Category: Free Essays

Personalisation is considered as a process that involves the usage of technology to accommodate the differences between the individuals. It is becoming an increasingly popular area within health and education sectors (Department of Health, 2008). When discussed in terms of Health care, Personalisation involves thinking in relation to care and support services in a completely different way, building care provisions around the person in a way as an individual with preferences, strengths and aspirations and combining them towards the center of the process of recognizing their needs and making choices about their living (Department of Health, 2008). It demands a significant transformation of social care so that all the processes, systems, staff and services are combined to put the people first. In addition, personalisation is indicated as offering people with much more choice and control over their lives within all social care settings. However, it is much of a wider concept than simply providing personal budgets to the people who are eligible for council funding. It also involves ensuring access to the universally determined services (transport, leisure, education, housing, health) and employment opportunities regardless of their age and disability characteristics (Department of Health, 2008). In a very short span of time, the personalisation concept has occupied its central place within the field of social work and adult care discourses in United Kingdom (Department of Health, 2008).

A study involving a consultation process was carried out by Department of Health (2006), it was observed that people showed much interest in accessing personalised approach and they demanded for its need and they expected it to be made available to them easily and quickly. In order to make better provisions relative to personalisation, various people who participated in this consultation process questioned their need about the availability of social care providers and their services (Department of Health, 2006). But in order to make it possible, the health care sector needs a clear vision with a direction to make personalisation a strategic shift towards the initial prevention and interventions of dreadful diseases (Department of Health, 2008). However, this seems to be a challenging agenda that cannot be possible by social work alone and it requires effective working away from the boundaries pertaining to social care like housing, benefits, leisure, health and transport. On the other hand, demographic variations show a significant impact upon the number of people who care and support the family members and this in turn influence the available care provisions (Department of Health, 2010). Although personalisation is the corner stone of public service modernisation, in terms of social care it can be meant that everyone who is receiving care (regardless of their need level, statutory services) should possess an equal choice and control over the way through which the support is delivered. Social care providers (involved in carrying out social work) will be potentially able to direct the use of resources, building on the technological support, family and the wider community in order to enable them in enjoying their role as citizens in their communities (Department of Health, 2008).

The document released by the Department of Health in 2010 on “Putting People First” offers a clear insight regarding personalisation along with the potential ways of its development when investments were made within the following aspects of support (in relation to the individual carers):

Universal Services: support that can be made available to everyone in the community in addition to transport, leisure, education, information and advice (Department of Health 2010).

Early interventions and preventions: helping people to live independently as long as possible and designing future cost efficiency systems.

Choice and control: helping people in understanding about the way of spending in relation to care and support and thus allowing them to choose in accordance to their needs.

Social capital: creating supportive communities that enable in determining the value of each and every contribution made by the citizens (Department of Health 2010).

Personalisation by Effective Participation

Personalisation through effective participation helps us in creating a better connection between the individuals and the group in a way by allowing users a direct, informed and creative rewriting in the script through which the service used can be designed, planned and evaluated (Houston 2010). This approach involves the following steps:

Expanded Choice: enables users in providing a greater choice over the various ways of mix through which the needs might be met and to combine the possible solutions around the user instead of limiting the provisions in relation to any institution in question like hospital, social service department to which the user seems to be much closer (Leadbeater, 2004; Lymbery 2010).

Intimate consultation: Here professionals work in an intimate relationship with the clients to help in opening up their needs, aspirations and preferences through an extended dialogue system (Houston 2010).

Enhanced voice: This is very difficult to follow through a white paper agenda and it involves the use of expanded choice in opening up the user’s voice. Making comparisons through the various possible alternatives can help in articulating the preferences.

Provision of Partnership: Generally, it can be possible to combine the solutions which are personalised to the individual if the services work in partnership. In instance, any organization – a secondary school can form a gateway for the learning services provided not only by the school but also to various other companies, colleges and distance learning programs (Houston 2010).

Advocacy: In this section, the professionals act as advocates to the users and help them to move their way through the system. This process can enable the clients in attaining a continual relationship with the professionals (Houston 2010).

Co-Production: Professionals who were found to be involved in shaping the service were expected to be more active and responsible in offering their help in relation to the service delivery. However, Personalisation aids in involving service users, creating more efficient, and responsible package of care services.

Funding: Within this, authorities need to follow the options or the choices made by the users and in certain cases-offering direct payments to the physically disabled people to assemble and obtain their own care packages. Funds should be left with the users for purchasing any good or commodity and this should be done with the advice of the professionals (Houston 2010).

Role of Personalisation

When considering the role of personalisation as an organizing principle with relation to the public service reforms, certain comparative studies need to be definitely performed with a broader emphasis on contracted services. Nevertheless, other public services do exist where in which personalisation fail in making a sensible approach (Duffy 2005). This can be exemplified by:

Someone who is entering in to an accident or emergency service department do not need a dialogue but instead he needs a quick and competent action (Leadbeater, 2004; Lymbery 2010).

Although in a public sector, defense is another area where in which personalisation principles cannot be applied and the people play a pivotal role in fighting against terrorism.

Thus it can be understood that, personalisation can be used only in certain public services which can be of face-face (like education, social services and non-emergency health care departments), those depending to establish a long term relationships (disease management) and the services involving a direct engagement between users and professionals through which the users can play a significant role in shaping the service (Leadbeater, 2004; Lymbery 2010).

Personalization- A Reality in 21st century

Making personalisation, a reality for the 21st century definitely requires huge cultural and transactional transformations within all the parts of the system (not only in social care but also in public sector, whole local government). Over the past ten years, direct payment option helped some people by providing an ability to design the services they need, but the potential impact was found to be very less. But in the recent years, figures indicated that about 54,000 people out of a million received help through direct payment (Department of Health 2010). Since personalisation describes the change within the whole system it needs the presence of strong leadership to communicate and convey its potential vision and values. To achieve a significant shift towards its cultural side and to construct a delivery model (Department of Health 2008), it demands all the stake holders to work in partnership with others.

Nevertheless, in future social care system allows individuals in undertaking their own choices with an appropriate support at the level they needed. It should be understood that personalisation need to be delivered in a cost effective manner. In addition, it must be recognized that personalisation with its early intervention and efficiency are not contrary and need to be strongly aligned in future to obtain better results (Department of Health 2010).

Personalisation in relation to the Mental Health Residential Care Homes

Personalisation in relation to the mental health can be defined as understanding and meeting the needs of the individuals in various ways that can seem to work best for them (Carr, 2009). Principles of personalisation can be applied in early interventions, prevention and other self directed approaches where in which the users are involved in maintaining and managing their own social support services (Lymbery 2004). However, it accommodates mental health promotion and its maintenance with a wider choice and control and thereby contributing to the improvement in well-being and quality of life.

The above mentioned principles pertaining to personalisation can be applied in Mental Health Residencies to direct payments and other internal budgets (Mc Donald, Postle, Dawson, 2008).

Direct payments: are in general, cash payments that are paid to the individual during which they can design and control the tailored support in order to meet the social care needs. Funding for this direct payments arrive from the respective local authorities (Fernandez et al., 2007). Though these were available from 1996, they are now-a-days considered to be as the only option for the people who are provided with the personal budget. Statistics indicate that direct payments users were found to be increased at a steady rate ranging from 50 in 2001 to 3373 in 2008 (Care Service improvement partnership, 2008). From the year of 2007 and 2008, the percentage of people using this option in order to meet their mental needs increased by 62% which was found to be one of the largest among all the care groups (Carmichael, Brown 2002; Ridley, Jones 2002; Spandler, 2004; Spandler, Vick 2004; Cestari et al, 2006; Taylor, 2008). But, when compared with the other impairment groups, the percentage of direct payment users in mental health is relatively low as a result of poor level of mental capacity, lack of awareness and non proactive attitude of managers towards the implementation of direct payment. This has been evidently noticed in my placement setting. Research studies indicate that, when offered with sufficient support people with the mental health condition will start to use direct payment option effectively and imaginatively (Carmichael, Brown 2002; Ridley, Jones 2002; Spandler, 2004; Spandler, Vick 2004; Cestari et al, 2006; Taylor, 2008). In a National Pilot Study of direct payments in mental health (2001 to 2003), around more than half of the people used a personal assistant in obtaining social, personal and mental support and they assisted the impaired ones in carrying out their daily activities and helping them in accessing community and leisure facilities (Spander, Vick 2004; 2006). Many barriers do exist for these direct payments in all the impairment groups and out of which many of them also apply within the mental field. They include lack of awareness, risk aversion and protectionism (Pearson, 2004; Fernandez et al, 2007; Hasler, Stewart 2004; Spandler, Vick 2005), potential difficulties in undertaking decisions pertaining to social care needs and other eligibility issues for the people whose condition changes within less time (Carmichael, Brown 2002; Ridley, Jones 2002; Spandler, 2004; Spandler, Vick 2004; Cestari et al, 2006; Taylor, 2008).

Personal Budgets: The cornerstone of the Government’s approach in creating transformations within social care especially mental health residential home care and relative support through personalisation is the allocation of Personal Budget (PB). My placement setting is a mental health residential home accommodating people with enduring mental health problems. I think individuals should be supported and assessed in conjunction with other agencies in order to meet users own needs, and by doing so a care provider can ultimately determine whether they are eligible for providing any social care funding. If individuals were found to be eligible, care providers can explain the amount of money they expected to receive in order to meet the needs (Department of Health 2006; Duffy, 2007).

