Variations in provider capacity to offer accessible health care for people with disabilities

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.     

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.     

Assistive technology and employment: experiences of Californians with disabilities

For people with disabilities, work remains the best route to independence and enacting one's own choices. Assistive technology (AT) is often crucial in removing barriers to employment, and in enabling workers with disabilities to work more productively. A participatory action research project known as Community Research for Assistive Technology surveyed people with disabilities using Independent Living Centers throughout California, in part to identify barriers to employment and study use of job-related AT to overcome such barriers. Across disability groups, disability itself was cited as the primary barrier to employment, with potential loss of benefits and lack of education cited as secondary barriers. A majority of working respondents reported using assistive technology (such as adapted telephones, wheelchairs, magnifiers, and adapted computer equipment) or services to perform job functions. The vast majority of those using job-related AT reported substantial benefits to their productivity and self-esteem. Employees' requests for AT as a workplace accommodation were granted more often than not, but many other employees had to pay for their own workplace AT.     

Social work with people with disabilities in Croatia: a qualitative study

In conducting this study, the authors aimed to gain insight into social work with people with disabilities. Due to the lack of research in this field, qualitative methodology was applied. Using semistructured interviews, data were collected about 30 respondents: 10 people with disabilities, 10 parents of people with disabilities, and 10 social workers who work in the public sector with people with disabilities. Analysis of the results revealed characteristics of approaches to social work, knowledge and skills used in working with people with disabilities, difficulties related to specific work with clients, and the position of the profession in society.     

Parents’ and Professionals’ Perceptions of the Services of Families of Children with Intellectual Developmental Disabilities

This study aims to investigate differences in perception among Kuwaiti parents, teachers, and employees regarding the services that are needed in different special education settings. The participants (n = 135) included 45 parents of children with intellectual developmental disabilities (IDD), 63 teachers in special education schools, and 27 employees working in the Higher Council of the Disabled. A survey was conducted using Hassan’s (The needs of parents of children with disabilities in relationship with child’s age, gender, and type of disability, 1992) Arabic version of the Family Need Inventory. The findings showed differences in perception among parents, teachers, and employees regarding what they consider to be the most important services for families of children with IDD. Another result showed significant differences in perception among the three groups regarding services (match or/and mismatch of responses), except for 3 out of 35 types of services. Suggestions and implications are discussed to provide information to social service providers to help them evaluate the laws that pertain to disability in Kuwait. The findings of this study will help social service providers determine and implement laws that meet the needs of parents of children with IDD and give them the right to be full partners in their children’s education.     

The lived experience of students with an invisible disability at a Canadian university

University institutions are required by law to make their services accessible to students with disabilities. Canadian universities have gone a long way to eliminate the physical obstacles that present barriers for students. Many students with disabilities have invisible disabilities that require different types of adjustments. Although some researchers have evaluated the needs of students with disabilities in higher education, the unique needs of students with invisible disabilities have received less attention. The best means of assessing these needs is through direct consultation with students with disabilities. Thus, in-depth interviews were conducted with university students with dyslexia, attention-deficit hyperactivity disorder, and mental illness. Themes were developed that related to the nature of the disability, the accessibility of the university context, the social and organizational barriers, and recommendations for change. This research lends insight into how individuals with invisible disabilities believe that they are perceived within the university context.     

Students' Attitudes to the Inclusion of People with Disabilities in the Community

This study measures and compares the attitudes of students studying different subjects to the inclusion of people with mental retardation and mental illness in the community. The Community Living Attitude Scale (comprising the four subscales of Empowerment, Exclusion, Sheltering, and Similarity) was administered to a random sample of 149 Israeli college freshmen and women (social work: n = 43: law: n = 24; natural science: n = 42; and social science: n = 40). Overall, the students endorse Empowerment and perceive the Similarity of persons with disabilities to themselves more than they agree with the Exclusion attitude of segregating persons with disabilities from community life. Social work students showed more positive inclusion attitudes to people with disabilities than other students. Students were more likely to endorse Exclusion for people with mental illness than for people with mental retardation.     

