Barriers to finding and maintaining open employment for people with intellectual disability in Australia

Everyone has the right to employment. Work is important for health, well-being, and social, economic, and financial inclusion. However, it is often difficult for people with intellectual disability to find and maintain work, especially in the open labour market. Policy challenges remain about who can access open employment (also sometimes called competitive or supported employment) and how often people with intellectual disability do so. Greater understanding about the barriers that people with intellectual disability encounter when they try to find and keep work in open employment is needed. Drawing on research with 51 people with intellectual disability in Australia, this paper examines the systemic barriers they report to finding and maintaining work in open employment. The findings highlight that the barriers they experience stem from narrow, dismissive, and discouraging attitudes to their work in open employment and from a spectrum of experiences of stigma and discrimination in open workplaces. The paper thus provides new knowledge about reasons that people with intellectual disability may either reject or not continue in open employment and take up less inclusive work options. The paper discusses the implications of the findings, including the need for policy development for attitudinal change, designing more varied roles for employees with intellectual disability, ensuring access to industrial relations protections, and increasing and better regulating and funding requirements on support to people with intellectual disability who are seeking work in open employment.     

Government perspectives on housing,technology and support design within Australia's National Disability Strategy

Australia's National Disability Insurance Scheme (NDIS) is a significant disability reform and part of a 10‐year National Disability Strategy that aims to build well‐being and inclusion of Australians with disability. Housing is recognised as a key determinant of health. Transition of state‐funded supported accommodation to an NDIS, within the new Specialist Disability Accommodation framework, aims to deliver housing responses that positively influence NDIS participant outcomes. This study aimed to gather perspectives of government disability and housing representatives on current opportunities and issues for Australians with disability. The study investigated four key research questions, relating to built design; integrated technologies; the relationship between housing and support provision; and community precinct design. Nineteen government representatives from seven of the eight Australian states and territories participated in a roundtable focus group in Melbourne, Australia (March 2017). Focus group data were audiotaped, transcribed verbatim and thematically analysed. Twelve themes were identified in response to the research questions identified. Key policy and practice implications were highlighted. This research offers insights from government that can contribute to strategic housing, technology, support and community design decisions and Australia's National Disability Strategy, to deliver improved outcomes for people with disability.     

THE CONTEXT FOR COMMUNITY PARTICIPATION IN HEALTH ACTION IN AUSTRALIA

Community participation is one of the underlying principles of democratic societies and the potential benefits of the participation process are well documented. Although a number of participatory mechanisms have been established by government departments and community agencies to facilitate community participation in health, few Australians regularly or actively participate. This paper examines the context for participation in health action in Australia including a political culture which serves to discourage participation in health, and many other areas, and barriers to participation associated with the complex structure and financing of the health care system.     

The Economic and Social Impacts of the CDEP Scheme in Remote Australia

The Community Development Employment Projects (CDEP) scheme is an unusual labour market and social development program for Indigenous people. Currently the CDEP scheme employs around 36,000 Indigenous Australians and accounts for over one‐quarter of total Indigenous employment. Despite the significance of the CDEP scheme, in recent times, relatively little attention has been given to the potential for the scheme to be used as an instrument for economic and social development in remote areas of Australia. This article present new evidence on the impact of the CDEP scheme on economic and social outcomes for Indigenous people in remote areas of Australia. It is concluded that the scheme has been successful in generating positive economic and community development outcomes at minimal cost to the Australian taxpayer.     

Poverty, Social Exclusion and the Politics of Disability: Care as a Social Good and the Expenditure of Social Capital in Chuadanga, Bangladesh

People labelled with disabilities in Chuadanga, Bangladesh, are denied equitable access to social networks and formal services. In terms both of funding future formal service programmes and of designing community‐based outreach programmes, this lack of access is not a simple reflection of one's impairment but a facet of the social exclusion and stigma that is culturally ascribed to disability in Chuadanga. We utilize a social model to focus on the cultural processes initiated by the onset of illness or impairment. Our participants are drawn from four types of diagnosed disability: blindness, orthopaedic impairment, hearing impairment and mental disorder. Although this inquiry is in line with Daly's focus on how future spending on formal services to promote care and equity in Europe can be helped by searching out information that is often ignored, the particular focus of this study is Chuadanga and the research questions incorporate a disability studies perspective. The authors consider care as a social good and an expenditure of social capital, in reviewing findings from a recent empirical study of disability and employment in the Bangladesh district of Chuadanga. Regardless of disability, poverty can be a morally and socially devastating ordeal. However, the authors conclude that the added loss of social solidarity and equitable access, due to the social exclusion and stigma of disability for the families concerned, make it statistically far less likely that they will access formal services or be able to escape poverty.     