Individual Budgets: On the other hand, individual budgets are quite similar to the Personal Budgets and these incorporate various other funding schemes along with social care funding (Glendinning et al., 2008). The funding schemes include: access to work, supporting people, living independently, disabled facilities and grants as well as integrated community equipment services. A National Pilot Study on Individual Budgets took place in the year of 2007- 2008, it was observed that around 14% of the people were found to be with mental health condition (Glendinning et al., 2008). The pilot study concluded that people who receive individual budgets experienced much higher levels of independence and were more likely to commission their valuable support from the main stream community services instead of specialist ones (Bamber, Flanagan 2008). This application offered a better mental health support need along with the flexibility in comparison to other conventional services or direct payments (Glendining et al., 2008; Manthrope et al., 2008). Many barriers were observed with Personal and Individual budgets in relation to the mental health field. The difference between the funding in relation to health and social care can also form a major barrier to the developing individual budgets in mental health (Glendinning et al., 2008). In addition, the following points need to be implemented within Residential care Homes in offering a personalised approach:

Person and relationship centered care and support at the heart of the service offered.

As the care home setting is considered to be as a community, the residents or the staff actively searches the various available opportunities to develop an effective relationship (Carey 2003; Bradley 2005).

The managers working in care homes need to be sure that the existing services respond to the needs and should look for the opportunities to diversify the offered services.

Staff should ensure that people has a live and breathe culture which is actively involved in promoting personalised services in a way by offering maximum choice and control for the people who are living in care homes (Cestari et al., 2006).

Residents need to possess the accessibility to all the information and advices as they need to make certain informed decisions including those pertaining to advocacy matters (Cestari et al., 2006).Team work and effective communication is needed with the people in care homes.

Staff development programs and the quality assurance systems must be introduced as they are considered to be crucial in offering a positive outcome.

Care home managers should be nicely placed in order to understand the potential needs of the local communities. Effective leadership work should be carried out in a collaborative manner with the people who are using these services along with their families and carers involved in design and delivery of services (Spandler 2004).

Assessing self directed approaches along with allocation of budgets (Cestari et al., 2006).

If a disabled person lacks capacity in choosing a direct payment or any other option, the local authorities must help them in undertaking a best interested solution and decisions (Ridley, Jones 2002).

Conclusion

The applications of principles of personalisation with the mental care residential homes share a lot of core values (Carmichael, Brown 2002; Ridley, Jones 2002; Spandler, 2004; Spandler, Vick 2004; Cestari et al, 2006; Taylor, 2008) The Mental Capacity Act (MCA) laid down in 2005 supports the practices and principles of personalisation by empowering many people in undertaking their own decisions. It also helps the mentally disabled people in taking their own decisions as much as possible (Spandler, Vick 2004). But in principle, this may not seem to be possible as the people lack mental ability and the individuals need play a very big role in decision making processes that can only directly detect them. The first research study underpinning this approach was carried out by Norah Fry Research Centre at the Bristol University in 2008-2009 (Philips, Waterson 2002). The study suggested that people experiencing mental health problems and distress need to possess a better choice and control over their care (Carey 2003; Bradley 2005).

The Personalisation Agenda in United Kingdom has more to offer in the field of mental health as it challenges the way through which health condition is perceived (Payne 2000). To implement the principles, the country need to support a social model in understanding the mental health condition and must recognize the important social factors that play a key role in contributing to that condition (Beresford, Wallcraft, 1997; Brewis, 2007).

Thus effective and proactive leadership from the managers in senior position along with the direct payment support agencies could help in creating awareness within the general public and thereby aid in developing expertise (Newbigging, Lowe 2005). Therefore, in the context of mental health, it can be understood that a move towards the direction of personalisation indicates a move towards a feeling of independent living philosophy (Vick, Spandler 2006). Various projects need to be developed to support that move and various practical tools must be designed to effectively meet the challenges associated to the mental health field. In particular we need to aim in developing strategies that encourage champions amongst various other service users, forums for discussions and networking in a way that progress can be made in overcoming the challenges to personalisation in mental health field. In addition issues of negligence pertaining to poverty and inequality, its weak conception regarding individuals utilizing social care work services, its view on welfare dependency and its potential for promotion as an alternative of challenging the depersonalisation in relation to social work, need to be tackled effectively in order to meet its future aims and objectives.

In the following I will be discussing the quotation “Social Work is an ethical and political activity made necessary by the consequences of social and economic disadvantage and inequalities”. I will be critically evaluating the statement by expressing my view of Social work role and what Social Services are there to do. I will be addressing the role of politics within Social Work and the effects it may have on service provision. I will also be highlighting the some of the ethical dilemmas and constraints social work services face. By discussing these issues I will be able to evaluate the statement and highlight the way in which service users may be discriminated against within Social Work.

Social Work in the 21st Century has changed and improved throughout the years. Within Social Work today great emphasis is put upon the service user and working in partnership. Thompson, 2005 highlights that partnership is a highly skilled activity, being able to work in partnership also demonstrates so many other skills necessary within social work. This approach is aimed at empowering the service user as so many of the individuals that we work with are discriminated against within society. However this has not always been the main focus as service provision was very different at the beginning of the welfare state when the Poor Law was implemented. The focus at that time was labeling people as deserving and undeserving which then oppressed those labeled undeserving as this reduced the opportunities available to them as they were often sent to the workhouse with poor conditions. The “underclass” where described by the middle class as “Dangerous” and ” dark” Mooney,1998 as they thought the increase in urbanisation would cause overcrowding leading to disease which would spread onto the middle class. Therefore along with the new poor law philanthropic woman were introduced to contain and reduce disease. It has been highlighted by Forsythe, 1995 that philanthropic agencies did not wish to reduce deprivation for everyone but only for those who were seen as worthy. The wealthy middle class woman viewed themselves as superior to the working class therefore discriminating against them. The main focus of the support was to limit and contain the spread of disease from those that were poor onto the middle classes. This again discriminated against those who were experiencing great levels of poverty and deprivation. In the years that followed the Beveridge Report in 1942, legislation was implement by the Government to tackle the five giants that were highlighted within the report. By concentrating on these issues the Government aimed to tackle the difficulties which society was facing at that time. Unfortunately the same five giants continue to be problematic today’s society although these difficulties are now approached with a different manner.

Today’s approach has been influenced by many reports highlighting various ways in which service provision could improve including social work. Today social work takes on so many different meaning and cannot be explained with a single definition. Social Works mission is to support and empower individuals to reach their full potential by addressing the difficulties they may be experiencing which then prevents dysfunction cited by IFSW, 1982. We do this by applying our social work skills and values and relating the knowledge and theory to our practice. By doing this we are then able to communicate and engage with the services user and gain knowledge of their environment which then enables the social worker to work in Partnership with the service user to address the difficulties that have been identified. This is done by applying the Social Work Process of Assessment cited by Coulshed & Orme, 1996. Many of the service users that require the support of a social worker often are experiencing discrimination or oppression at some level within society due to social and economical constraints. It is the social worker’s role to work in a non discriminatory and anti oppressive manner to empower and encourage the service user to address their issues and minimize the level of disadvantage they they may be experiencing

Social Work knowledge enables us to gain a greater understanding of the service users by applying a holistic view. One way this can be applied within the social work process is with the use of systems theory. When carrying out the assessment process with a service user it is important to gain a holistic view of the individual which will then enable an accurate assessment of the individuals needs and level of risk. By apply theory to practice you are able to adopt a holistic approach effectively. Systems within an individual’s life are symbols for the different relationships which they are connected to. As all systems are interlinked they will then all impact on the individual therefore all systems need to be considered for the service user. Parker & Bradley, 2007 highlight that this approach demonstrates that social workers commitment to work in an anti oppressive manner as this approach will enable the discrimination to be addressed and challenged. This is because systems take into consideration and social structures which may affect the service user.

When carry out an assessment there are many skills that need to be implemented in order for the assessment to be accurate. One that I have already highlighted was the need for a partnership between the service user and social worker. However before this can form there is basic skills such as communication and engagement. As this takes place at the beginning of the assessment it is important that this is effective. By using communication this does not just mean to speak or inform but can also mean non verbal communication such as eye contact, facial expression or gesturing. It important to use effective non verbal communication as Thompson, 2002, highlights, non verbal communication can enable us to communicate our emotions and illustrate our reaction to what we have been told. When communicating, it is important to use the communication appropriately and in a non discriminatory or oppressive manner an example of this may include the use of jargon. Many people within Social Work can at times forget that they are using jargon with service users as they are so comfortable with it this. However this can present a barrier between the social worker and service user as the service user may not understand what they are being told. This can then lead to oppression as the social worker is discriminating against the service user by using inappropriate language and therefore the service user is being oppressed as s/he is not receive the support required cited in Thompson, 2003. This can then lead to relationship breakdown as the service user may not wish to full engage as a result.

Lastly values are also crucial when applying the skills required to address discrimination and disadvantage when working with service users. The values that we apply within our practice then enable us to work in a non discriminatory and oppressive manner. One of the main social work values includes approaching with a non judgmental attitude. It is important to remember that so many of the service users that we support are already being disadvantaged or discriminated against within society this could be a form of sexism, racism or classicism as so many service users are experiencing poverty and disadvantage which is often why social services are implemented. By applying a non judgmental attitude you are then able to engage and form a positive relationship which will then allow for a more holistic assessment to be carried out in order to identify the services user’s needs and level of risk. By doing this we are able to identify ways in which the service user’s needs can be met effectively and therefore minimse the level or oppression which they experience as a result of discrimination within society for example stigmatization.

