Variations in Provider Capacity to Offer Accessible Health Care for People with Disabilities

Abstract

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care.     

Research Methods with Disabled Populations

Abstract

Although social work and related fields need more research involving people with disabilities, such studies can pose special challenges due to lack of understanding of disability issues, the disempowerment and invisibility of many who are disabled, and communication barriers. This article discusses ways of eliminating bias and maintaining ethical safeguards when designing and conducting research on people with disabilities. Participatory action research, which engages those studied in the design and conduct of research, is discussed as a model, as is the use of qualitative methods. Recent methodological innovations in survey research with deaf populations are also described and illustrated.     

Disability Through the Lens of Culture

ABSTRACT

Effective social work requires cultural sensitivity and competency. Until recently, there was little discussion of culture outside of the contexts of race or ethnicity. This article is an exploration of the key components of culture with application to the community of people with disabilities. The language, history, stigmatization, economic concerns, common behaviors, and practices of people with disabilities are highlighted. A literature review of sensitivity and competency in cross-cultural practice is provided. The article furnishes insights into the lived experience of disability. Suggestions to help practitioners reduce the risks of harm and improve service to this population are presented. Content on disability culture is proposed for social work educators to infuse into core curriculum or add to diversity electives.     

A Youth Perspective on Life with a Disability

Abstract

A momentous piece of legislation, the Americans With Disabilities Act (ADA) of 1990 provided for the elimination of discrimination against individuals with disabilities and more significantly is aimed toward improving their employment opportunities. There is, however, evidence that the ADA implementation has not moved fast enough in increasing employment opportunities for persons with disabilities. This article reviews the literature on disability and employment barriers, federal statutes, societal attitudes and biases, and human relations misconceptions associated with disabilities. It discusses social work roles, advocacy for social justice, implications for rehabilitation counselors, and issues related to disabilities and employment.     

The Implications of Disability Protests for Social Work Practice

Abstract

This article examines the demands which have been made in the over 800 US protests this author has analyzed. Some demands are cross-disability, meaning they could apply to people with all types of impairments; these include demands for rights and accessibility in all domains. Other demands are disability-specific: they apply to people with specific types of impairments, ranging from mobility impairments to developmental disabilities. Many demands have been related to services, which can be either cross-disability or disability-specific. The paper examines the implications of these demands for social work practice. These include that disability be de-stigmatized by practitioners, that people with disabilities have choices, that they have control over their services, and that all aspects of social work practice be accessible to people with any type of disability.     

Involving People with Profound and Multiple Learning Disabilities in Social Work Education: Building Inclusive Practice

Abstract

Service user and carer engagement is a foundational requirement of social work education. Despite this, questions remain about how diverse experiences are represented and who might be excluded from involvement. This paper focusses on one group of people who it is suggested are excluded from involvement, people with profound and multiple learning disabilities. Evidence is presented which demonstrates the extent to which this group have been marginalised and excluded from processes of involvement. The paper then provides a case study of one universities’ experience of developing work in this area, when a man with profound and multiple learning disabilities was commissioned to design and deliver specialist teaching for a group of qualifying social work students. We argue that the main barrier to inclusive involvement for people with profound and multiple learning disabilities is the attitudes and assumption of others about what they are capable of. We demonstrate how involvement in social work education helps to address these barriers by challenging the assumptions of students, the academy and society more broadly.     

Public Documents and Legislation: The South Australian Juvenile Courts Act, 1971, and Community Welfare Act, 1972

Abstract

This study of social work practice and disability follows the history of two fields of disability: mental illness and intellectual disability. Of particular interest are two key policy influences in the disability sector, deinstitutionalisation and normalisation. The extent to which deinstitutionalisation and normalisation have brought real benefit to people with disabilities is examined from social workers' perspectives. The implementation of these policies and practices on the daily work of social workers is discussed. This research indicates that social work practice in these two fields involves significantly different foci and approach. The study found that the similarities and differences between the two fields of practice are influenced by the historical and contemporary developments in the care and control of people with disabilities.     

