Our pilot research and recent scoping review suggests that people with cognitive impairment, such as acute mental distress, cognitive decline, intellectual disabilities, autism, and ADHD, may be at high risk of exploitation. They may also struggle to recognize when they are being exploited and face difficulties in effectively communicating or reporting exploitation. Understanding how exploitation intersects with cognitive impairment is crucial for implementing strategies that prevent and mitigate harm.  

While there are standalone statistics reporting disability prevalence and exploitation rates, finding intersecting data has been a key challenge for our research project. To the best of our knowledge, there are no publicly available statistics in England that quantify this relationship. This blog post condenses findings from a descriptive analysis of national and regional trends in cognitive impairment and exploitation to shed light on this critical topic. 

Our analysis draws from three data sources: the Family Resources Survey (FRS), the National Referral Mechanism for people who have experienced modern slavery (NRM), and the Safeguarding Adults Collection (SAC). The FRS provides insights into disability prevalence and the types of impairment experienced by individuals. The NRM data focuses on exploitation rates and types, while the SAC data documents the counts of Section 42 (S42) enquiries conducted by local authorities in England. 

According to the FRS data, approximately 11 million adults in England have a disability, representing 25% of the adult population. Half of these individuals have cognitive impairment, including learning disabilities, memory/cognitive disabilities, and mental health conditions. While mobility remains the most common form of impairment, a recent rise in disability prevalence has been driven by the increasing prevalence of mental health conditions. The prevalence of disability varies across regions, with the North East having the highest rates and London, the lowest. 

NRM statistics show an increase in the number of modern slavery referrals between 2017 and 2022. The number of referrals per 100,000 adults varied across regions, with London having the highest number of referrals. Labour, criminal, and sexual exploitation were the most prominent forms reported. However, the NRM currently does not collect information on an individual’s disability status or specific impairment, limiting the ability to explore the intersections between cognitive impairment and exploitation. 

The SAC data potentially provides a unique key to unlock this intersection as local authorities currently collect data relating to S42 enquiries on primary support needs (including different forms of cognitive impairment) and types of risk (including modern slavery and other types of exploitation).  Although the form in which S42 data is currently published does not enable this intersecting analysis, we can identify patterns, assess the involvement of people with cognitive impairment, and determine the frequency of exploitation as a factor.  

The SAC data shows an increasing trend in the number of enquiries recorded for people with mental health support needs, particularly people who have had no previous contact with services. There is also a growing concern for exploitation, with reports of modern slavery increasing by about 0.2 percentage points over time, albeit from a low base. Sexual exploitation has typically hovered around 0.8% of cases, ranging between 890 to 1,235 concluded enquiries per year, with the exception of 2021, when numbers peaked at over 1600 (1.1%). Financial abuse, which may also include financial exploitation, account for roughly one-fifth of concluded enquiries with numbers dropping by approximately 3,000 counts (a 2% percentage point drop) between 2020 and 2022. 

Local authority-level variations in S42 enquiries were diverse and are not significantly influenced by disability prevalence rates, gender ratios, age distribution, household deprivation shares, or net migrant flow. Other factors that influence the counts of S42 enquiries in local authorities may be explained by differences in local processes for addressing safeguarding concerns, and we hope to explore this qualitatively. 

In sum, the quantitative analysis demonstrates a high prevalence of cognitive impairment among individuals considered to be at risk. However, data limitations currently hinder a comprehensive understanding of the specific intersections between different forms of cognitive impairment and exploitation. Moving forward, it is crucial to address the gaps in data collection and analysis.  

The next phase of the research project involves a survey to gain insights from relevant stakeholders on the overlap between cognitive impairment and exploitation, as well as to gather information on current policies and practices in safeguarding people. You can find our policy and practice survey by clicking on this link. We are also asking local authorities to help us in understanding specific data overlaps.   

We hope that this research will shed more light on this anecdotally acknowledged, but poorly evidenced issue. 

For more information, please contact Aisha Abubakar: aisha.abubakar1@nottingham.ac.uk