Within Social Work practicing in an anti discriminatory and anti oppressive manner is highlighted as being crucial from the beginning of the social work training and has always been a focus throughout the work carried out by students. Forsythe, 1995 stated all students had to demonstrate a level of competence in anti discriminatory practice when completing the Social Work Diploma. This is an area and a requirement that is emphasised in today’s training with an emphasis on applying anti discriminatory practice. With recent literature such as Thompson, 2003 discrimination can be explained in a clear manner. Thompson’s P.C.S. Model helps to prevent discrimination and oppression of the client and aids the Social Worker to work in an anti oppressive and anti discriminatory way. It explains how discrimination and oppression affects individual on three different levels these being Personal, Culturally and Structurally. This allows the Social Worker to become aware of these levels in working in and anti Discriminatory way. “Each of these levels is important in its own right, but so too are the interactions between them” Thompson,2003, pg,13 Each level is linked therefore by understanding how discrimination effects individuals at a personal level you can then relate it in the wider context of Cultural and Structural. By understanding the model you can promote good anti discriminatory practice and work with the client in an empowering manner.

The Scottish Government has highlighted that they are now providing the largest budget for social work than ever before with an increase to all services as highlighted by Scottish Executive, 2001. This budget has been used for services provision, training for staff etc this money should enable better service provision and reduce the inequality that many of the service users are currently experiencing within society as a result of a disability or mental health. The funding and support can then be offered to empower and enable the service user to progress with their lifes. However this money is not always evident within the social work services as many service users are being denied service provision. It has been highlighted that in the 21st century families are not having as many children therefore the birth rate has fallen while the elderly appear to be living for longer and requiring more support as cited by Hill, 1996. So much of the time social worker are having to negotiate with managers or services to enable their service user to gain a service as highlighted by Trevithick, 2005. When thinking back to the quotation social work can be viewed as a political activity with regards to budgeting. So much of the time resources are limited when service provision is higher than average e.g. high levels of unemployment. With the recession which is currently taking place more people are attempting to access services due to poverty, mental health and increased crime rates, all of these negatives will increase with the condition that society now faces. With the same budget in place this will then impact on the services available. This then causes disadvantage within social work services due to high numbers and low service provision. Social work aims to tackle discrimination but due to political restriction can often disadvantage and discriminate their service users.

Nevertheless there have been positive influences by the government to improve social work provision to and promote an anti discriminatory practice. One of which includes the introduction of the care commission which was implemented with the Regulation of care (Scotland) act 2001. This was set up to regulate the care provision of social services including elderly care homes. By regulating the care the service user is then ensured that they will be provided with a consistent level of care which can minimise people being discriminated against due to a disability for example as their care will be regulated as cited by Care Commission, 2009

Another way in which the government has impacted on service provision within social work includes the introduction of the SSSC which was also introduced also under the Regulations of care (Scotland) act 2001. Their aim is to increase the protection of vulnerable people by regulating the training and registration of those working in social services and highlight the codes of practice. By doing this they are able to limit the discrimination and disadvantage that the service users may encounter as all people working in social services are registered. They highlight that they encourage equality by delivering a high level of competence in their work which can then enable and empower the service user to take up the opportunities available to them which will then prevent them from feeling oppressed within society.

Within Social work ethical dilemmas are evident throughout practice. At time this can be due to challenging discrimination appropriately or being in conflict with your personal and professional values. As highlighted within the quote social work should be approached in an ethical manner by demonstrating the social work values. However at times social workers may experience ethical dilemmas in the work that they are carrying out in order to do the best for the service user. At times due to low levels of service provision which was highlighted earlier this can then impact on the service user and whether their needs are being meet in an effective way. If needs are assessed and identified then it is the role of the social worker to encourage the service user to meet their needs effectively. However if the service provision is not available this can then impact on the service user. Banks, 1995 highlights that the welfare state is benefiting and embracing those in need as it will increase the budget received from the government, although they are also seeking to limit and control poverty. However while the welfare state may be benefiting from those in “need” social workers cannot help but feel guilty when those needs cannot be met due to lack of resources. Social workers are accountable and answerable to their actions. At time it is not the social workers fault as Trevithick, 2005 advises that often social worker negotiate to the best of their ability for service provision but at times the resources and not available. This is similar to what was carried out regarding the deserving and undeserving as shows that at times services users do need to be prioritised due to lack of resources. This may then mean that they are oppressed by this as their needs cannot effectively be met.

Another ethical dilemma which I have became aware of is Care vs. Control as it demonstrate the level of power that you as the social worker has although by informing the service user of your duty as a social worker, to pass relevant information on, you are also limiting the control as the service user may then withdraw or hold back in what is being said. This can have a great impact upon the relationship that has been built between the social worker and the service user. Thompson, 2005 advised that the basis of a positive working relationship is trust and respect. With this in mind it is possible that you may need to pass on information to the police etc regarding your service user. This may be difficult as the service user may then become disempowered and let down by social services. Lishman, 2007 states social workers are there to empower and encourage the service user to address their needs effectively. However if information was required to be passed on from what a service user had disclosed this would then demonstrate the power imbalance within your relationship. However this should be fully explained at the beginning of the working relationship and an appropriate connection should be made. This service user and social worker relationship is determined by confidentiality, accountability as the social worker has the responsibility as a professional personal to uphold the two were appropriate as cited by Hugman & Smith, 1995.

When working within social work there can be constraints that impact upon how we are able to fulfill our role to encourage and empower and this may then lead to further discrimination or disadvantage out with our control. One of which includes the legislation such as the Children’s Scotland Act 1995. The legislation highlights that the welfare of the child is paramount cited in Anderson et al, 2008. Therefore within child protection any referral that is made will be looked into which enables an assessment of the child to take place. This legislation enables better and more efficient child protection procedures; although the legislation states that a minimalist approach should be taken with the child. This may mean that the child continues to stay in the home as there may not be clear evidence of abuse or neglect. This can impact greatly upon the child and can cause the child to feel let down by the system and oppressed. This is due to the constraint of legislation and is put in place for the best interest of the child however this can lead to the oppression amongst young people who do not want to speak out and therefore their needs may go undetected.

Another constraint that has been considered is in relation to service provision. I have previously discussed that at times service provision can be limited and what is available to that service user may be restricted. As a result the criteria for the service may then increase to reduce the level of service users who require the service. If this happens their need will not be met effectively and this will not be addressed. However the role of a social worker is to identify needs and risk and ways in which these could be met. Therefore this may then raise questions regarding the accuracy of the assessment. Social workers may alter the truth to ensure that their service user will be provided with the appropriate support. The focus for assessments should be needs led and the services should fit around the service user. However this is not always the case as Parker & Bradley, 2007 state that at times due to limited service provision the services users have been placed wherever has been available.

To conclude I agree with the quotation as I feel that at times social workers are providing services for those who are socially and economically disadvantaged within society for various reasons. If these people were not experiencing inequality there may then be no role for social work. It is important to remember that social work is informed by the knowledge skills and values which then enable us to practice and approach with a non discriminatory attitude this encourages and empowers the services user to reduce the inequalities which they be facing. However at times due to the constraints within social work e.g. resources services user continues to experience inequality.

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There are various drugs which are abused by teenagers and adults. Most of these are addictive and have adverse health effects to users. The common drugs of choice are alcohol, cigarettes, speed, prescription drugs, heroin, cocaine and marijuana. Alcohol is the most abused drug, and it inhibits judgment among users (Stimson 34-48). Long term use leads to liver and kidney failure. Tobacco, or cigarettes are one of the most addictive drugs and their long term use leads to development of cancer, impotency, lung collapse and others. Cocaine and heroine are drugs which are injected, smoked or taken orally. They are very addictive and they distort reality among users. Long term use may lead to heart problems, mental disorders and high blood pressure. Sharing of needles may transmit STDs while drug overdose may be fatal. Marijuana is another common drug abused and it distorts reality among users. Long term use may lead to mental damage, and some researchers have linked it to development of schizophrenia. Prescription drugs are also commonly abused by the old and young alike. Although done innocently, these drugs may cause sudden death due to overdose or fatal combination of drugs, as has been witnessed among many celebrities who have died early due to use of prescription drugs (Isralowitz 122-123).

Causes of drug abuse

There are various causes of drug abuse. Drug abuse can be blamed on parents, friends, individuals and society at large. These causes will be briefly discussed to show how everyone is responsible for the problem of drug abuse.

Lack of parental supervision

Parents have an important role in their child’s upbringing. They serve an important purpose of instilling values in their children through socialization at early age. Parents should ensure that their children are morally upright and that they do not engage in social vices. However, in the modern world, parents have put professional lives ahead of their families and delegated the role of raising children to nannies and teachers. As a result, the children do not acquire much needed guidance on life’s issues, and many end up taking drugs through peer influence. Lack of supervision from parents, who pursue their careers at the expense of their families, can therefore be blamed for the high number of drug abuse cases among teenagers. Parents should supervise their children at all times to avoid negative influence from peers.