Social Work Students’ Interest in Working with Persons with Serious Mental Illness

Educating and recruiting practitioners to work in community-based settings with persons with serious mental illness has become a national health issue, particularly in underserved rural areas. To inform curriculum development and recruitment efforts, the authors conducted a needs assessment. Graduate and undergraduate social work students in a rural New England state university were surveyed about their interest, perceived competence, and perceived training needs in working with persons with serious mental illness. The findings indicated that almost half of the students expressed an interest in working with this population. The extent and nature of previous work with this population and educational level were shown to be related to students’ responses, in areas including interest in work with persons with serious mental illness and the perceived ability to handle a psychiatric crisis. The findings suggest important implications for the social work curriculum, additional needs assessment, and recruitment activity.     

Client-centered care for individuals with dual diagnoses in the justice system

1. The characteristics of people with developmental disabilities, such as poor judgment, low frustration tolerance, lack of impulse control, and naivete, compounded by the symptoms of a mental illness, contribute to their susceptibility to engage in problematic or criminal behaviors. 2. Nurses should recognize that conducting risk assessments for this population may take time and could involve modifying risk assessments to the individuals' abilities. 3. Providing appropriate care for this vulnerable population requires a long-term, interdisciplinary approach and quality community support services     

Self-reported musculoskeletal pain and working conditions among employees in the Swedish public sector

Musculoskeletal disorders constitute a considerable public health problem, often resulting in sickness absence, particularly in public sector employees. Increased knowledge on how this is related to individual and work-related factors is required. The objective of this study was to investigate the associations between self-reported musculoskeletal pain and the following factors: physical and psychosocial work conditions, lifestyle, psychosomatic symptoms and sick leave. A comprehensive questionnaire was completed by a total of 2523 people, of which 87% were women and 13% men. The participants were employed in public hospitals, educational institutions, home care services for the elderly and domestic/catering services in a Swedish county. The response rate was 92%. Multiple logistic regression analyses showed that the high level of self-reported musculoskeletal pain was highly associated with strenuous physical and psychosocial work conditions. The physical factor with the highest odds ratio (OR) was working in a forward-bent position. High work demands was the most prominent psychosocial factor and distinctly associated with musculoskeletal pain among men. Physical work strain and other demanding working conditions, which were associated with musculoskeletal pain, were frequent among employees in home care services for the elderly and domestic/catering services. There was a strong association between long-term sick leave and high musculoskeletal pain. Furthermore, there was a strong association between a high level of musculoskeletal pain and the exhibition of psychosomatic symptoms in both women and men; this is an interaction that may intensify the total experience of illness and thus needs to be further investigated.     

The implications of disability protests for social work practice

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.     

Social firms: Building cross-sectoral partnerships to create employment opportunity and supportive workplaces for people with mental illness

A major barrier to employment for people with mental illness is limited access to supportive and non-discriminatory workplaces. Social firms are businesses committed to employing up to 50% of people with a disability or other disadvantage and to providing supportive work environments that benefit workers. Little research has been conducted to understand the features and social processes that support the vocational experiences of employees with mental health issues in social firms. Objective: This ethnographic study sought to explore the experiences of nine employees at one Australian social firm. Participants: Nine employees of a social firm, with and without mental illness. Methods: Study methods used included participant observation, interviewing and document analysis. Results and conclusions: The study highlights the complexity of running a socially-invested business, and the importance of cross-sectoral partnerships to support their operational success. Natural workplace supports, adequate training and support infrastructure and enabling participation in the business, were identified as important to creating a supportive workplace. Partnerships within the workplace and in support of the workplace are discussed. Future growth and development of partnerships are recommended to support the establishment of social firms.     

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.     

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.     

