Disabled people,inclusion and policy: better outcomes through a public health approach?

The social model of disability has implications for evaluation of disability policy. Public health analyses suggest that a population and environmental approach to enablement is more likely to impact positively on disabled people than person-centred action. The capacity of people living with disabilities to participate in a range of social activities and the attitudes of others to such participation are, along with environments, important factors contributing to disability situations and therefore the restriction of our promotion of personhood. These are areas where metrics could be used to evaluate the impact of disability policy.     

Chinese disability independent living policy

Despite strong statements on disability rights in Chinese legislation since 1990, independent living policy as experienced by disabled people falls short of the social inclusion goals expected from such a policy commitment. Analysis of empirical research about disabled people's experiences shows that responsibility for independent living rests primarily with disabled people and their families. Only when they have no family does the government provide support, in the form of institutional care. Very little personal assistance or community-based housing is available. Minimum income support and the introduction of social services are slowly addressing the social exclusion of disabled people in China.     

'Out of Place', 'Knowing One's Place': space, power and the exclusion of disabled people

Disabled people are marginalised and excluded from 'mainstream' society. In general, our understanding of the processes of exclusion is grounded in time and history. In this paper, it is argued that space, as well as time, is instrumental in reproducing and sustaining disablist practices. Disability has distinct spatialities that work to exclude and oppress disabled people. Spaces are currently organised to keep disabled people 'in their place' and 'written' to convey to disabled people that they are 'out of place'. Furthermore, social relations currently work to spatially isolate and marginalise disabled people and their carers. Disability is spatially, as well as socially, constructed. It is contended that an understanding of society's reaction to, and the experiences of, disability should be framed within an approach that combines a spatialised political economy with social constructivism. Unlike neo-Marxist approaches this approach is centred on notions of power rather than capital. Using this approach, the spatialities of disability are explored.     

Sheltered and Supported Employment in the 1990s: the experiences of disabled workers in the UK

Sheltered and supported employment are important areas of social policy provision for disabled people in the UK, but they have received little attention in the sociological literature on disability. This omission is addressed by developing a framework for understanding the state's employment policy for disabled people. It is argued that recent changes in sheltered and supported employment provision must be understood in the context of broader labour market restructuring. This argument is illustrated by an exploratory survey of workers in both programmes. The findings suggest that sheltered and supported employment tend to prioritise the needs of employers over those of disabled workers. In concluding, it is argued that an adequate approach to the employment needs of disabled people needs to go beyond micro-policy debates on the relative merits of existing employment programmes and, instead, engage at a broader level of societal change.     

On the Road to Damascus: First Steps towards Changing the Relations of Disability Research Production

This paper distinguishes between participatory and emancipatory research, and discusses how both differ from other research practice. A further distinction is made between material and social relations of disability research production. It is argued that, although there are significant constraints imposed by the material relations of research production, genuine progress can still be made in changing the social relations of disability research. Based on the experience of doing research commissioned by organisations of disabled people and other work carried out within a framework of 'user's perspectives' on services and policy, the discussion focuses on the lessons we have learnt-and those we still need to learn-about how to change the relations of research production. Consultation between researchers and disabled people, subjecting research to critical scrutiny, and making researchers accountable to disabled people are suggested as key issues in the development of participatory research.     

‘Stuck In The Middle With You’: Towards Enabling Social Work with Disabled People

This article explores progress to date in embedding enabling social work understandings and practices with disabled people by reviewing the UK social work curriculum. Based on these observations and the ideas from UK disability studies, it will offer possible solutions or at least better pathways to enabling practice with disabled people. As Meekosha has pointed out in a global context, to date social work has been experienced as an ambivalent practice [Meekosha, H. & Dowse, L. (2007) ‘Integrating critical disability studies into social work education and practice: an Australian perspective’, Practice, vol. 19, no. 3, pp. 59–72], often both enabling and disabling; an intervention that can both lock and unlock resources, and challenge and reaffirm traditional notions of the ‘disability problem’ [Finkelstein, V. (1993) ‘Disability: A Social Challenge or an Administrative Responsibility?’, in Disabiling Barriers ‐ Enabling Environments, eds J. Swain, V. Finkelstein, S. French and M. Oliver, Sage Publications in association with the Open University, London]. Social work also has the potential to both challenge, but also be an (inadvertent) apologist for contemporary social support and welfare systems. Indeed it is clear that social work as a profession and social care as a policy area have been the poor relations of healthcare and health professions [King's Fund (2011) Social Care Funding and the NHS: An Impending Crisis?, King's Fund, London]. Viewed anthropologically, social work remains a largely non-disabled workforce ‘ministering’ to disabled clients (BCODP, 1997). This might reinforce the perception of ‘us and them’ in some social work encounters. As Paul Longmore questioned, can we begin to go ‘beyond affliction’ (2003) in our work with disabled people? Can social work help support the collective struggles of disabled people or is their role inevitably to reinforce that of individual(ised) clients?