Poor communication between parents and teens

Lack of communication between children and parents, especially during teenage years is also another causality of drug use. Many teenagers are unable to effectively communicate with their parents since neither group understands the other’s needs. Parents appear too harsh to teenagers while teenagers appear to demanding to parents. When parents and teenagers are unable to effectively communicate about issues teenagers face, teenagers are left to seek advice from peers, who may influence them to take drugs. Parents should understand children’s needs and vice verse, if drug abuse is to be eliminated.

Mental & Physical abuse

Domestic violence and abuse has been one of the most common triggers of drug abuse. When people are emotionally or physically abused, and they do not seek help, they may engage in drugs to forget their problems. Since most abuse cases are perpetrated by close family members, this makes it harder for victims to overcome, and many opt to try out drugs, which they perceive will distort reality and make them forget their concerns (United States Department of Justice Website 2000). Drugs of choice in such circumstances include alcohol, tobacco and marijuana. However, victims are unaware that use of drugs increases their problems since it leads to addiction, which needs to be treated. Publicizing abuse, passing tough laws and offering free help to victims will help reduce abuse cases and thereby reduce drug use cases.

Media influence

Media influence is a major causality of drug abuse, especially regarding drugs such as alcohol and tobacco. The media makes it appear “cool” to use such drugs through flashy advertisements in the media. However, less emphasis is placed on adverse effects of such drugs; hence teenagers are influenced to use them without enough information on repercussions faced due to drug use. This leads to addiction, and by the time victims realize, they cannot do without drugs. This influence from media can be stemmed through use of warning labels and bans on certain forms of drug advertising which targets the youth.

Warning signs

There are various symptoms and warning signs which are associated with drug use. These symptoms vary according to drugs used, genetic make up of users, quantity used, personality and other aspects. It is important to note that presence of a particular symptom does not automatically means that the individual abuses drugs, rather that it shows that further investigation should be done to ascertain drug use by the individual. Some of these signs are discussed below;

Dropping Grades

Sudden drop of grades without clear reasons may indicate drug use. This may be linked to missing of classes when taking drugs, or harmful effects of drugs which affect the brain and cause poor academic performance. This behavior is usually accompanied by disrespect for school authorities and fellow students.

Missing Curfew

Missing curfews without adequate explanation of one’s whereabouts may also indicate drug use. When teenagers are unable to explain their movements, this shows that they are secretive, and drug use may explain this situation. However, teenagers’ movements should be established before accusing them of drug use.

Disrespectful to parents

Drug users are usually disrespectful to other people. This is due to the label which society gives them of “drug addicts”, which makes them harbor hatred towards society. Teenagers who use drugs are unable to explain their “odd” behavior to parents and much resort to disrespect as a means of covering up drug use (Giannini 69-73). Others are influenced by drugs to make irrational choices leading to disrespect of family, friends and the community.

Stealing & lying

Stealing is a common trait amongst drug users and it emanates from the need to purchase drugs. Drugs are expensive to purchase and drug users may be forced to steal from family and friends to maintain the vice. When questioned about it, they are likely to lie about it. This makes it a symptom of drug abuse, and parents should be careful to note such behavior from their children.

Who to blame

Various discussions have centered on who is to blame for the problem of drug abuse. However, there is consensus that everyone is to blame for the problem. Parents have neglected their children and left nannies and teachers to raise them, as they pursue professional goals. Teachers have also neglected students since they focus on academic curriculum at the expense of social development. The society has tolerated drug abuse and perceived it as “normal” behavior without taking action against drug users (Roleff 39-44). This has left adolescents to seek advice from peers, who may influence them to abuse drugs. Teachers and parents ought to give attention to teenagers and advice them on harmful effects of drug use. The society should also condemn and punish drug users, since this will deter them from practicing the same.

Risks involved

There are many risks which are involved in drug use. These risks affect the health of the user, their relationships with family, society and friends, and their ability to achieve full potential in later life. In addition to this, some risks may be potentially fatal to users. Risks associated with drug abuse include addiction, health problems, transmission of STDs, accidents, mental disorders and problems with law enforcers. These risks will be discussed below in more detail;

Addiction

Most drugs are addictive to users. The degree of addiction varies according to several factors including specific drug used, genetic make up of user, quantities used and other factors. However, since most drugs are addictive, users become dependent on the drugs for performance of everyday activities. Drug addiction is the most harmful effect of drugs since it ensures that users are unable to quit drugs, and instead use more quantities of drugs to achieve the state of intoxication over time. Some of the most addictive drugs include cocaine, heroine and tobacco. However, other drugs such as alcohol, prescription drugs and marijuana are also addictive and may make users dependent on them. This makes it expensive to sustain abuse, and users may use illegal means of getting money to satisfy the addiction. Drug manufacturers use the aspect of addiction to ensure they have a steady supply of cash from addicts.

STDS

Many drugs affect the ability to make reasonable judgments by users. Some drugs, especially alcohol, marijuana, cocaine and other hard drugs interfere with decision making abilities of users and may allow them to engage in irresponsible sexual behavior. This behavior may lead to transmission of STDs among people who engage in this behavior after drug abuse. In addiction, users who share needles when injecting themselves may acquire STDs as a result. Some STDs such as HIV are incurable and developing them leads to fatalities after a period of time. Others which are curable are expensive to treat, which leads to financial burdens on families of such drug users.

Health problems

Several health problems are linked to drug use. In fact, all drugs have a side effect or health problem associated with it. Drugs such as alcohol lead to kidney and liver failure while others such as tobacco may lead to development of cancer or lung damage (Learn about alcoholism website 2009). Hard drugs such as cocaine and heroin may lead to high blood pressure and heart problems. As earlier stated, sharing of needles may transmit STDs. It is clear that all drugs have adverse health repercussions. This leads to high medical costs to victims, and these problems may also lead to fatalities. This is an economic cost to families and governments around the world. Drug overdose may lead to instant death to users.

Mental disorders

There are various drugs which may lead to the development of mental disorders amongst users. These drugs adversely affect the brain leading to distortion of reality, leading to mental disorders. Drugs such as marijuana, cocaine, heroin and others have been known to cause psychosis and illusions, which may develop into mental disorders. People with such disorders may perform unreasonable acts as they perceive themselves as normal and the rest as abnormal. These disorders are expensive to treat, and may at times be incurable to victims.

Accidents

Many accidents are caused by drivers or pedestrians who have taken drugs. Alcohol is the most common drug linked to accidents, although others also lead to accidents in our roads. In the US, over 37,000 people died as a result of accidents caused by drink-driving, while this figure exceeded 41,000 in the previous year. These figures show the severity of the matter. This is a matter of great concern especially when sober drivers are exposed to accidents caused by drunk drivers, which end up taking their lives. There are also other accidents at the workplace which are caused by working while intoxicated, especially in industrial plants where there is dangerous machinery. Accidents cause serious injuries or fatalities to victims.

Trouble with the law

Many drug users are arrested at some point in their lives due to drug use. Drug use causes addiction, which forces users to seek more. Since most drugs are illegal, law enforcers arrest drug users through elaborate schemes and plans put in place to deter drug use. Arrests over drug use have adverse repercussions including heavy fines and prison sentences. It also leaves a record which may affect future employment opportunities. Families suffer when breadwinners are arrested, and one loses employment when arrest over drugs is publicized. This creates a large population of social deviants who are a liability to society.

Solutions

In order to solve the problem of drug abuse, each society stakeholder should join efforts to fight the vice. The problem of drug abuse needs to be publicized and help given to drug users. In addition, stiffer punishment should be given to traffickers. These and more interventions will be discussed below;

Family Counseling

Counseling is the first step in solving the drug abuse problem. Users need to accept that they face a problem and counseling will enable them see the effects of drugs to themselves and their families. Family counseling also teaches families to be supportive of drug users in attempts to stop drugs (Evans & Sullivan 75-76). This is important as drug users have families as primary socialization units. Family counseling should also address problems such as domestic violence which are causalities of drug abuse.

Community and youth programs

Community and youth programs educate youth on harmful effects of drugs. These programs also offer youth alternative activities to do with leisure time such as sports activities. When youth are aware of harmful effects of drugs, they are likely to avoid using them, thereby reducing the problem of drug abuse.

Harsher punishment

In order to deter trafficking and sale of drugs, laws which heavily punish drug use and trafficking ought to be passed. These should involve heavy fines and long prison sentences. When such laws are passed, they will deter drug traffickers, and when drugs are unavailable, the problem of drug abuse will reduce, if not completely eradicated. Harsh laws are very effective in deterring commission of crime.

Communication

In order to solve the drug problem, better communication between teenagers, teachers and parents should be developed. This will enable teenagers to share their concerns with parents and guardians, who will advice them on choices to make as opposed to peers, who may give wrong guidance and direction. Communication will also provide opportunities to teenagers to be aware of adverse effects of drug use.

Summary

The problem of drug use has been discussed in detail. Common drugs abused have also been discussed. Drugs have been seen to be harmful not only to users but also to their friends and families. Their harmful effects include health complications, fatalities, loss of employment, and economic burdens amongst other effects. Every member of the society is responsible for the problem of drug abuse and appropriate interventions should be implemented to discourage the vice. These include communication with teenagers, stricter laws against drug trafficking, family counseling and community programs which publicize the problem of drug use. This will ensure that teenagers are safe and free from drug abuse.