Unemployment of professional artists: empirical evidence from Australia

This paper analyses the determinants of professional artists' unemployment. A sample of 1030 Australian artists was examined to determine the relationship between the probability of unemployment and artistic profession, education, origin and other demographic covariates. Special attention is focussed on factors influencing the probability of long‐term unemployment. It is found that artists in Australia are a heterogeneous labour market group, as regards exposure to unemployment and long‐term unemployment risk. The probability of unemployment episodes varies significantly depending on the artistic occupation: community cultural development workers, actors and directors are most likely to experience unemployment, while musicians and craftspeople are the least likely. Youth, disability, living in a capital city or in Tasmania, South Australia, Victoria or New South Wales, as well as level of tertiary education, can all increase the likelihood of unemployment episodes. On the other hand, participation in formal training in the artistic profession and living in a relationship or marriage are associated with a lower probability of unemployment. Being a writer or visual artist, living in the Northern Territory, and lower levels of education can increase the probability of experiencing long‐term unemployment. Neither gender, nor origin nor age affects the risk of long‐term unemployment of Australian artists.     

The experience of sole mothers balancing paid work with care for a child with a disability

There are increasing numbers of families in Australia headed by sole parents, but little is known about the experiences of those who also care for a child with a disability. Additional caring responsibilities have previously been shown to impact on the work participation of parents. This study involved qualitative analyses of interview data conducted with sole mothers with school‐aged children with disability (N = 11). Thematic analysis revealed four themes that enabled and supported participation in the workforce: social support; managing appointments; characteristics of the workplace; and the role of the school. Results suggest the importance of practical help from family and friends in facilitating participation in paid employment. Additionally, the importance of flexible appointment scheduling on the part of service providers was highlighted, as well as the importance of workplace flexibility and supportive workplace cultures. Such factors were important in supporting sole mothers to balance work with care, with important implications for personal and family wellbeing.     

Disability poverty and ageing in regional Australia: The impact of disability income reforms for indigenous Australians

Australian disability policy has undergone considerable reform since the early 2000s. While recent research and scholarship has largely focused on the new National Disability Insurance Scheme, there is a dearth of research that examines the impact of reform to the Disability Support Pension, and even less so the effects on Indigenous Australians living with disability. This is surprising as a higher proportion of Indigenous Australians live with disability than the non‐Indigenous population. This article pays particular attention to the experiences of Aboriginal Australians who have acquired a disability after extensive years of working (25–40 years), yet are still of workforce age (less than 65 years of age). Because of tightened eligibility criteria for the Disability Support Pension, people in this group are placed onto the lower paid Newstart Allowance (general unemployment benefit). The article illustrates the high levels of poverty that Aboriginal Australians with disabilities experience daily, and the ongoing costs they incur in managing Newstart conditionality to maintain continued access to the general unemployment benefit.     

‘Any one of us could be among that number’: Comparing the Policy Narratives for Individualized Disability Funding in Australia and England

In this article we compare the introduction of individualized budget policies for people with disabilities in Australia and England. Data is drawn from semi‐structured interviews undertaken in Australia with politicians, policymakers, providers, disability rights groups and care planners, along with analysis of policy documents. This data is compared to the authors’ earlier research from England on the personalization narrative. We argue that the National Disability Insurance Scheme (NDIS) currently being introduced in Australia deploys an insurance storyline, emphasizing risk‐pooling and the minimizing of future liabilities. This contrasts with the dominant storyline in England in which attention has focused on the right to choice and control for a minority of the population. This difference can be explained by the different financial context: the NDIS needed to build public and political support for a large increase in funding for disability services, whereas in England the reforms have been designed as cost‐neutral. Tensions in the English narrative have been about the extent to which personalization reforms empower the individual as a consumer, with purchasing power, or as a citizen with democratic rights. Australia's approach can be characterized as a form of social investment, evoking tensions between the citizenship of people with disabilities now and the future worker‐citizen.     

Rural Victorian service provider responses to the National Disability Insurance Scheme

The National Disability Insurance Scheme (NDIS) has transformed the nature of funding available to health and human service organisations to provide services to people with disability in Australia. However, there is relatively scant literature on the rural implementation of the NDIS, particularly how rural NDIS service providers are affected by the NDIS. Researchers conducted semi-structured interviews with 20 health professionals employed by rural providers, and analysed data using rural and remote health and organisational change frameworks to understand how rural providers were impacted by and responded to the NDIS. The findings suggest rural providers were impacted to differing extents and responded to the NDIS in different ways. Participants reported that disability and community health services were affected more than hospitals and private allied health practices. Impacted rural providers responded by changing the nature and types of services, service processes and their workforce, and redefining organisational characteristics. Impacted rural providers may require additional support to continue providing services, and those less impacted may require other incentives to better engage with the NDIS. Rural proofing of NDIS policy could reveal suitable supports and incentives to ensure rural people with disability can access required services.     