Involving People with Disabilities in Volunteer Roles

Abstract

According to the 2002 National Health Interview Survey, 33.7 million non-institutionalized Americans have limitations in usual activities. A recent poll on community participation found that, overall, people with disabilities have lower rates of community participation compared to those without disabilities. An analysis of that same poll concluded that people with disabilities continue to be treated as second class citizens by being excluded from the mainstream of everyday life. Social role valorization theory proposes creating and supporting socially valued roles for people who are kept at a social distance. It is through these valued social roles that they gain equal access to other opportunities that society has to offer. One such socially valued role is that of a community volunteer. Volunteer activities can foster a social environment where people with disabilities are seen as credible coping individuals. This paper reports the results of a survey of twenty-six community agencies which regularly use volunteers. The purpose of the survey was to identify barriers to volunteer opportunities for people with disabilities and to explore openness to methods to remove the barriers through community collaborations.     

Editorial

Abstract

This comprehensive research study examined how schools of social work in Canada have responded to disability issues. The study focused upon specific policies and practices ofthe Canadian schools of social work which have been developed to create a more inclusive environment for students, staff, and faculty members with disabilities and to prepare students for practice in dealing with individuals who are disabled. A ten page survey consisting of closed and opened-ended questions was sent to the deans and directors of the thirty-five schools of social work in Canada. This study found that although there have been significant changes in these schools over the last ten years, there are many barriers to disability inclusion from recruitment and admissions; accommodations; retention, graduation, and employment; curriculum; hiring faculty and staff with disabilities; and university relations/resources. It concludes with recommendations for schools of social work.     

Knowledge,Tasks and Strategies for Teaching About Persons with Disabilities

Abstract

Persons with disabilities are a distinct and insular minority group within the United States. Given the fact that social workers offer critical social services to this group, it is important for social work programs to offer meaningful curriculum content on persons with disabilities. This article presents key issues that social work educators should find useful for teaching about persons with disabilities. Specifically, a discussion is offered on the disability civil rights movement, the culture of disability, models for defining disability, knowledge areas on disability issues, teaching tasks and strategies for focusing on persons with disabilities.     

Independent Mental Health Advocacy: A Model of Social Work Advocacy?

ABSTRACT

Advocacy has received less attention in social work research than other aspects of social work practice. This paper draws attention to two tensions in social work advocacy; between worker-led advocacy and person-led advocacy, and between individual advocacy and system level advocacy. We argue that human-rights-based social workers must choose a person-led approach over a worker-led approach while advocating with both systems and individuals. This argument is made by drawing on findings of an evaluation of Independent Mental Health Advocacy (IMHA) in Victoria, Australia. It is shown that social work training had not prepared social workers for rights-based, person-led advocacy and that social workers in public mental health services were struggling to maintain the rights of people in their services even with assistance from IMHA.

IMPLICATIONS

• Independent Mental Health Advocacy (IMHA) is a model of advocacy influenced by social work theory and delivered in part by social-work-trained advocates.

• Social work training is not preparing social workers for person-led, human-rights-based advocacy.

• Public mental health social workers are struggling to maintain the rights of people in mental health services even with the support of external advocacy services.

     

Children with disabilities in Swedish child welfare – a differentiating and disabling practice

ABSTRACT

Research shows that children with disabilities are victims of violence and abuse to a higher extent than other children and thus need support from social services. In Sweden, cooperation between two different social services units is required to support children with disabilities in socially vulnerable families. In this study, we have examined the intersection between children and disability in a Swedish social services context from the perspective of childhood studies and disability studies. The reasoning of the two units including the child perspective emerged during focus group interviews based on two vignettes. The results show two different rationalities, which has consequences for the disabled child. In spite of a social policy where the ‘best interests of the child’ are meant to prevail and disabilities are meant to be interpreted as barriers in society, children with disabilities seem to be reduced to individuals who are lacking in ability and competency and who are profoundly victimised by power structures that favour the adult perspective in social services.     

Supporting the Well-Being of People with Mobility Disabilities Through Social Work Practice

ABSTRACT

The purpose of this insight generating study was to explore the viewpoints of people with mobility disabilities (PWMD) about ways for social workers to promote their well-being through social work practice. A qualitative participant action style methodology encouraged PWMD to voice their concerns and recommendations. Eighteen PWMD were interviewed, including nine consumers and nine social workers. Participants indicated from their experiences that social workers commonly are not sufficiently cognizant of the personal goals, perspectives, and health potentials of PWMD. Overall, they suggested that the social work practice approach for people with disabilities should become more holistic and proactive. Their recommendations are consistent with current ideas about best practice in the social work and disabilities literature and they reinforce the importance of making these ideas more widely practiced.     