Pregnancy and motherhood is a significant part of womens lives. In fact, motherhood is a privilege that only women can experience. However, not all women feel privileged about becoming a mother. Knowles and Cole (1990) suggest that there is an increasing number of cases wherein soon-to-be mothers are not happy about their pregnancy either because of their current marital relationship, the biological father of the baby is not responsible enough to give emotional and financial support, or simply because they have negative past experiences such as being sexually or physically abused by their own parents, brothers, or relatives (Knowles and Cole 1990). Due to high incidence of unhappy pregnant women and mothers, the number of female perversion also increases.

Sexual abuse towards children or the act of inflicting harm towards her own body or the child’s body is considered as female perversion in the sense that sexually abusing her own children, inflicting harm towards one’s own body or her child’s body is totally the opposite of the true concept of motherhood and femininity. Welldon (2008) argues that female perversion is often expressed by inflicting self-destructive harm caused by biological or hormonal disorders that normally affects their reproductive meaning (Welldon 2008). Unlike male perversion, researchers highlight that female perversion aims at causing physical harm against their own body or against the objects that they created, including their babies (Welldon 2008; Springer-Kremser et al. 2003; Richards 1990). Motz (2001) acknowledges that there are many ways in which female perversion could cause physical harm towards her own body. Since perverse women identify their own body as their mothers’ body, perverse women is capable of attacking their own body through self-mutilation or self-starvation (Motz 2001). Other signs of perverse women include, as Balsam (2008) and Somers and Block (2005) note are: the act of exhibitionism wherein the woman shows off her body as a way of showing her active sex life and pleasure they get during procreation and sexual promiscuity ( Balsam 2008; Somers and Block 2005). In the case of perverse mothers, Banning (1989) explains that they attack their own children as a way of expressing their violent revenge (Banning 1989). Various researchers note that perverse mothers are often guilty of infanticide, unlawful abortion, and concealing a birth (Fraser 2008; Spinelli 2004; Tekell 2001; Boswell 1984).

Boswell (1984) suggest that infanticide cases normally occurs when the mother abandon their infant in outdoor places in order him or her to die from hypothermia, animal attack, hunger, or dehydration (Boswell 1984). In some cases, as Spinelli (2004) highlights, infanticide can also happen by intentionally suffocating the infant using a pillow or drowning the infant in a bathtub (Spinelli 2004). Spinelli (2004) and Tekell (2001) argue that that regardless of whether maternal infanticide cases happened because of postpartum mental illness or psychosis, schizophrenia, or purely because of neglect on the part of the mother or carer ,infanticide outside the concept of mental illness is clearly a crime under the law (Spinelli 2004; Tekell 2001).

Postpartum mental illness or psychosis is a kind of mental illness that can occur because of too much blood flow that passes through the brain (Meyer, Proano and Franz 1999;Cox 1988). In some cases, as Rapaport (2006) highlights, the practice of lactation could become a ground for mental disturbances among mothers who has just given birth to a baby (Rapaport 2006). Fraser (2008) also argues that biological and hormonal imbalances cause significant changes in the mood such as agitation, delirium, and delusions on the part of the mothers (Fraser 2008). Aside from biological or hormonal disorders, other common factors that can trigger female perversion, as researchers suggest, include the early exposure to maternal abuse and neglect, alcoholism, the use of illegal drugs, and stress related to socio-economic problems (Barnett 2006; Motz 2001).

Peter (2008) suggests that when a young girl is physically or sexually abused or neglected in the past, the future relationship of the abused might lead to confusion between the appropriate and inappropriate sexual activity, especially if the relationship is an abusive one. Since the negative experience with man could further damage their self-image and psychological functioning, the victim’s ability to become good mother will also negatively affected (Peter 2008). Barnett (2006) also notes that childhood experiences such as a young girl who failed to receive emotional support from mothers and fathers could grow up feeling devastated about their life. Because of their strong desire to rebel, some women may end up becoming unwed mothers only to prove their femininity or their ability to become more superior than another person – in this case, their own children (Barnett 2006). In line with this, other studies, Barnett (2006) and Welldon (1991), highlight that young girls who were sexually abused or emotionally deprived by their mothers often end up as prostitutes as a way of revenge. Authors also suggest that such mothers with psychological imbalance will intentionally inflict physical harm on their children (Barnett 2006; Welldon 1991). Welldon (1991) also explains that perverse mothers can either be a facilitator – someone who is capable of adapting to the child’s needs; or regulator – the type of mother who anticipate that their baby is capable of adapting to their own needs , which the second type leading more to physical abuse of children (Welldon 1991).

Society in general perceves mothers as a role models to their children, loving, nurturing. As part of being a role model, ideal mothers should refrain from the use of illegal substances,alcohol and smoking addictions. Aside from molding, educating, and nurturing their children to become good citizens, ideal mothers are expected to make their children happy and confident by instilling only good values in their minds. In other words, the role of ideal mothers are not limited in feeding their children but also to make them feel that they are loved by not being selfish. Every woman, on other hand, desires to be accepted socially as a good mother.In line with the strong desire to be accepted in public, the act of idealizing motherhood may lead to denial of female perversion. As it was highlighted previuosly, perverse mothers are capable of sexually abusing or physically harming their own children due of their negative childhood experiences. By strictly idealizing the concept of motherhood in our society, there is a strong possibility for perverse mothers will deny participating in any forms of such actions.

As mentioned in the previous statement, various researchers suggest that female perversion can be noted when there is alarmingly disturbed relationship between the mother and her infant, mother and son, or mother and daughter (Peter 2008; Hetherton 1999; Banning 1989). In line with this, women who have been neglected or deprived of love in the past or were sexually abused, could make them capable of sexually abusing their own children. Although the possibility wherein perverse mothers could sexually abuse their children is high, Motz (2001) highlights that these type of cases are often under-reported because of the complex relationship or emotional attachment that is present between the mothers and children. The absence of concrete evidences, it would be difficult to prove that a perverse mother is indeed punishing their children physically or sexually especially when the child is too young to talk and defend themselves against their abusive mothers (Motz 2001). As a part of idealizing motherhood and femininity, the idea wherein perverse mothers are abusing their own children physically or sexually is totally not acceptable within our society. As a result of idealizing motherhood and femininity, there is a strong possibility wherein perverse women are more likely to deny their act of perversion in order to protect themselves from being humiliated and judged by the public as irresponsible, immoral, and/or cruel mothers. For this reason, Hetherton (1999) and Banning (1989) argue that idealization of women could result to more under-reported cases especially with regards to criminal issues wherein female perpetrators would sexually abuse a child (Hetherton 1999; Banning 1989).

Researchers studies suggest that women’s past and unresolved experiences of being sexually abused during her childhood days can make them prone to inferiority complex which makes her an easy victim of abusive men (Balsam 2008; Springer-Kremser et al. 2003). In line with this, a good example is drawn by Motz (2001) where a perverse mother wherein becomes as an accessory of sexually abusing her own children, when the husband coerced the wife to encourage 7 and 10 year-olds, sexually abused victims, to masturbate the husband while the wife was taking pictures (Motz 2001). We can suggest that in case these two children refused to participate in the sexual activity with the father, either the mother or the father would physically harm the children for disobedience. There is also a strong tendency for both parents to threaten these children not to inform other people about the sexual activity that happened between them. Given that the society strictly idealizes the concept of motherhood, perverse mothers will continuously deny their willingness to abuse their children physically or sexually as a way of protecting themselves from becoming involved in child abuse cases. Based on the given example, it is possible on the part of the perverse mother to claim that it was the husband who made her encourage children to perform illicit sexual activities with the couple. For this reason, as we may suggest, it is the husband who is more likely to face the legal consequences or punishment for engaging children to participate in illegal sexual activities as compared to the perverse mother.

According to Welldon (1991), perversion in motherhood is possible when society denies mother’s perversion and idealises being a mother. Author further agrues that due to sexual or social politics, some women are not treated as a complete human beings because they were not born as men. By not allowing women to feel completely as human beings, there is a greater chance wherein of emotional instability leading mother to result in perverse motherhood (Welldon 1991).

Considering the cases of maternal infanticide, Rapaport (2006) explained that the law in UK has a distinctive legislation with regards to the act of killing infants and young children by their own mothers. In line with this, women who are proven victims of biological or hormonal disturbance caused by immaturity or unfavorable circumstances such as rape cases are qualified for settled law. For this reason, women who are guilty of maternal infanticide are free from death penalty. Under the British’s infanticide statute of 1922 and 1938, mothers who are guilty of killing their infant or children because of postpartum mental illnesses or psychosis are exempted from capital punishment related to murder. Author further acknowledge us the legal charges that are most likely to be imposed on the accused mothers will be reduced to manslaughter provided that there are enough biological evidence to prove that the accused mothers are going through postpartum-related mental disorder. Instead of sending the accused mothers to prison, perverse mothers who happened to be convicted of killing their infants due to post-partum syndromes are mandated to undergo hospitalization for necessary treatments (Rapaport 2006). In relation to the case of maternal infanticide, Card (2002) explained that evil actions can be classified as either “intolerable harm” or “culpable wrongdoing” (Card 2002:4). Since conscience plays a significant factor which enables us to act good deeds and avoid those that are evil, each person should be free from mental illnesses when judging whether a human action is morally good or bad (Card 2002). Card (2002) suggest that those women who are suffering from postpartum mental illness or psychosis, should not be classified as perverse female simply because they are not mentally capable of determining what is right from wrong at the time they had committed a crime. Infanticide caused by postpartum mental illness and psychosis should never be considered as an intentional crime. For this reason, the level of legal punishment imposed on postpartum mothers who are accused of infanticide should be different from perverse mothers who are guilty of intentionally inflicting physical or sexual harm on their children (Card 2002). West and Lichtenstein (2006) also draw a good exaple of criminalization of Andrea Yates case who drowned her five children in the bathtub and was inicially convinced for capital murder, who later on was found guilty of insanity and eventually was moved to state mental hospital. Authors argue that society’s myths and perceptions about perfect mothehood plays a great role in womens lives and stigmatizes those who’s behavoir is unnatural and deviant. Aside from taboo and stigma, society also don’t take into account the role of women;s daily activities, which as authors argue, lead to “double shift” both at home and at work which often result in emotional and physical stress and therefore could escallate to murder of a child (West and Lichtenstein 2006). Although it is possible that the act of idealizing motherhood could lead to denial of female perversion, it is by no doubt that justice will always prevail. Even though perverse mothers are capable of denying the act of harming their children physically or sexually, the local authorities can still gather concrete evidences from the victims of child abuse in order to convict preserve mothers who are guilty of committing a crime. Perverse mothers may continuously deny their act of female perversion, as in Andrea Yates case due to delusional thoughts about Satan, but they are not free from being legally punished for their socially unacceptable behaviour.

