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102.6 Safety in Families: Abuse, Neglect and Crisis
Recognize, report and connect: violence, trafficking, and mental health crises
Your materials
Slides (PowerPoint) Handout (Word)
For instructors
Facilitator guide Printable pre and post tests Quiz (LMS import)
What you will learn
- Recognize signs of family violence, abuse, neglect and human trafficking
- Follow agency protocol and Ohio reporting steps for suspected abuse
- Recognize mental health and substance use crises and make a warm handoff
- Use a trauma-informed approach in every contact
Start here
When someone you care about was in danger, who did you trust to help, and why them?
Lesson
Before we begin: a content note
Today we talk about abuse, violence and suicide. Take care of yourself.
- Step out if needed: You may leave the room or turn off your camera at any time. No one will ask why.
- Keep stories private: Share only what you choose. Never use names or details that identify a client or family.
- Help is here: Call or text 988 any time, for yourself or someone you are worried about.
Signs that may mean harm
| Type | Signs we may notice |
|---|---|
| Partner violence | Fear of partner, injuries explained away, partner controls money or phone |
| Child abuse or neglect | Unexplained injuries, hunger, fear of going home, missing care |
| Elder abuse or neglect | Unexplained bruises, missing glasses or walker, unsafe home, isolation |
| Financial exploitation | Caregiver controls money, unpaid bills, papers signed without understanding |
| Human trafficking | Cannot speak alone, no ID, story does not add up, fearful |
When you suspect abuse or neglect
Follow your agency protocol. These are the general steps.
- Danger now? Call 911: If anyone is in immediate danger, call 911 first.
- Stay calm and listen: Believe the person. Do not push for details or promise secrecy.
- Tell your supervisor: Report to your supervisor the same day, following your agency protocol.
- Make the report: Child: 216-696-KIDS. Adult 60 or older: Adult Protective Services, 216-420-6700.
- Write what you saw: Record facts and the person's own words, not guesses.
Who to call in Greater Cleveland
- Journey Center: Domestic violence and child abuse help, 24 hours. Call or text 216-391-HELP (4357).
- National DV Hotline: Call 800-799-SAFE (7233) or text START to 88788 to reach a trained advocate.
- Trafficking Hotline: Call 1-888-373-7888 or text 233733, 24 hours, in many languages.
- 988 Lifeline: Call or text 988 for suicide, mental health or substance use crisis. Local counselors answer.
Crisis: warm handoff or cold referral
Warm handoff
- Stay with the person while you call 988 together
- Introduce the person and share what they agreed to share
- Stay on until the counselor takes over
- Check back the next day
Cold referral
- Hand over a card with a number
- Leave the person to call alone
- No one knows if they got help
- No follow-up
A trauma-informed approach
SAMHSA names six principles. We use them in every contact.
- Safety and trust: Make the person feel physically and emotionally safe. Be open and honest about what you will do.
- Peers and partnership: Value peer support. Share power and work side by side, not from above.
- Voice and choice: People who lived through trauma are strong. Offer choices and respect their decisions.
- Culture and history: Recognize historical trauma, gender and culture. Push back on stereotypes and bias.
Why harm hides in families
- What we see: Mrs. Alvarez, 78, in Lorain seems thin and scared. Her nephew handles her checks and does not let visitors stay long.
- Why it happens (upstream): Isolation, few paid caregiving options, caregiver stress, poverty, and shame that keeps families from asking for help.
- What we can build on (assets): Adult Protective Services, her parish, a senior center, neighbors who check in, and Area Agency on Aging caregiver supports.
Situation: the quiet goodbye
Situation: During a follow-up call, Marcus, 34, from Fairfax, says he is tired of everything. He mentions he gave his gaming system to his little brother. He says, "It won't matter soon."
What do you say and do?
- Stay calm, thank him, and keep him on the line
- Ask directly if he is thinking about suicide
- If he has taken something or has a plan, call 911
- Otherwise, connect him with 988 together and tell your supervisor
Study sheet
The big idea: We notice harm, keep people safe, follow protocol to report, and connect people warmly to help.
Key points
- If anyone is in immediate danger, call 911 first.
- A sign of abuse is not proof. Notice, document facts, tell your supervisor, and report; never investigate yourself.
- In Cuyahoga County, report child abuse at 216-696-KIDS and adult abuse to APS at 216-420-6700.
- Never promise to keep abuse a secret; explain kindly what you must share.
- Ask directly about suicide. Asking does not plant the idea.
- In a mental health or substance use crisis, call or text 988 together: a warm handoff.
- Trauma-informed care centers safety, trust, peer support, partnership, choice and culture.
Remember
- Emergency: 911
- Suicide and crisis: call or text 988
- Cuyahoga child abuse hotline: 216-696-KIDS (5437), 24 hours
- Cuyahoga Adult Protective Services: 216-420-6700, 24 hours
- Trafficking: 1-888-373-7888; Journey Center: 216-391-4357
Ask yourself
- What will I say if someone asks me to keep a secret about harm?
