Negotiating identities: the lives of Pakistani and Bangladeshi young disabled people

Research has generally amalgamated minority ethnic (all called 'Asian' or 'black') disabled young people's experiences and failed to acknowledge the multiple aspects of Asian and black disabled identities, for example how the combined attributes of race, ethnicity, religion, gender, culture, class and disability shape their perspectives and experiences. In an attempt to address this issue my doctoral research explored the experiences and perspectives of 13 young Pakistani and Bangladeshi disabled people. By drawing on the substantive and theoretical findings which emerged from my analysis in this paper I shall consider how multiple aspects of identity, such as ethnicity, disability and gender, affect this population's identity and self-image and how this makes their experiences different from white disabled young people and other minority groups' experiences.     

Using participatory and creative methods to facilitate emancipatory research with people facing multiple disadvantage: a role for health and care professionals

Participatory and creative research methods are a powerful tool for enabling active engagement in the research process of marginalised people. It can be particularly hard for people living with multiple disadvantage, such as disabled people from ethnic minority backgrounds, to access research projects that are relevant to their lived experience. This article argues that creative and participatory methods facilitate the co-researchers’ engagement in the research process, which thus becomes more empowering. Exploring the congruence of these methods with their professional ethos, health and care professionals can use their skills to develop them further. Both theory and practice examples are presented.     

Supporting families: Outcomes of placement in voluntary out-of-home care for children and young people with disabilities and their families

Parents caring for children and young people with disabilities typically have extensive additional demands on their time and resources. This added pressure can significantly impact well-being and mental health. In extreme circumstances, parents may seek an out-of-home placement for their child. Previous research has looked into factors that influence decisions for families to place their child into out-of-home care but little is known about outcomes for these young people and their families. The Supporting Families study aimed to explore the impact of a voluntary out-of-home placement on young people with disabilities, and consequences for their families. Fourteen parents/carers, twenty six case managers, six accommodation services' managers, and four young people with disabilities participated in face-to-face and telephone interviews and focus groups. Participants reported a range of outcomes for young people in care. Positive outcomes included increased levels of respect for themselves and others, an improvement in independent living skills, and reductions in challenging behaviours. Negative outcomes centred on their experiences of grief, loss and rejection, as well as behavioural problems. Positive and negative outcomes were also found for families. For many parents/carers there was a reduction in perceived stress and caring load, as well as improved mental health and wellbeing for them and the child's siblings. However, parents/carers often experienced ongoing feelings of guilt, grief and loss. The study adds to knowledge about outcomes of being in voluntary out-of-home care for this small but vulnerable group of young people in care and their families.     

Shit is good: Mental health social work with lives of squalor

This paper investigates the phenomenon of three clients living in squalor, all of whom have severe and enduring mental health problems, and are on the caseload of a mental health social work team. By thinking about the clients both individually and as a group, within a psychoanalytic framework, it attempts to understand their squalor in a new way, with particular regard to the transference and countertransference experienced by the practitioner. By making use of social work literature as well as that concerning organisations and community care, it also discusses the impact these clients make on the wider community around them, and examines some of the dilemmas faced by the practitioner. The implications for social work are serious and far-reaching and these are discussed with regard to long-term intervention as well as professional and personal scrutiny.     

My home, your workplace: people with physical disability negotiate their sexual health without crossing professional boundaries

This paper aims to describe research that examined the views of people with physical disability, living in Australia, of their sexual well-being needs from their own perspective. We explored the impact their sexual well-being needs had on their relationships with professional carers. A social model of disability was used to understand how sexual well-being is facilitated or denied in community care. We also explored whether clients' sexual well-being needs could be met without carers or clients 'crossing the line'. Our findings indicate the multiple ways that 'professional boundaries' were negotiated between clients and professional carers. The data show that the location of the 'line' changed, depending on a range of personal, social, economic and environmental factors. The data also show a gap between the sexual well-being needs of people living with a physical disability and the level of support provided at the social and organisational levels. Suggestions are made for research and practice directions.     