Rapaport (2006) suggests that when maternal infanticide is classified by psychiatrists as a form of postpartum mental illness or psychosis, suspected mothers who are positive for postpartum mental illness or psychosis should be given the privilege to receive psychiatric treatment (Rapaport 2006). In line with this, Spinelli (2004) highly recommended the need to make use of formal DSM-IV diagnostic criteria when scrutinizing a suspected mother for killing her infant and deciding for the level of punishment to be imposed on mentally ill person (Spinelli 2004). Considering the fact, as Hetherton (1999) highlights, that idealization of women could result to more under-reported cases particularly with regards to criminal issues wherein female perpetrators would sexually abuse a child, criminologists together with the assistance of social workers and school teachers should continuously educate children concerning ways on how they can protect themselves from abusive parents including issues related to perverse mothers. By teaching the victims of sexually and physically abusive parents on how they can report such cases to the authorities, the number of victimization caused by perverse women is more likely to decrease over time (Hhetherton 1999).

Barnett (2006) and Motz (2001) , as noted previously, suggest that the factors which can trigger female perversion include hormonal imbalances causing mental illness, the early exposure to maternal abuse and neglect, alcoholism, the use of illegal drugs, and stress related to socio-economic problems (Barnett 2006; Motz 2001). For this reasons, the kind of punishment imposed on women who are convicted of murdering their children varies on case to case basis. Wilczynski (1997) notes that unlike men, the universal characteristic of ideal women is passive by nature. Since the public’s perception of women is characterized by femininity, there is a lesser chance wherein perverse women and mothers will be accused of inflicting physical and emotional harm on their children. This is one of the main reasons why it has been a common legal practice in the United Kingdom that women who are found guilty of killing their own children are most likely to receive lesser punishment as compared to men (Wilczynski 1997). Up to the present time, there is on-going situation wherein perverse women and mothers are sexually abusing both male and female children. Since the cases of female perpetrators are often left unreported and considered by society as rare, there is a risk that the number of perverse female and mothers who are on the loose will continuously abuse children either sexually or physically (Peter 2008).

The legal system in the United Kingdom strongly recognizes the possible link between maternal mental illness with maternal infanticide and child homicide. Since there are cases wherein perverse mothers and young women who are convicted of murdering their children are using insanity as a defence for murder or child abuse, criminologists in UK should be able to learn more ways on how they can improve their ability to differentiate perverse mothers from those mothers who are suffering from mental illnesses caused by postpartum. By psychiatrists to strengthen their ability to detect postpartum-related mental disorder and psychosis, there is a higher chance wherein the accused perverse mothers will be able to receive proper medical treatment and free themselves from the punishment of life-time imprisonment.

As Raitt and Zeedyk (2004) suggest there is a very thin line that separates innocent women from perverse women who are guilty of murdering or physically harming their own children. Considering the fact that idealization of motherhood can enable perverse women and mothers who has just given birth to a baby to mislead the authorities by acting similar to mothers with postpartum mental disorders, criminologists should take it as a challenge to focus on determining the truth by gathering concrete evidences that will prove whether or not perverse women or perverse mothers are guilty of a crime. To prevent false accusations or wrong judgment, it is important on the part of criminologists to make use of medication intervention such as autopsy in order to determine whether the death of an infant was intention or merely caused by unexplainable infant death syndrome (Raitt and Zeedyk 2004).

*** End ***

“Qualified, hardworking Americans are denied job opportunities, fired or otherwise discriminated against just because they are lesbian, gay, bisexual or transgender (LGBT)” (Human Right Campaign). Even with the passing and enforcement of employment anti-discrimination laws, statistics show that persons with minority status such as people of color, persons with disabilities and women continue to experience discrimination in the workplace, particularly sexual minorities – LGBT persons (Niles & Harris-Bowlsbey, 2005). LGBT individuals who are also ethnic minorities are at an even greater disadvantage, with African American transgender people faring the worst (Grant, Mottet, Tanis, Harrison, & Keisling, 2001). To date, no federal law exists which consistently protects LGBT individuals from discriminatory practices in the workplace. It is still legal in 29 states to discriminate against employees and job applicants based on their sexual orientation, and legal in 38 states to discriminate based on gender identity (Human Rights Campaign). Within the state of Florida, there are no provisions in place which formally address discrimination based on gender identity; however a Florida court ruled that a person with Gender Identity Disorder (gender dysphoria) is within the disability coverage under the Florida Human Rights Act, as well as sections of the act that proscribe discrimination based on perceived disability. There is no state-wide non-discrimination law that protects individuals based on sexual orientation (Human Rights Campaign).

Vocational psychology researchers, practitioners, and LGBT advocates have made significant attempts to call attention to the vocational concerns and needs of both ethnic and sexual minority groups. Over the past few decades, work discrimination has become a topic of interest in the fast growing literature regarding the vocational issues and challenges of LGBT persons (Chung, 2001; Gedro, 2009; Loo & Rocco, 2009; O’Neil, McWhirter, & Cerezo, 2008).

Work Discrimination

Chung (2001) defined work discrimination as, “unfair and negative treatment of workers or job applicants based on personal attributes that are irrelevant to job performance” (Chung, 2001,p. 34) and proposed a conceptual framework that describes work discrimination along three dimensions: a) formal versus informal, b) perceived versus real, and c) potential versus encountered. Formal discrimination refers to institutional policies or decisions that influence one’s employment status, job assignment, and compensation. Informal discrimination refers to workplace behaviors or environments that are unwelcoming. Perceived discrimination refers to acts perceived to be discriminatory; whereas, real discrimination is based in actuality/reality. Potential discrimination refers to discrimination that could occur if a persons’ LGBT identity is either revealed or assumed. Encountered discrimination refers to discriminatory acts one experiences.

Findings from Research on Work Discrimination against LGBT persons

Following is a brief overview of some of the recent research findings on work discrimination of LGBT individuals. In their report entitled Bias in the Workplace, Badgett, Lau, Sears, and Ho (2007) summarized research findings about employment discrimination of LGBT persons from four different kinds of studies throughout the United States. Surveys of LGBT persons’ experiences with workplace discrimination (self-reports and co-worker perceptions), revealed that 16% to 68% of LGB persons reported experiencing employment discrimination, with 57% of transgender persons reporting the same. A significant number of heterosexual co-workers also reported witnessing sexual orientation discrimination in the work place against their LGBT peers. Of note, 12% to 13% of respondents in specific occupations (e.g., the legal profession) reported witnessing anti-gay discrimination in employment. An analysis of employment discrimination complaints filed with governmental agencies in states where discrimination based on sexual orientation is prohibited, findings revealed that LGB persons filed complaints at rates similar to women and racial minorities (e.g., people of color). An analysis of wage differentials between LGBT and heterosexual workers revealed that gay men earn 10% to 32% less than heterosexual men with similar qualifications and that transgender persons reported higher rates of unemployment (6% to 60% were unemployed) with incredibly small earnings (22% – 64% of the employed earned less than $25,000 per year). Finally, findings from controlled experiments – where researchers compare treatment of LGBT people and treatment of heterosexuals by presenting hypothetical scenarios in which research participants interact with the actual or hypothetical people who are coded as “gay” or “straight – also revealed significant discrimination on the basis of sexual orientation in the workplace.

According to the American Psychological Association (2011), those who self-identify as LGBT are particularly vulnerable to being socioeconomically disadvantaged; this is important as socioeconomic status is inextricably linked to LGBT persons’ rights and overall well-being. Although LGBT persons tend to be more educated in comparison to the general population, research suggests that they make significantly less money than their heterosexual and cisgender counterparts.

