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Prevention and Management of Missing Person Incidents
Introduction
Missing person incidents are one of the most serious types of incidents that may place a consumer at risk of harm. There are various reasons why this type of incident may occur. Some consumers may have needs that require more supervision than others. If there are lapses in this supervision, even brief lapses, a consumer may wander away from a location without staff being aware. Common settings, such as shopping malls or crowded public events, may be stressful to some individuals. Because of feelings of restlessness or anxiety, a consumer may walk away from support staff.
In other situations, a consumer may intentionally leave a location without staff knowledge. When this occurs, the consumer may be either (a) expressing a dislike of something or (b) seeking to obtain some other preferred activity, place, person or item. He or she may want to do something that support staff take exception to, such as visiting a friend late at night. Some consumers may simply be expressing their desire for independence.
There are steps that can be taken to prevent or reduce the risk of this type of serious incident. Further, how others respond when this incident occurs can impact how quickly the consumer is found and safely returned.
Identifying Individual Risks
As a component of program planning, it is important to evaluate the risks that each consumer has for this type of incident. It is particularly important when the consumer has a prior history. Regardless, anticipating where, when, and why this could occur is the first step in incident prevention and management. Consumers' planning teams and Service Coordinators responsible for designing services and supports should include the following considerations when identifying individual risks:
- Identify the setting(s) in which this may occur. Most often, consumers are missing or become lost from their home or day program. Take into account the complete range of places they frequent: work or day programs, shopping malls, stores, restaurants, doctors' offices, theaters, sporting events, and recreation sites. Also identify any places the consumer appears to find unpleasant and could prompt them to leave if the opportunity should arise.
- Consider contributing factors. Identify the circumstances that may contribute or otherwise lead to a situation in which a consumer is missing or lost. A consumer may be more vulnerable to wandering away from others when exploring new settings. Some consumers, when upset, may want to be alone. There are times when staff may become distracted and not provide enough supervision. For example, transitioning from one activity (or location) to another, is a time where there is a high probability for the occurrence of a missing person incident.
- Evaluate underlying causes. If a consumer has a history of purposely leaving a location, identify the outcome that consumer is seeking. Is he or she attempting to avoid something or perhaps attempting to obtain something? In some situations a consumer may be expressing boredom or a desire to be involved in another activity. Oftentimes a consumer may simply want to be with a favorite person or spend time away from the home or day program.
Developing Prevention Strategies
- Identify special precautions and supports. Once individual risks have been considered, it is then possible to outline special precautions or supports that are needed. Carefully examine the consumer's preferences, the things they like and enjoy. Similarly, examine the consumer's dislikes or fears, the things or situations they want to avoid. Then address how the consumer can be best supported within this context. For example, if a consumer is unexpectedly leaving home to visit with family or friends, consider how he or she can be effectively supported by perhaps arranging more scheduled visits. A consumer who may walk away from others when staff are not close by may need staff to be particularly attentive and supportive at certain times or locations. As appropriate, this may include plans to avoid particular settings or locations. For example, a consumer could enjoy shopping in a small store yet strongly dislike large retail stores because the environment is too noisy and crowded.
Designing a Response Plan
While each service provider should have written procedures for responding to a missing person incident, it may be necessary to develop an individualized response plan to appropriately address a consumer's support needs. Listed below are important elements to consider in response plans:
- Immediate Actions Taken: Staff should have a protocol that details the initial steps to take when it is suspected that a consumer is missing. It is important to consider provisions for ensuring the safety of other consumers who need to be supervised. Include in the immediate actions taken:
- Immediate Search Strategies: This includes instructions for quickly conducting a through search of the immediate area.
- Instructions for Obtaining Assistance: The persons who may assist with the immediate search should be identified as appropriate to the setting in which the incident occurs. These instructions should be posted in a location that is readily available to staff without compromising confidentiality.
- Actions When A Consumer is Confirmed To Be Missing: If the consumer is still missing after a search of the immediate area, the staff person in-charge should have a protocol that details the next steps for:
- Initial Notifications: This includes instructions for alerting provider management staff or others designated to provide additional instructions, obtain back-up staff to assist with searching, and make decisions about contacting local law enforcement. There should also be instructions for notifying the consumer's family members, conservator, and significant others, as appropriate.
- Expanded Search Strategies: Instructions for conducting an expanded search should be provided. It is important to include prompts for staff to search locations (or otherwise contact individuals at that location) that the consumer may be likely to go. It is helpful to define how search efforts will be coordinated and by whom.
- Planning Other Actions: If the consumer is still missing after an expanded search has been conducted, there should be provisions for determining what other steps should be taken such as consulting or meeting with other team members, family members, and clinicians to plan a course of action. Responsibilities for maintaining communication with family members, conservators, and significant others should be outlined.
- Actions When A Consumer Is Found: When a missing consumer has been found, staff should have instructions for:
- Responding to the Consumer: How staff should best approach and respond to the consumer should be described.
- Making Notifications: In addition to notifying the consumer's family members, other persons who should be alerted are designated.
- Evaluating the Consumer's Health Status: Depending upon the circumstances, it may be necessary to arrange a medical evaluation for a consumer following a missing person incident. Steps for determining when this should be performed and how it is arranged should be outlined.
- Identifying Need For IPP Revisions: Responsibilities should be defined for assessing whether changes in supervision strategies are needed or if other measures should be taken to prevent future incidents.
- Evaluating Response to the Incident: After the missing consumer has been found, responsibilities and steps for evaluating the actions taken in response to the incident should be detailed so that any needed revisions to the response plan are promptly made.
Coordinating with Local Law Enforcement & Emergency Services
Missing person incidents are just one of the emergency situations that may arise in which local law enforcement agencies and other personnel may be called for assistance. There may be opportunities to improve the coordination with local law enforcement agencies, fire departments, emergency medical personnel, and 911 Call Centers, so that emergency responses are timely and effective.
Emergency personnel may have limited experience with people with developmental disabilities and may not understand the nature of various situations that pose unique challenges. Through collaboration with local emergency response agencies, actions can be taken to strengthen the overall response system.
Listed below are possible steps that may be taken with emergency services to facilitate timely, safe and effective emergency services for consumers:
- Establish forums to facilitate the exchange of information, collaborate about issues, and resolve problem areas;
- Provide opportunities to acquaint emergency personnel with basic information concerning developmental disabilities;
- Overview the various settings and locations in which consumers are supported and explain how supervision is provided;
- Determine the information needs of various emergency personnel and how to best accommodate those needs;
- Review possible situations and scenarios in which emergency services are called so they better understand the nature of the emergency and the risks involved;
- Identify how certain actions and behaviors of consumers may be misinterpreted by emergency personnel; and
- Review availability of crisis response teams, if applicable.
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