The development of the personalisation agenda and self-directed support is clearly welcome in this context [DoH (2006) Our Health, Our Care, Our Say: A New Direction for Community Services, Department of Health, London; DoH (2007) Independence, Choice and Risk: A Guide to Best Practice in Supported Decision-Making, Department of Health, London; DoH (2009) Personalisation of Social Care Services, Department of Health, London]. Such developments reflect the changing service user–professional relationship. The temptation to see these developments as the icing on the social support cake needs, however, to be resisted. Arguably, with the increased rationing of social support, the continued role of social workers in assessment and monitoring of support could be seen to require a yet more reflexive and enabling professional education and training in an age of austerity, one where previously supported disabled people are being told that their needs can no longer be met.     

Disabled People,Health Professionals and the Social Model of Disability: Can there be a research relationship?

The social model of disability is proposed as an alternative to models that have viewed disability as an individual, rather than a socio-political issue. The use of this model to guide both research theory and practice is proposed in order to equalise research power relationships, and involve and empower disabled people. Health professionals have traditionally reinforced the medical model of disability in both research and practice, and this has been seen as contributing to the oppression and marginalisation of disabled people. If the social model is to achieve wider dissemination, it would appear important to develop a dialogue between disabled people and health professionals. However, because of negative perceptions it can be difficult for health professionals to find an appropriate position in relation to disabled people, research and the social model of disability. While not denying the past, it appears essential to look at ways in which disabled people and health professionals can work together to overcome the oppression and marginalisation that has been linked to the provision of health services.     

Decolonizing Indigenous disability in Australia

Cultural diversity and social inequality are often ignored or downplayed in disability services. Where they are recognized, racial and cultural differences are often essentialized, ignoring diversity within minority groups and intersectionality with other forms of oppression. This is often an issue for Indigenous Australians living with disability. This paper argues that understanding Indigenous disability in Australia requires a critical examination of the history of racism that has systematically disabled most Indigenous people across generations and continues to cause disproportionate rates of impairment. Approaches that focus on the cultural ‘otherness’ of Indigenous people and fail to address taken-for-granted normative ‘whiteness’ and institutional and discursive racism are unable to escape that history.     

Decoding Valuing People

Government policy frameworks on the support of disabled people can often be difficult to 'read', as they contain contradictory elements that simultaneously support and confront social processes that create inequalities and oppression. Valuing People (VP), the UK government's policy framework for learning disability (intellectual disability), provides such a context for work that enhances learning-disabled people's inclusion in community and society, and to reverse some of the systemic disadvantage they have experienced. However, as an uneasy amalgam of the progressive and the neoliberal, the romantic and the practical, it has been difficult to evaluate in order to use its opportunities and minimise its dangers. This article attempts to decode VP in terms of ideologies in human services, and the current New Labour policy mix. Its emphases on Person Centred Planning, Direct Payments and employment will be analysed to try to establish what VP means, and to suggest more adequate priorities. This analysis might also be relevant to other sectors where there is a similar problem of decoding their particular policy context.     

Listening for policy change: how the voices of disabled people shaped Australia’s National Disability Insurance Scheme

Voice has become an important yet ambivalent tool for the recognition of disability. The transformative potential of voice is dependent on a political commitment to listening to disabled people. To focus on listening redirects accountability for social change from disabled people to the ableist norms, institutions and practices that structure which voices can be heard in policy debates. In this paper, I use disability theory on voice and political theory on listening to examine policy documents for the National Disability Insurance Scheme in light of claims made by the disability movement. Although my study finds some evidence of openness in the policy development stage, the scheme falls short of valuing the diverse voices of disabled people as partners in shared dialogue.     