In 2009, the National Center for Transgender Equality and the National Gay and Lesbian Task Force published the preliminary findings of their National Transgender Discrimination Survey (NTDS). A staggering 97% of survey participants reported experiencing mistreatment, harassment, or discrimination in some form on their jobs, which included privacy invasion (48% said “supervisors/coworkers shared information about me inappropriately” and 41% said “I was asked questions about my transgender and surgical status”), verbal abuse (48% said “I was referred to be the wrong pronoun, repeatedly and on purpose”), and physical or sexual assault (7% said “I was a victim of sexual assault at work” and 6% said “I was a victim of sexual assault at work”). Survey respondents also reported experiencing unemployment at twice the rate of the population, with 47% having experienced an adverse job outcome – being fired, not hired or denied a promotion at some point in their careers due to their gender identity. Similar findings were reported in the NTDS’ official report, Injustice at Every Turn. Other significant findings were that 57% of participants reported trying to avoid discrimination by keeping their gender or gender transition a secret, and 71% by delaying the transition. Sixteen percent reported that they had to resort to work in the “underground economy” to earn income (e.g., prostitution or selling drugs). Unemployed respondents reported experiencing devastating outcomes, including double the homelessness, 85% more incarceration, and increased negative health outcomes, including twice the rate of HIV infection and nearly twice the rate of current drug use to self-medicate/cope in comparison to their employed LGBT counterparts (Ramos, Badgett, & Sears, 2011).

Frye (2001) argued that transgender persons are regular targets of workplace discrimination even more systematically than their LGB counterparts. In an attempt to ensure professional survival and avoid discrimination, many LGB employees choose not to “come out” at work; however because transgender persons may possess physical and behavioral characteristics that clearly identify them as transgendered at some point in their lives (mainly during gender transition), they are more susceptible to having their sexual minority status revealed against their will (being “outed”). More so than LGB individuals, transgender persons are frequently targets of hate crimes because of their visibility (Frye, 2001).

How/ Why Work Discrimination is related or important to career counseling.

“In the United States, a dominant career-related belief is that the individual controls his or her own career destiny” (Niles & Harris-Bowlsbey, 2005, p. 1); however, individual control is always exercised within a context that varies based on the degree to which it supports one’s career goals. In the case of LGBT persons, factors such as heterosexism, socioeconomic status, and racism may restrict access to certain occupational opportunities. Work discrimination in any form can have a profound effect on one’s career path and development (Neary, 2010). “LGBT people face a complex set of choices that are unique to them because of their sexual minority status” (Gedro, 2009, p. 54). Many of them have to confront “exclusion from certain types of jobs, such as elementary school teachers and child care workers; physical assault, verbal harassment and abuse, destruction of property, ridicule, trans-phobic jokes, unfair work schedules, workplace sabotage, and restriction to their careers” (Kirk & Belovics, 2008, p.32 as cited in Neary, 2010). In the case of transgender individuals, concerns about personal safety while at work preclude the focus on career interests (Neary, 2010). Because of the large amount of energy it requires to integrate a positive gay, lesbian, bisexual or transgender identity, as well as cope with discrimination (within and outside of the workplace), career development for such persons to be postponed, hindered, or misdirected (Alderson, 2003 as cited in Gedro, 2009, p.56; Haley, 2004).

Pepper and Lorah (2008) identified 3 major problems related to the job search process – an integral part of career development – which poses several challenges for transgender persons: 1) potential loss of work history, 2) navigating the job interview process (many struggle with confidence and self-esteem issues), and 3) if an employer asks about work experience under another name. Although slightly different, such challenges may be generalized to LGB job-applicants as well. Helping LGBT clients prepare for these problems is essential in assisting them in their career choice and job search efforts (Neary, 2010).

Work discrimination also has a significant impact on LGBT persons’ mental state, with the most common psychological issues include increased levels of stress and anxiety, depression, lack of self-confidence, drug and alcohol dependency (Neary, 2010), and attempted suicide (Grant et. al., 2011).

Implications & Suggested Interventions for Career Counselors

Like all other clients, the LGBT client may require help with career planning, self-assessment, career exploration, career or job transitions, job search strategies etcetera (Neary, 2010; O’Neil et. al., 2008). Career counselors working with sexual minorities need to create a LGBT-positive/affirming counseling environment, in which clients are free to explore their personal needs, interests and values in a safe place. Such an environment includes tangible and process-related forms of support and affirmation (e.g., displaying quarterly newsletters from the America Psychological Association’s Division 44 and other reading materials or paying careful attention to unique aspects of assessment interpretation) for LGBT clients. Intake forms should encourage them to note their gender presentation, and gender-neutral washrooms should be made available (O’Neil et. al., 2008).

Counselors and other helping professionals involved in the career development process of LGBT individuals should ensure that they develop relevant multicultural knowledge, skills and awareness for conducting culturally appropriate career discussions, realizing that more traditional approaches will likely be ineffective with this particular population. (Niles & Harris-Bowlsbey, 2001). When a LGBT client presents for career counseling, counselors should assess whether they are competent to provide the services requested (O’Neil, et. al., 2008). It is also imperative that career counselors assess their personal biases, stereotypes, and assumptions about the LGBT client presenting for counseling. A client-centered approach is recommended given that the issue of trust building is critical with the LGBT population. From a narrative perspective, adopting a stance of “informed not knowing” will allow the LGBT client the best chance to share their story about their career and life in their own words. Following, the counselor and client collaborate to deconstruct the cultural narratives of gender and heterosexism that promote negative messages and replace them with a more accurate and affirming narrative (Neary, 2010). In the case of personal dislike to LGBT individuals, O’Neil et. al., (2008) advised that counselors refer the client to another professional, receive continuing education and supervision, and engage in personal exploration of the topic as a means to prepare for future clients with similar concerns. The career counselor’s ability to provide effective services to their LGBT clients will be improved by staying current with the relevant literature (O’Neil et. al., 2008).

Career counselors are encouraged to help improve cultural sensitivity where their clients are concerned; this can be achieved by using appropriate names, pronouns and other terminology preferred by their LGBT clients to help validate their identity. Career counselors should also make it a point to educate themselves about the different legal issues experienced by their clients and investigate any written workplace policies that may hold relevance to LGBT individuals, such as the Employment Non-Discrimination Act (O’Neil et. al., 2008; Human Rights Campaign). Further, career counselors should identify and attend to all of the salient aspects of the client’s identity, as clients may identify themselves with an array of sociocultural backgrounds. This is especially important for transgender clients who not only suffer discrimination in the workplace, but in almost every aspect of their lives: education, housing, public accommodations, receiving update identification documents, and health care (Ramos, Badgett, & Sears, 2011).

Pope (1995) as cited in Gedro (2009) outlined four useful interventions for career counselors working in their work with sexual minorities. Pope suggests a discussion about discrimination interventions (exploring the nature and extent of discrimination and any resources available to the client should he or she chose to change their job or career), dual-career couples (e.g., Do you openly reveal the relationship at work?), overcoming internalized transphobia or homophobia with the client (many sexual minority clients possess an intense self-hatred and – loathing), as well as supporting LGBT role models (particularly those who do not work in “safe” occupation).

Finally, career counselors are also strongly encouraged to serve as advocates for their LGBT clients. One author noted that a weakness in the field is “the reluctance or inability to see career counselors as change agents who can help not only individuals to change but systems to change as well” (Hanson, 2003 as cited in O’Neil, 2008, p. 299). Neary (2010) cited Muniz and Thomas’ (2006) five strategies in organization settings that career counselors can use to help cultivate an affirmative LGBT work environment. They include: 1) setting up the context – advocating in the workplace for anti-discrimination and harassment policies, 2) preparing for resistance – taking steps to make the concerns and needs of the LGBT population more visible, 3) leadership commitment – gaining commitment and support from the leadership/management of organization, 4) becoming familiar with or launching affinity and/or resource groups for LGBT persons, and 5) continued learning – additional diversity training (Neary, 2010). The Human Rights Campaign Foundation provides a 5-step checklist for advocating for the rights of transgender persons, and the NCTE’s list of 52 Things You Can Do for Transgender Equity, is also a useful guide for initiating social advocacy (O’Neil, et. al., 2008).

This essay will firstly define what discrimination is and what it means to discriminate. Examples will be used to demonstrate what discrimination may look like. A definition of empowerment will also be used. The essay will then critically explore theory and ideas around power and how power manifests between groups. This part of the essay will touch on the idea of ‘othering’. The essay will move on to focus on mental health, ‘race’ and racism. The essay will use the idea that ‘mental illness’ is a social construct and look at how ‘mental illness’ can be open to influences of racism from society (Bailey 2004). The essay will make links to institutional racism in mental health and psychiatry.

In a basic sense to discriminate means to: “differentiate” or to “recognise a distinction” (Oxford Dictionaries 2012). In this basic sense it is a part of daily life to discriminate. For example, a baby will often discriminate between a stranger and their caregiver. Discrimination becomes a problem when the ‘difference’ or ‘recognised distinction’ is used for the basis of unfair treatment or exclusion (Thompson 2012). Anti-discriminatory practice in social work concerns itself with discrimination that has negative outcomes; whether this is ‘negative discrimination’ or ‘positive discrimination’. Both are equally as damaging.

Thompson (1998) defines discrimination as a process where individuals are divided into particular social groups with an uneven distribution of power, resources, opportunities and even rights. Discrimination is not always intentional (Thompson 2009) and there are various types of discrimination (EHRC 2012). Discrimination can be direct, indirect, based on perception or on association (EHRC 2012). The Equality Act 2010 is legislation that protects individuals and groups against discrimination. The Equality Act 2010 brought together several pieces of legislation to protect several ‘protected characteristics’: age, disability, gender reassignment, marriage and civil partnership, race, religion or belief, sex and sexual orientation. Discrimination does not just occur on a personal level, according to Thompson (2012), discrimination occurs on three levels; personal, cultural and structure. This will be explored more later on.