- Who will I talk to after a hard visit, so I can keep doing this work?
Vocabulary
| Word | What it means |
|---|---|
| Intimate partner violence | Physical, sexual or emotional harm, stalking or control by a current or former partner. |
| Neglect | Failing to give a child or dependent adult the food, care, supervision or safety they need. |
| Financial exploitation | Misusing another person's money or property, often an older adult's, for someone else's gain. |
| Human trafficking | Using force, fraud or coercion to make someone work or perform sex acts for another person's gain. |
| Mandated reporter | A person Ohio law requires to report suspected child abuse or neglect because of their job. |
| Adult Protective Services | The county service that looks into reports of abuse, neglect or exploitation of adults 60 and older. |
| Crisis | A moment when a person's safety or ability to cope is at serious risk and they need help now. |
| Warm handoff | Connecting a person directly to the next helper, staying with them until the connection is made. |
| 988 | The Suicide and Crisis Lifeline: call, text or chat any time for mental health or substance use crises. |
| Trauma-informed approach | A way of working that assumes people may have lived through trauma and centers safety, trust and choice. |
| Safety plan | A plan a person makes, often with an advocate, to stay safer from violence or a crisis. |
Real-life situations
The bruise on the arm
During a home visit in Glenville, you notice bruises on 6-year-old Jayden's arms. His mother says he fell, but Jayden flinches when an adult walks in and says he does not want to go home after school.
What to do
- Stay calm; do not question Jayden or accuse anyone
- Leave safely and call your supervisor right away
- Follow agency protocol to report to 216-696-KIDS
- Write down only what you saw and heard, in exact words
- If you believe Jayden is in danger right now, call 911
Why: Children's services is trained to investigate. The CHW's job is to notice, report through protocol and keep the child safe.
"Please don't tell anyone"
Rosa, 29, a client in Clark-Fulton, tells you her boyfriend shoved her into a wall last week. She begs you not to tell anyone. She has no children.
What to do
- Thank her for trusting you and say it is not her fault
- Explain honestly what you must share with your supervisor under agency policy
- Offer the Journey Center (216-391-4357) and National DV Hotline in a way that is safe for her phone
- Respect her choices about next steps; offer to call an advocate together
- If she is in danger now, call 911
Why: Adult survivors make their own choices. Our job is safety, honesty and connection, while following agency policy.
The worker with no ID
At a health fair in Slavic Village, a young woman asks about a clinic. A man stands close, answers for her, and says he keeps her ID "for safety." She looks at the floor.
What to do
- Stay friendly and calm; do not confront the man
- If you can do so safely, offer a health card with the trafficking hotline number on it
- Tell your supervisor right after
- Call the National Human Trafficking Hotline (1-888-373-7888) to share what you saw
- If you see immediate danger, call 911
Why: Someone else speaking for a person and holding their ID are known warning signs. Confronting a possible trafficker can put the person at more risk.
Too much to drink
Mr. Hollis, 55, in East Cleveland, has been drinking heavily since losing his job. On a call he says he is hopeless but has no plan to hurt himself.
What to do
- Listen and reflect back what you hear without judgment
- Ask directly about thoughts of suicide
- Offer to call or text 988 together right now
- With consent, connect him to ADAMHS-funded treatment options
- Tell your supervisor and set a check-in for the next day
Why: 988 serves substance use crises as well as mental health. A warm handoff makes it much more likely he gets help.
Activity: My safety and crisis card
About 25 minutes.
- Make a pocket card with the numbers from this module: 911, 988, 216-696-KIDS, APS, Journey Center, and the trafficking hotline.
- Add your supervisor's name and number and one line from your agency's reporting protocol.
- Write the exact words you will use to ask about suicide, and say them out loud three times.
- Write one thing you will do to care for yourself after a hard visit.
- Share the card (not your self-care line, unless you want to) with a partner for feedback.
Post-test
Ten questions. You need 75% to pass, with one retake. Your result is saved in this browser.
Sources
- Cuyahoga County, Report Child Abuse or Neglect
- Cuyahoga County, Adult Protective Services
- Cuyahoga County Division of Senior and Adult Services, Red Flags of Abuse
- Ohio Revised Code 2151.421, Reporting child abuse or neglect
- Child Welfare Information Gateway, Mandatory Reporting of Child Abuse and Neglect: Ohio
- Ohio Legal Help, Journey Center for Safety and Healing
- National Domestic Violence Hotline
- Administration for Children and Families, National Human Trafficking Hotline award (2025)
- HUD, Human Trafficking Fact Sheet
- 988 Suicide and Crisis Lifeline
- The Land, 988 billboard campaign in Cuyahoga County (FrontLine Service and ADAMHS Board)
- SAMHSA's Six Principles of Trauma-Informed Care (Peer Support open textbook)
- U.S. Department of Transportation, human trafficking rest area poster (2026)
- Ohio Department of Job and Family Services, Adult Protective Services