Substance Use and Disabilities: Experiences of Adults' Social Care Professionals and the Implications for Education and Training

This paper draws on data from a national survey of social workers and social care practitioners in England undertaken in 2010–2011. It focuses on practitioners working in services for adults with either learning or physical disabilities and, in particular, their experiences of responding to alcohol and other drug use among their service users. Based on secondary analysis of survey and focus group data from the earlier study, the paper outlines the extent to which workers in these areas of practice encounter alcohol and drug problems and discusses the key challenges this poses for them. The findings show that between 4% and 10% of adults' practitioners' service users have alcohol and drug problems depending on the nature of the disability. Regardless of the type of disability, practitioners reported difficulties in talking about substance use with their service users as well as identifying tensions around life-style choice and risk management. They also reported the need for education and training in a number of areas. Social work education and subsequent training in working with substance use problems needs to be available to adults' practitioners and it needs to address the specific issues and needs in different areas of social work practice.     

An analysis of the basic population structure of Shanghai Municipality

This paper analyzes the changes in Shanghai's population structure over the last 30 years in the 4 aspects of age structure, sex composition, urban and rural composition, and labor and employment structure. In 1953 those of the 0 to 6 age group accounted for 21.2% of the total population; in 1957 the group represented a proportion of 24.6%. Since the 1960s, especially after the 1970s, the family planning program gradually took effect, and the birthrate of the entire municipality fell drastically. The number of school-age children in 1979 was 1 1/2 times more than the same age group in 1953; there should be no worry that population control may result in a shortage of manpower to meet the needs of the work force and the armed forces either toward the end of this century or at the beginning of the next. The economy in China is underdeveloped, production and technology remain at a low level, average wages for employees are low, and for a long time the low living standard of the people has shown little sign of improvement. The problem is mainly manifest in the following areas: 1) distribution of the work force in heavy and light industries is not sufficiently rational, 2) the distribution of the work force between captial construction and transport and communications on the 1 hand and the national economy on the other is out of proportion, 3) the distribution of the work force between commerce, service trades, and public utilities on the 1 hand and the national economy on the other is disproportionated, and 4) the distribution of the work force between undertakings of culture, education, scientific research, health, and medical care on the 1 hand and economic construction on the other is improper. How to control population growth and adjust parts of the population structure to suit the national economic development poses a problem that calls for further in-depth study and analysis to resolve it step by step.     

Social work field education: believing in supervisors who are living with disabilities

Much of what is written by non-disabled authors about living with disabilities does not mirror people’s experiences or opportunities. Literature is often written about people’s abilities (or disabilities) rather than by or with people. Discourse about supervision of social work students can risk assuming that supervisors are people who do not identify as living with disabilities. This research is a co-operative inquiry into the experience of being an Australian social work student supervisor who is living with disabilities. The article extends the literature about being a social work field educator to include ability, and values the practice wisdom of experienced social workers including a current student supervisor who is living with a disability.     

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.     

The National Protection and Advocacy System

Abstract

Many in the profession of social work are unfamiliar with the national system of protection and advocacy services that were set in place by Congress. The system provides advocacy and legal representation to protect the civil rights of all persons with disabilities, with a particular emphasis on persons with developmental disabilities and persons with mental illness. The article describes this system of resources, its method of operation, and shows its compatibility with the purpose and mission of social work.     

Supporting people with intellectual disabilities to take part in focus groups: reflections on a research project

This paper discusses how support offered to people with intellectual disabilities who take part in research might affect the resultant data. People with intellectual disabilities from a long‐stay hospital, a day centre and a self‐advocacy group, all in the UK, participated in focus groups during a research project on nurse advocacy. Their supporters were staff employed by those services who were familiar with and to the group members. The support given to participants reflected the ethos of the services involved, relating either to the medical or the social model of disability. The paper argues that the philosophy of care influencing supporters of research participants with intellectual disabilities may have profound effects on the support provided. It may facilitate or inhibit open exchange of information. It may also aid clarification or cause contamination of the resultant data.