Physically disabled women and sexual identity: a PhotoVoice study

The issue of sexuality for young disabled women is not often talked about in society. Our study aimed to explore four young physically disabled women’s experiences and perspectives regarding sexuality and disability. We used PhotoVoice, a participatory action research method which uses photographs, to capture and convey our participants’ concerns. Through their photographs they showed that everyday interactions with others, particularly strangers or meeting people for the first time, were made difficult by how they were always seen as having a disability. Other parts of their identity were not recognised. The change the young women wanted was for people to see them as young women and not just as disabled.     

Supporting Asian Deaf Young People and their Families: the role of professionals and services

This paper discusses how Asian deaf young people and their families engage with welfare provision. Our findings, based on group and individual interviews with young deaf people and individual interviews with their parents, explore the assumptions underlying current provision and how they influence the options available to young people and their families. The paper suggests that the welfare state exerts a form of social control where professional help, although well intended, may disempowers Asian deaf people by privileging 'oralism' over sign language, and western norms over other cultural values. On the other hand, positive constructions of deafness privilege Deaf identity while failing to accommodate ethnic or religious diversity, resulting in Asian deaf young people and their families having an ambivalent relationship with the Deaf community. We argue that services need to recognise and address the reasons for this ambivalence if they are to adequately engage Asian deaf people and their families.     

Being disabled: towards a critical social ontology for disability studies

In Disability Studies the question of ontology is establishing itself as a live issue. Whilst there are many arguments and tendencies emerging from this literature, this paper identifies and critically examines an approach to the ontological question in disability studies that is based on an appeal to frailty as a universal characteristic of humanity. The argument builds on the relatively familiar claim that everyone is only temporarily able-bodied. This approach is exemplified in recent work by Bryan Turner and by Tom Shakespeare and Nick Watson. I argue that their universalistic approach is problematic. While it may constitute a theoretical means of ameliorating the existential negativity associated with being disabled it does so at the expense of disability identity. What is required is a critical social ontology that problematises non-disablement and exposes the forms of invalidation that lie at the heart of disabling culture.     

Helping parents with mental illnesses and their children: a call for family-focused mental health care

1. Large numbers of individuals with mental illnesses are parents to minor children. 2. Recommendations to improve services suggest that services provided by the adult mental health system and child service agencies be coordinated. 3. Nursing care intersects both the adult and child systems, and nurses have the expertise to offer a variety of services. 4. There is an urgent need to improve family-focused mental health nursing care to benefit parents with mental illnesses, their children and families, and the overall community and society.     

Mental health support needs of people with a learning difficulty: a medical or a social model?

People with learning difficulties, like all disabled people, face social oppression. Much recent policy and practice are underpinned by at least some understanding of this oppression, and the social model of disability has been influential in discussions of services and supports for people with learning difficulties. However, in the area of mental health, the picture is somewhat different. This paper argues that the medical model has predominated in discussions of mental health support for people with learning difficulties, and that a social model approach could have much to offer. The paper draws on an ongoing action research study in which service providers, families and young people with learning difficulties are working together to articulate what is needed, in order to find routes to improve the support offered to young people with learning difficulties and mental health support needs.     

Public health policy and social support for immigrant mothers raising disabled children in Canada

A literature review regarding the social support of immigrant mothers of disabled children in Canada was undertaken with a focus on settings where supports need to be shored up. An integrative review of published papers and policy reports concerning key aspects of social supports for immigrant mothers and disabled children was undertaken. Immigrant mothers experience numerous barriers to social supports for themselves and their disabled children. Maternal immigrant populations experience unique challenges in the setting of childhood disability as well as the challenges of mothers in the dominant culture. There are negative impacts on maternal health as a result of inadequate policy offerings. Public health policy needs to be refashioned in light of weak systems and supports for both immigrant mothers and disabled children and to acknowledge that the current system poses concerning implications for the long-term health of both groups.     

Payment mechanisms for social work in health care: Today and tomorrow

Accepting the establishment of a national health policy as iminent, this paper surveys the way social work services are organized and financed within the health care system. It also outlines what measures can be taken to ensure the inclusion and importance of the profession within this system, and what developments can be expected in the next ten years.     