Families with Children with Disabilities - Inequalities and the Social Model

This article suggests that families with children with disabilities experience a range of inequalities that families with children without disabilities do not suffer. It draws on a recent qualitative study to illustrate the way in which it is not just disabled people, but in the case of disabled children, whole families that suffer from unequal opportunities and outcomes. We draw on the social model of disability to show that the lives of these families are often characterised by financial hardship, stress and anxiety as a result of social barriers, prejudices and poorly conceived service provision. The social model of disability is usually drawn upon to illustrate the way in which social organisation disables people with impairments. In this instance, we illustrate the way in which social organisation disables not just the family member who has an impairment but the whole family unit. By applying this model of disability, new ways of creating practices and policies for these families can be developed which incorporate their views into the heart of the policy-making process.     

Social Workers’ Roles in Supporting the Sexual and Relational Health of Children with Disabilities

The purpose of this study was to understand social workers’ roles in meeting the sexual and relational health needs of children (aged 3–11) with disabilities. We conducted semi-structured interviews with 12 social workers from a range of practice settings. A phenomenological lens privileged the perspectives of social workers in their definitions of disability and sought to convey the meaning they assigned to their experiences of working with children in practice concerning matters related to sexual and relational health. Social workers enacted a broad definition of disability and often came to work with youth in contexts labeled as sexually problematic. In the provision of sexual health services, social workers embodied commonly adhered to roles including as practitioners, enablers, advocates, brokers, and managers. Services are needed that promote positive sexuality and relational health among children with disabilities. It is important that social workers be proactive advocates for the full inclusion of people with disabilities as equal sexual citizens.     

Discovering Women with Disabilities

Abstract

The unique characteristics, strengths, and challenges facing women with disabilities are discussed. A feminist perspective is used to identify and understand the implications for developing policy, and providing services for and practicing with women with disabilities. Rather than utilize a traditional paradigm that places the “problem” within the individual woman with a disability, disability is explored within a social context.     

The Effect of Social Work Education and Self-Esteem on Students' Social Discrimination of People with Disabilities

Social work education on disability content has become more important due to political changes in the last two decades. The United States protected people with disabilities from discrimination in community and employment settings with the enactment of the Americans with Disabilities Act of 1990. These changes have empowered people with disabilities to become more independent; however, social workers primarily fulfill roles as case managers, and often make decisions for people with disabilities. This is not consistent with the empowerment perspective embedded in the disability movement. Most social work schools have minimal courses covering disability content. Previous research and the Self-Esteem Hypothesis indicate that social work education, social proximity to people with disabilities, self-esteem and other demographic characteristics are associated with social discrimination, or attitudes, toward people with disabilities. Social work students (n = 73) participated in a survey in the last semester of their program to assess how these characteristics were associated with their attitudes towards people with disabilities. A multiple linear regression revealed that social work education preparedness to work with people with disabilities, an MSW education, self-esteem, and having a friend with a disability were significantly associated with students' social discrimination towards people with disabilities.     

Social Work Admissions and Academic Accommodations for Students with Disabilities

ABSTRACT

The Americans With Disabilities Act of 1990 (ADA) protects students wth disabilities from discrimination by academic and professional programs in higher education. A student with a disability cannot be denied admission to an educational program because of his or her disability if the student is otherwise qualified. This means that a student with a disability who is qualified for an academic or professional educational program cannot be denied admission to a program based solely on the student&s disability. This educational requirement mandated by the ADA applies to all educational fields including social work education. The purpose of this study was to explore how social work programs are dealing with these requirements in their admission and academic accommodation procedures. Twelve social work programs located in the mid-western United States participated in the study. Representatives of each of these programs were given an in-depth interview focusing on their admissions process, academic accommodations, and general topics related to social work education and disabilities. All programs taking part in the research were accredited by the Council on Social Work Education (CSWE). The CSWE is the national accreditation body for social work education within the United States.