Means Testing and the Heterogeneity of Housing Assets: Funding Long-Term Care in Spain

The access to publicly funded long‐term care (LTC) in Spain has been traditionally rationed through the use of means tests based on individuals’ current income and needs. However, individuals’ wealth, primarily housing assets, is progressively taken into account. Parallel to this feature, the responsibilities for the organization of LTC services have been devolved to region‐states – autonomous communities (ACs), giving rise to some regional heterogeneity, though limited evidence has been reported on the underlying determinants. This paper examines the current role of housing assets in determining public and private funding for long‐term care in Spain. Secondly, we present a qualitative and quantitative examination of the regional heterogeneity in the provision and public funding criteria determining eligibility for public support for LTC. Finally, we report survey evidence on the individual's willingness to sell (WTS) their housing assets in order to either totally or partially finance the access to LTC. Our findings suggest that housing assets are the main source of wealth accumulation at old age. Yet there is significant regional heterogeneity in the access to LTC resulting from regional differences in the means testing criteria. Progressively, all ACs are considering housing assets in their means testing criteria. Interestingly, individuals’ willingness to sell their housing assets declines with age and is more common among less skilled and widowed individuals.     

The school to work transition for young people in state care: perspectives from young people,carers and professionals

Workforce participation has many positive effects on quality of life. However, as young people in care have generally below‐average levels of educational participation and attainment, they may be ill‐equipped for the transition to further education and work. A mixed‐method study conducted in Australia about career development for young people in care investigated how this population develops ideas about future work: the social and cognitive variables that influence career decision‐making; practices for preparing young people in care for the transition to work or further education; and factors that support or impede the transition. Findings from the qualitative study are reported in this paper. Interview data were obtained from the multiple perspectives of young people in care, foster carers, caseworkers and school personnel. The overall picture was one of young people in care lacking the encouragement, resources and capacity to realistically plan for the job they want. Specific interventions are required to enhance career development and employment outcomes for this population.     

Return of the Nanny: Public Policy towards In‐home Childcare in the UK,Canada and Australia

Research on early childhood education and care (ECEC) policy focuses overwhelmingly on formal, centre‐based provision and, to a lesser extent, on family day care (or childminding) provided in the homes of registered carers. Comparatively little research addresses the policy treatment of care provided in the child's home by nannies and au pairs. This article examines the position of in‐home childcare in Australia, the UK and Canada, and the varied nature and extent of public funding and regulation. Introducing a new dimension into comparative studies of ECEC, it also explores how shifts in migration policy in each country have intersected with ECEC funding and regulation to reshape the recruitment and employment of in‐home child carers. Australia, the UK and Canada are all liberal, market‐oriented countries, but there is considerable diversity in the way governments support and regulate in‐home childcare, their rationales for so doing, and in the connections between childcare and migration. We argue that connecting the analysis of in‐home childcare to migration policies raises new questions about the classification and comparison of ECEC policies.     

Employment status transitions among young adults,with and without disability

Employment is a crucial avenue through which young people with disability can experience material wellbeing and social participation. While the low employment rates of young people with disability are well established, little is known about the stability of employment status – that is, the degree to which individuals remain in or move in and out of employment. This article uses longitudinal data from a large Australian national data set to investigate the transitions between full‐time, part‐time and non‐employment for young people with and without disability. Considerable mobility was found between employment states for both young people with and without disability, with young people with disability more likely than their peers without disability to transition to reduced levels of employment and less likely to transition to increased levels of employment. Social background and contextual factors predicted employment for young people with disability; however, disability represented an additional penalty even after taking these factors into account. Findings suggest a need for social policy targeted specifically towards the barriers to maintaining and increasing employment experienced by young people with disability.     

Indigenous Australians and Impaired Decision‐Making Capacity

This article explores issues associated with impaired decision‐making capacity for Indigenous Australians. There is very little published on the subject of impaired decision‐making capacity in Australia, particularly in relation to Indigenous people. To gain some insight into this subject, this article looks at some indicators of impaired decision‐making capacity for Indigenous Australians such as rates of intellectual disability and mental illness. The Australian state‐based Guardianship and Administration system—the legislative framework designed to provide for decision‐making for people with impaired capacity—is briefly described before looking at the cultural relevance of this Western system and its constructs for Indigenous Australians. Future investigation should be directed at exploring existing and alternative strategies to support Indigenous Australians with impaired capacity and their carers.     