Public health,research and rights: the perspectives of deliberation panels with politically and socially active disabled people

Public health research purports to provide the evidence base for policies, programmes and interventions to improve the health of a population. However, there is increasing awareness that the experiences of disabled people have played little part in informing this evidence base. This paper discusses one aspect of a study commissioned by England’s National Institute for Health Research (NIHR) to review the implications for public health of theories and models of disability. This part of the study focused on the development of a tool or decision aid to promote ethical inclusion of disabled people in public health randomised controlled trials (RCTs) and evaluative research. The tool was introduced at four regional ‘deliberating panels’ involving politically and socially active disabled people. In addition, we held a panel with public health professionals. The deliberation panels debated how the focus of public health was narrowing, why disability was excluded and positive and negative issues with using rights to guide research and evaluative practice. Politically active disabled people argued for a social model of human rights to guide any rights based tools or decision aids in public health and disability research.     

Do self‐assessment and self‐directed support undermine traditional social work with disabled people?

In recent years, self‐assessment and self‐directed support have become mainstream options within disability services. The Disabled People’s Movement has advocated the need for such change for a long time but this has been persistently resisted by many social workers. In this article, it will be argued that both self‐assessment and self‐directed support undermine traditional social work and that social workers need to begin to work alongside disabled people, rather than ‘for’ disabled people, in order to achieve substantial system change.     

Permanence for disabled children and young people through foster care and adoption: A selective review of international literature

Children who have been removed from their parents need stability and permanence; this is as true for disabled children as it is for others. Yet many children are subject to extended periods of uncertainty and instability. Growing attention has been paid to the need to achieve permanence within a timescale which meets children's needs. As disabled children are over-represented in looked after (in care) populations it is especially important that their needs are considered when formulating policy and practice in this area.This review of literature covers international material related to stability and permanence for disabled children, in particular permanence achieved through fostering and adoption. A scoping method was used to identify and analyse a broad range of material. Ninety texts were included in the review, including material from the US, the UK, Canada, Australia, China and the Netherlands. Empirical research included quantitative, mixed methods and qualitative studies. Other sources included literature reviews and a small number of research-based ‘think pieces’ and briefings.Disabled children often have permanence outcomes and experiences which differ from those of other children; most often they are disadvantaged by systematic features of services and by the latent disablism of decision-makers, professionals, carers and potential carers. The findings also show that disabled children are not a homogenous group and that characteristics such as age, gender, ethnicity and impairment type show complex relationships with permanence through adoption and foster care.Important gaps in current knowledge are identified, including disabled children's views and experiences in relation to achieving permanence. Several areas of policy and practice are highlighted where effort to improve permanence needs to be made. These range from tackling negative professional attitudes about the prospects of placing disabled children to further development of non-traditional approaches to the recruitment of foster carers and adopters.     

Unmet health care needs of people with disabilities: population level evidence

The present study examined population level data on unmet needs for adults with physical, sensory and cognitive disabilities, using the National Population Health Survey. The study revealed that disabled adults (aged 20–64) reported more than three times as many unmet health care needs as their non‐disabled counterparts. Even after controlling for the effects of age, gender and poor health, disability had a significant effect on the perception of unmet needs, particularly disabilities associated with pain, hearing impairment and emotional problems. The greatest deterrent to receiving needed services among individuals with disabilities was cost. Despite being publicly funded and thereby presumably equally accessible to all, the health care system in Canada fails to meet the needs of some of its most vulnerable constituents – adults with disabilities.     

College health professionals and academic librarians: collaboration for student health

College health professionals must find new ways of educating students on finding and evaluating consumer health information, specifically in the online environment. Librarians are trained as information professionals; however, librarians at general academic libraries are not taking a lead role in providing consumer health information. OBJECTIVE: The authors' purpose in this research was to determine the health information resource needs of college and university students and provide a model for collaboration between college health professionals and academic librarians. PARTICIPANTS AND METHODS: The authors compared data from a national survey on college health (N = 54,111) with their own results from a survey of general academic librarians (N = 17) to create recommendations for synching students' reported health information needs with librarians' resources. RESULTS: Although the Internet was students' second most-often consulted health information source, they ranked the believability of online health information above only television. In the librarian survey, although 12 respondents indicated that health information provision is a library's responsibility, the majority (n = 11) believed their library's consumer health outreach to be passive. CONCLUSIONS: The authors offer recommendations for partnerships between college healthcare professionals and academic librarians to better provide this information to students.