Disability is multi-dimensional, so a joined-up response is needed

Disabled people and their carers are looking for allies in their struggle for survival and quality of life

 

The majority of support and assistance for disabled people is provided by family members.

With many hundreds of delegates from all over the planet, the Joint World Conference on Social Work and Social Development is a wonderful forum for raising one of the most important human rights issues of our time: disability. When I first started participating in the disability movement more than 20 years ago, jokes about social workers were popular in British activist circles. Few of them could be repeated here. Social work has changed since then, but I suspect there still remains some of that underlying anger of people with disabilities against the professionals whom they perceive to be unresponsive and controlling.

The UK is one of 117 nations to have ratified the UN Convention on the Rights of Persons with Disabilities. A further 36 have signed it. Most of the articles of this human rights and development treaty have some relevance to social work: the right to live independently and be included in the community; freedom from exploitation, violence and abuse; respect for home and family; adequate standards of living and social protection. But even more importantly, the whole convention reflects the principles of equality, diversity, non-discrimination and respect which should be at the heart of social work practice.

In June last year, the World Health Organisation and the World Bank launched the World Report on Disability at the UN in New York. The biggest headline from the launch was the estimate that there are 1 billion people with a disability in the world, or 15% of the population.  But the point of the report, of which I was an author and contributor, was to support implementation of the UN convention. Chapters on health, rehabilitation, assistance and support, enabling environments, education and employment each provide the evidence base and make recommendations to help governments achieve their convention obligations.

Which aspects of the report are most relevant to social workers? Probably the discussion of assistance and support. Many countries need to move further and faster towards de-institutionalisation, particularly, for example, in eastern Europe. Evidence shows that personal assistance schemes – where disabled people employ their own support workers – are preferred by service users, benefit informal care-givers and can be cost-effective. Both service users and personal assistants themselves should be trained to make the most of this new arrangement, and to avoid exploitation.

The majority of support and assistance for disabled people and older people – even in high-income countries such as Britain and Sweden – is provided by family members. Therefore it is essential to support informal care-givers with information, with respite care and with social assistance. In many low- and middle-income countries, arrangements for assessing and organising support are absent or underdeveloped. Community-based rehabilitation tries to fill the gap, through families and volunteers mobilising to remove barriers and support disabled people to participate. As national income increases, appropriate and empowering support services should be a priority.

As well as these headlines, the report highlighted other points relevant to the social work profession. For example, co-ordination of services – between health and social services, between statutory and voluntary providers – is often lacking.  Disability is multi-dimensional, so a joined-up response is needed from agencies that support people with disabilities and their families. Too often are they faced with a plethora of forms and staff and a confusion of procedures and regulations.

The problem of violence and abuse also receives attention in the report. Institutions are places where vulnerable individuals can be abused. But when individuals move from institutions into communities, they risk becoming victims of bullying and hate crime. In times of austerity, as in Britain and many European countries, disabled people can face more hostility or exploitation, particularly if they are scapegoated as welfare dependants. Heightened awareness, more reporting and better responses from criminal justice agencies are required. If disabled people are included in their communities – in neighbourhood meetings, in local social and leisure activities – they are less likely to be isolated and victimised.

The theme of empowerment of disabled people themselves, but also of family members and informal care-givers, runs through the report. Listening to their voices, and working in partnership with them, leads to better outcomes. Disabled people and older people and their families are looking for allies in their struggle for survival and quality of life. Rather than a faceless bureaucrat or a rigid gatekeeper, they hope to find a social worker who understands their difficulties, who operates within a framework of human rights and who can accompany them on their journey towards resolving problems and achieving a situation within which they have a chance to flourish – and even to have a laugh, together.

Tom Shakespeare is a technical officer in the department of violence and injury prevention and disability at the World Health Organisation. He is a leading commentator on disability issues and addressed the joint world conference in plenary session.

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