Contextualising the ‘Crisis in Aged Care’ in Australia : A Demographic Perspective

Australia's ‘old‐old’ population is growing even faster than the total aged population and despite improved incomes, living conditions, health risk behaviours and health care this will result in a concomitant increase in the numbers of older people with disabilities. This paper examines ABS 2003 survey data on the incidence of disability among older Australians and their need for, and utilisation of, formal and informal care. It uses this as a basis for projecting the incidence of disability among older Australians and the need for informal and formal care up to 2031. These indicate there is a major challenge since the aged care workforce has grown only slowly in Australia and is concentrated in the older working ages presaging a loss of workers through retirement. There needs to be a significant effort put into attracting workers to both the skilled and unskilled parts of the aged care industry.     

‘Replacement Care’ for Working Carers? A Longitudinal Study in England, 2013–15

In the context of rising need for long‐term care, reconciling unpaid care and carers’ employment is becoming an important social issue. In England, there is increasing policy emphasis on paid services for the person cared for, sometimes known as ‘replacement care’, to support working carers. Previous research has found an association between ‘replacement care’ and carers’ employment. However, more information is needed on potential causal connections between services and carers’ employment. This mixed methods study draws on new longitudinal data to examine service receipt and carers’ employment in England. Data were collected from carers who were employed in the public sector, using self‐completion questionnaires in 2013 and 2015, and qualitative interviews were conducted with a sub‐sample of respondents to the 2015 questionnaire. We find that, where the person cared for did not receive at least one ‘key service’ (home care, personal assistant, day care, meals, short‐term breaks), the carer was subsequently more likely to leave employment because of caring, suggesting that the absence of services contributed to the carer leaving work. In the interviews, carers identified specific ways in which services helped them to remain in employment. We conclude that, if a policy objective is to reduce the number of carers leaving employment because of caring, there needs to be greater access to publicly‐funded services for disabled and older people who are looked after by unpaid carers.     

Australia's Individualised Disability Funding Packages: When Do They Provide Greater Choice and Opportunity?

Australia's new National Disability Insurance Scheme (NDIS) uses individualised funding packages instead of traditional block‐funded disability services to support people with disability. The NDIS works with the person and their family to assess the person's needs and develop a plan that determines their funding allocation. Funding can be used to purchase support from a disability service or from the open market. People can purchase support that suits their cultural and personal preferences. This paper examined whether individual funding packages met their aims in Western Australia, where they had been the primary mechanism of disability support for over 25 years. An exploratory case study was conducted consisting of face‐to‐face, in‐depth interviews with 11 key participants: people with disability, senior government administrators, service provider managers, and a support worker. Complex systems theory was used to review the data and findings showed that individualised funding packages did not automatically result in more choice and greater opportunities. People needed information to make informed decisions; supportive and creative support from social workers and other professionals; and welcoming communities. The findings can inform policies and assist social workers facilitate maximum choice and opportunities for people with disability and their families.     

Models of Disability, Work and Welfare in Australia

In discourse around disability there has been a shift away from a ‘medical model’, which perceives disability as an individual problem to be ‘cured’ or contained, towards a ‘social model’. The latter focuses on the relationship between people with disabilities and their social environment, locating the required interventions within the realm of social policy and institutional practice. Drawing upon a small qualitative study conducted in Melbourne, this article argues that recent plans by the Australian government to introduce mutual obligation requirements for recipients of the Disability Support Pension (DSP) sit in tension with this shift from the medical to the social models of disability. Mutual obligation is based on the assumption that income support recipients need to be taught how to be more ‘self‐reliant’, to ‘participate’ in society more fully and to become ‘active’, rather than ‘passive’, citizens. This language appears to overlap with that used to articulate a social model, which places emphasis on participation in the community and attempts a shift away from reliance on the medical profession. However, examples from interviews conducted with current and former DSP recipients demonstrate that, in practice, mutual obligation is likely to reinforce a medical model of disability, frame DSP recipients as ‘conditional’ citizens and ignore the obligations of the state and society regarding access and inclusiveness for people with disabilities.     

Models of disability support governance: a framework for assessing and reforming social policy

In many developed countries, the provision of disability services has undergone significant transformations, from institutional to community based care, and from oganisational to personalised funding. Yet delivering disability support remains an ongoing challenge for governments. Specifically, the relative success of different types of disability support governance is convoluted and problematic given the diversity and complexity of disability support systems and the people they serve. To enhance the systematic analysis and evaluation of disability support governance, this paper conceptually advances four distinct models based on the locus of control and coordination of such support: uncoordinated; casework governance; dwelling‐based governance; and user‐coordinated. Using illustrations from case studies of individuals receiving care, the identification of these ideal types enables their relative strengths, weaknesses, and the occasions of governance failure to be articulated. No one model is universally applicable to people, nor immune to failure. Furthermore, the paper presents a novel approach to visualising actual disability support arrangements as social networks. The utility of such visualisations for analysing individual and system‐ wide arrangements is outlined. In the context of Australia's developing National Disability Insurance Scheme, these conceptual and analytical developments are argued to be important tools for policy and service analysis and reform.