaway is a child who has run away from their home or care placement, or feels they have been forced or lured to leave. Going missing and being absent should be recognised as a wider safeguarding issue. To consider someone who goes missing to be at risk of harm underplays the situation and it is more correct to consider them to be actually suffering harm and therefore in need of safeguarding.

If you are concerned

If you think a child is in immediate danger, dial 999 or contact your local Social Services Gateway Service or Regional Emergency Social Work Service (out of hours including evenings, weekends and bank holidays) at 028 95 049 999.

If you are concerned about a MACS employee, volunteer or contractor, call Head Office on 028 90 313 163 or email your concern to

For more information about getting help for you or somebody else, please see our Get Help page.