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The purpose of this paper is to examine responses by police and Adult Social Care to honour based abuse (HBA) victims who have a diagnosed or perceived vulnerability, such as a physical disability or mental health issue. The aim is to improve professional practice in ensuring vulnerable victims are safeguarded.

Findings are drawn from 100 HBA investigations (2012-2014) derived from classified police electronic records and interviews with 15, predominantly specialist, public protection police officers in one UK force.

HBA against vulnerable adults is an obscure crime area. In cases of diagnosed vulnerability (3 per cent), police officers wrongly attributed “freewill” and choice to vulnerable adults who legally lacked the capacity to consent to marriage. Conversely, in 9 per cent of cases where victims were depressed and/or self-harming, perpetrators exaggerated the poor mental health of victims in order to discredit them to law enforcement. Professionals illogically latched onto perpetrator explanations and in turn undermined and problematised the victims.

There is limited access to data on vulnerable adult abuse, making this an under researched area of crime.

Failing to undertake risk assessments, or record whether the victim is legally vulnerable should lead to a review of police practice. An evaluation of joint working arrangements is necessary concerning which agency (police or Adult Social Care) should take primacy.

Vulnerable adult victims were retained in risk predicaments alongside perpetrating family members.

Police officers suggesting vulnerable adults can “consent” to marriage is a new concept, along with issues of goal displacement which illustrates avoidance behaviours by professionals and under protection by the state.

In our March issue, we discussed briefly the reappearance of the deficiency diseases among children in parts of this country; particularly rickets and, as far as our own experience goes, mainly among the immigrant peoples. With evidence on every hand of bigger and bonnier babies, school children several pounds heavier and at least two inches taller than the average of a generation ago; stores bulging with foods of every description and the accent always on the health aspect of foods, this news may have been difficult to believe. Now, under the title “Rickets Recurs in British Children”, the May issue of the Practitioner contains a survey of the increasing incidence of rickets among children in the Glasgow area (Arneil, Gavin O., 1964, Pract. 192, 652).

The ageing and disabled population is fast growing, which emphasises the need to effectively modify current homes and environments to support healthy ageing and increasingly diverse health needs. This paper aims to bring together findings and analyses from three adaptations-focussed projects, drawing on perspectives from key stakeholders alongside the lived experiences of service users acquiring adaptations.

Following an Adaptations Framework developed from interviews and focus groups with older people and key stakeholders, the paper discusses barriers experienced by older people and front-line workers in receiving and delivering adaptations through all stages of the process.

This paper reveals how experiences around adaptations might diverge with unseen, hidden investment and need amongst individuals, and how conceptual and cost-focussed evidence gaps impact wider understandings of adaptations delivery. In so doing, this paper highlights how the adaptations process is perceived as a “fight” that does not work smoothly for either those delivering or receiving adaptations services.

The paper suggests a systematic failure such that the adaptations process needs to be rehauled, reset and prioritised within social and public policy if the housing, health and social care sectors are to support healthy ageing and prepare for the future ageing population.

The paper brings together insights from key stakeholders alongside service users' experiences of adaptations to highlight key policy drivers and barriers to accessing and delivering adaptations.