New policies,old ideas: the question of disability assessment systems and social policy

This paper reports on qualitative content analysis research and critically analyzes the state’s intention to use the International Classification of Functioning, Disability and Health as a tool to develop a national disability assessment system that will guide social policy developments, and particularly the allocation of pensions and benefits to disabled people. The work uses Cyprus as an example, and reviews the most important issues arising from a recent study prepared by the Department for Social Inclusion of Persons with Disabilities. The most important points stemming from the analysis are grouped and discussed in such a way as to shed light upon the most controversial aspects of the proposed assessment system, such as the definition of disabled people in national laws, and the implications of associating social policy with the assessment of disability and functioning. The discussion addresses issues that are of interest at international level.     

Disability activism in the new media ecology: campaigning strategies in the digital era

This article examines the changing nature of disability activism through the influence of social media. As disabled people in the United Kingdom have been subjected to acute austerity, this has coincided with a new era of disability activism channelled through increased social media participation. Drawing on the analysis of one group’s online activities and a qualitative content analysis of disability protest coverage in traditional news media during the 2012 Paralympic Games, this article positions this shift in the broader framework of ‘new media ecology’. We explore how emerging structures of disability activism have begun to offer a more visible profile to challenge government policy and negative stereotypes of disabled people. This highlights the usefulness of campaigning strategies for generating favourable news coverage for disability protest.     

Application of the International classification of functioning,disability and health in Taiwan: victory of the medical model

Since July 2012, eligibility for disability benefits and services in Taiwan has been assessed based on the International Classification of Functioning, Disability and Health. This study examines disabled people’s experiences of this new assessment system: does it incorporate the social model or a multidimensional understanding of disability and assess the needs of disabled people adequately? In-depth interviews were employed with 24 disabled persons to answer these questions from the perspective of disabled people. The findings show that the new assessment model is still medicalised: social roles and social participation are not considered, the assessment process is dominated by professionals, users’ perspectives are not included and only those who are assessed to have a high level of disability are satisfied with the new system while many others would prefer the old assessment system. These findings have relevance for the analysis of needs assessments of disabled people in different countries.     

Self-identity and the arts education of disabled young people

Overall, little is known about the ways in which disabled children and young people produce artwork or how they experience arts education. Neither is it known to what extent they are encouraged to produce work that engages with the expressive development of a sense of self that incorporates experiences of impairment and disability. This article is based on my recent PhD research which has investigated the ways in which a group of disabled young students are being enabled, via their arts education, to engage in a process of self-realisation whereby negative and oppressive perceptions of disability have been identified and addressed via their artwork. Whilst current post-social model discourses that emphasise the multiplicity or plurality of identity are acknowledged, my research has demonstrated that disabled young people can be empowered through the expression of the lived experience of impairment and disability and thereby encouraged towards a positive, inclusive and potentially multi-identity perspective.     

Difficulties in Shifting from Individualistic to Socio-political Policy Regarding Disability in Canada

An individualistic conception of disability has been replaced by a socio-political definition. The socio-political model implies that disability stems from the failure of the social environment to adjust to the needs of people with disabilities rather than from the inability of disabled individuals to adapt to societal demands. This paper will examine the extent to which Canadian policies have changed to embrace this new definition. There has been some progress in policies related to shelter, transportation and recreation. However, policies related to income and employment are still individualistic in nature because policy change in these areas requires a major shift in governmental approach to unemployment and fundamental reform of the Social Assistance system. In a period of high unemployment, people with disabilities are viewed as surplus labour, and the Canadian government has found that high unemployment is politically tolerable. Obstacles to an increase in income support include a strong work ethic, the philosophy that social assistance benefits should be less than could be earned in the work-force, and the private insurance and litigation industries which benefit from the current income system. Other barriers to change are the lack of power of disabled groups and the dominance of professionals.     

From isolated fence to inclusive society: the transformational disability policy in China

China’s disability policies are changing, some of which are gradually closer to the requirements of the Convention on the Rights of Persons with Disabilities. Based on the social model of disability, this article explains the driving forces of disability policy reform, and especially adopts the critical policy analysis approach to evaluate the revised education policy along with the rehabilitation policy of disabled people. The inclusive education policy is improving disability policy issues the most compared with others because of the disability advocacy by disabled persons’ self-help organizations. Meanwhile, the nascent rehabilitation policy is typically top-down oriented by the government. Public participation may be the main way forward, especially with the growth of the disability movement in China. It is hoped that scholars pay more attention to the transformational disability policy in non-western settings.     

The Dialectics of Multiple Identities and the Disabled People's Movement

This paper explores the issue of commonality and difference in the disabled people's movement in relation to ethnicity, gender sexuality, age and class. Hitherto, disability academics have either ignored or tagged on the experience of disabled black and minority ethnic people, women, older people, and gay men and lesbians. When they are discussed, they have more often than not been discussed separately - for example, disabled black people's experience has always been discussed separately, disabled women, disabled gay men and lesbians and disabled older women. Hence it is not surprising if 'simultaneous oppression' is perceived to be the unique experience of a minority of disabled people. Here, I suggest that it is, in fact, the experience of a majority of disabled people since the majority is not a homogenous mass of disabled white heterosexual middle-class young men, but individuals from diverse backgrounds with a wide range of identities and experiences, and to accept that their only concern is disability is to fall into the same trap as the general population most of whom only see the impairment and not the person. It is imperative to note, however, that the blame does not lie with the social model of disability, as it is sometimes assumed, for that is merely a conceptual tool. The paper discusses the concept 'simultaneous oppression' as applied to the experience of black women and later disabled black people. It is suggested that this is too simplistic an analysis to capture the day to day experience of those who possess negatively labelled multiple identities. An alternative framework is suggested to link the experience of different groups of disabled people and, hence, offer a common ground for unity in the disabled people's movement.     

Precarious lives and resistant possibilities: the labour of people with learning disabilities in times of austerity

This paper draws on feminist and queer philosophers? discussions of precarity and employment, too often absent from disability studies, to explore the working lives of people with learning disabilities in England in a time of austerity. Recent policy shifts from welfare to work welcome more disabled people into the job market. The reality is that disabled people remain under-represented in labour statistics and are conspicuously absent in cultures of work. We live in neoliberal-able times where we all find ourselves precarious. But, people with learning disabilities experience high levels of uncertainty in every aspect of their lives, including work, relationships and community living. Our research reveals an important analytical finding: that when people with learning disabilities are supported in imaginative and novel ways they are able to work effectively and cohesively participate in their local communities (even in a time of cuts to welfare). We conclude by acknowledging that we are witnessing a global politics of precarity and austerity. Our urgent task is to redress the unequal spread of precaritization across our society that risks leaving people with learning disabilities experiencing disproportionately perilous lives. One of our key recommendations is that it makes no economic sense (never mind moral sense) to pull funding from organisations that support people with intellectual disabilities to work.     

Orientating disability studies to disablist austerity: applying Fraser’s insights

Many disabled people in Britain have experienced profound challenges brought about by a government policy programme characterised by ‘austerity’. Drawing on the work of Fraser and Polanyi, this article explores new ways in which disability studies can become theoretically orientated to the task of explaining and challenging what has become an issue of overbearing importance for many disabled people. It is argued that Fraser’s notion of bivalency encapsulates the combination of cultural and economic challenges which characterise ‘disablist austerity’. Fraser’s development of Polanyi’s work is used to argue that disability studies should be orientated to large-scale economic challenges as well as cultural and discursive concerns that are more often the object of study in the field.     

Human capital, social capital, entrepreneurship and disability: an examination of some current educational trends in the UK

Influenced by European policy, human capital and social capital are currently of interest in UK education policy and practice, expressed particularly in the concepts of lifelong learning and entrepreneurship. Human capital and social capital ideas are shown to be flawed by not taking disability into account. The characteristics of entrepreneurship and entrepreneurship education are examined for relevance to young people with disabilities or learning difficulties and it is concluded that more could be done to develop opportunities for entrepreneurship. The position of people when work is not an option is considered, leading to the question of whether there is a 'disability industry', and an acknowledgement of the importance to the economy of disabled people as consumers and producers. A wider definition of entrepreneurship, which includes people with disabilities and learning difficulties, is sought and the paper concludes by discussing the wider implications for the learning community.