‘Empowerment’ is a term that often comes in to play when examining discrimination; therefore it is important to have an understanding of both. Empowerment is the capacity of individuals or groups to take control of their circumstance and use their power to “help themselves and others to maximise the quality of their lives” (Adams 2008: xvi). Empowerment is then not an absence of discrimination and power but an individual’s capacity to own or share that power and take control. Therefore empowerment is an anti-oppressive practice not an anti-discriminatory one. They are linked but not the same.

Social workers act as ‘mediators’ between service users and the state. Social workers are in a role that can potentially empower or oppress (Thompson 1997). For this reason Thompson (1997: 11) argues that “good practice must be anti-discriminatory practice”, no matter how high the standards of practice are in other respects (Thompson 2012). Thompson (1997) reminds the reader many times throughout his book that “If you’re not part of the solution you are part of the problem”. I choose to include this because it reinforces that social workers need to challenge discrimination and take action against it. Discrimination is political, sociological and psychological (Thompson 2012). To ‘accept’ and tolerate it and to not to challenge it does indeed make social workers part of the problem. Discrimination has links with power which the essay will move on to explain next.

As defined by the Oxford Dictionary (2012) power is “the ability or capacity to do something; the capacity or ability to act in a particular way to direct or influence the behaviour of others or the course of events; or physical strength or force exerted by someone”. From this definition power could be seen as a coercive force or authoritarian. However, some theorists would argue that there is more to power than just coercion and authority. Parsons (1969 cited Rogers 2008) took a different view on power. He saw power as a way of maintaining social order instead of a force for individual gain (Rogers 2008).

Parsons (1969 cited Rogers 2008) believed that to be able to enforce coercive action and justify it, there needs to be a collective interest from the social system as a whole (Rogers 2008). Lukes (1974) would disagree with Parsons definition on power. Lukes argues that power is less abstract (Rogers 2008) and that exercising power is the decision to exert control. Lukes (1974:74) illustrates this point as: “A exercises power over B when A effects B in a manner contrary to B’s interests”. Dominelli (2008) focuses more on the idea of competing power; which group has more power than the ‘other’. This splits people to either be in the dominant group or the minority. A dominant group tends to be deemed superior, and with superiority comes privilege (Dominelli 2008). As a result the other group is deemed inferior, the minority and disadvantaged. It is this compound of dominance and oppression that discrimination derives from (Rogers 2008). It is a groups perceived superiorly over another group (Thompson 2012) that ‘justifies’ coercive action, control and discrimination.

When people form oppressive relationships the tendency is to make a strategic decision that excludes a particular group or individuals from accessing power and resources (Dominelli 2002). ‘Othering’ can be experienced as multiple; multiple oppression. People can be ‘othered’ simultaneously due to a number of social divisions (Domenelli 2002), for example, being a black woman who experiences mental health issues.

Social workers need to recognise power and its links to discrimination. Not to could further oppress (Thompson 2012). It can feel uncomfortable to be in the privileged position; whether this is as a white person or a man and so on. The ‘privileged group’ need to engage in the fight for equality (Corneau and Stergiopoulos 2012). White people need to engage with the fight against racism and accept responsibility for racism as it is a problem of white society and therefore involves white people (Strawbridge cited Corneau and Stergiopoulos 2012). This explanation can be applied to any other groups that are considered to be the ‘other’.

Rogers and Pilgrim (2006: 15) suggest that superiority is a social construction: a “product of human activity”. Dominelli (2002) goes further to say that oppression itself is a social construct as oppressive relations are not pre-determined but they are reproduced between social interactions and routines. Language is often used as a key part of social interaction and is also a very powerful tool. This relates heavily to social work as social workers are responsible for writing reports/care plans/assessments. Depending on how social workers word written pieces of work can indeed paint a very different picture of the service user they are working with. I was once told that ‘words are the bullets of prejudice’, this illustrates that labels and language can be powerful, damaging, potentially discriminatory and oppressive.

Although labels can be damaging they are a part of social interaction. Labels help us to construct our social world and we use them to find similarities and differences to process the world around us (Moncrieffe and Eyben 2007). Although the process of labelling is “fundamental to human behaviour and interaction” (Moncrieffe and Eyben 2007:19) social workers need to be aware of when these labels have the potential to be damaging, oppressive and rein forcers of discrimination. Social workers need to reflect and consider what labels they give people and what impacts this may have. Labels can be used to change or sustain power relations which can have an impact on prejudice and on achieving equality (Moncrieffe and Eyben 2007).

This essay will use the themes discussed so far to focus in on mental health as an area of practice and critically explore institutionalised racism within mental health practice and psychiatry. To begin I will briefly return to Thompson’s (2012) PCS analysis in relation to mental health and ‘race’. The ‘P’ level is our own individual attitudes and feelings (Thompson 2012). Although it is important to examine our own beliefs we do not live in a “moral and political vacuum” (Coppock and Dunn 2010: 8). For this reason Thompson (2012) also refers to the cultural (C) and structural (S). ‘P’ is embedded in ‘C’ and ‘C’ and ‘P’ in ‘S’ which builds up interlocking layers of discrimination; personal, cultural and structural.

The ‘C’ level is where we learn our norms and values. Individuals learn these values and norms through the process of socialisation which occurs through social institutions such as the family, religion and the media (Haralambos and Holborn 2008). These institutions can produce ideas about what is considered ‘normal’ or ‘right’ (Coppock and Dunn 2010). From this it is not surprising that there is an attitude in society that people who experience mental health issues are violent and a danger to society; even though there is no relationship between mental health and violence (Rogers and Pilgrim 2006). However, the general media uses terms like ‘psycho’ (Ward 2012) or ‘crazed gunman’ (Perrie 2011) in relation to acts of violence creates prejudice. This prejudice can then be used to discriminate. For example, a community may not want a ‘mental home’ to open near them as ‘the mental people’ will cause a threat to their community.

The ‘S’ level is the level of institutional oppression and discrimination. Ideas that Thompson (2012: 34) refers to as being “‘sewn in’ to the fabric of society”. Western psychiatry is laden with cultural values and assumptions that are based on western culture (Coppock and Dunn 2010). This suggests that western and white is ‘normality’ and anything that deviates from this is ‘abnormal’ (Corneau and Stergiopoulos 2012), or as previously discussed; ‘other’. It is the ‘C’ and ‘S’ level which the essay will focus on more.

Institutional racism explains how institutional structures, systems and the process embedded in society and structures that promote racial inequality (Jones 1997). It is considered to be the “collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture or ethnic origin” (MacPherson 1999). Jones (cited Marlow and Loveday 2000: 30) goes further than this definition to also include “laws, customs, and practices which systematically reflect and produce racial inequalities”. Institutional racism is believed to be a more subtle and covert type of racism (Bhui 2002) and often said to be unintentional (Griffith et al 2007).

BME groups are differently represented in psychiatry (Sashidharan 2001). People of African-Caribbean heritage are over represented yet people of Asian heritage underrepresented in mental health settings (Sashidharan 2001). As BME groups deviate from the ‘white norms’ they appear to receive either too much attention or too little (Sashidharan 2001). This would suggest that the systems which operate within psychiatry are institutionally racist.

Both ‘race’ and ‘mental illness’ are social constructs (Thompson 1997; Bailey 2004). Thompson (1997) argues that despite the lack in biological evidence for the explanation of racial categories it is still a widely common way of thinking. Bailey (2004) argues that ‘mental illness’ has always been a social construct therefore open to racism and other forms of discrimination. The declassification of homosexuality in the Diagnostic and Statistical Manual of Mental Disorders (DSM) illustrates Bailey’s (2004) point.

‘Race’ immediately brings up issues around power and the relationship between what is seen as ‘natural’ and ‘social’ (Westwood 2002). Historically ‘it was viewed that inequalities around ‘race’ had a ‘natural’ explanation (Westwood 2002). ‘Race’ could be traced back to anthological tradition (Rogers 2006; Craig et al 2012) and colonial discourse with the belief that white identity is superior (Westwood 2002) and that black people are “lacking civilisation”, “savages” and a “subhuman species” (Bailey 2004: 408-409). According to Bailey (2004: 408) “the effects of racism on psychiatry can be directly linked to the early stereotypes about black people arising from pseudoscientific racism”. It is this pseudoscience racism (science which lacks scientific method or evidence) that underpins racism in mental health services today (Bailey 2004).

Racism has many different sides and is a multidimensional form of oppression and discrimination (Corneau and Stergiopoulos 2012; Thompson 2012). Racism is widely known to be the cause of disparities in health and mental health (McKenzie in Bhui 2002; Griffith et al 2007; Craig et al 2012). BME individuals find themselves navigating their way through a system that works from the dominant discourse of the ‘medical model’ (Corneau and Stergiopoulos 2012). This allows a small amount of room for different and alternative frameworks to challenge racism which is already ingrained in the system.

To illustrate this point I will use an example from my practice. I work with a black woman who experiences mental health issues. She has spiritual beliefs and usually openly takes about her beliefs at home. She fears one resident as he is very religious and she feels that he has ‘special powers’. I supported her to an appointment with her psychiatrist as she had begun to feel mentally unwell. He did not enquire about any social, cultural or structural factors that may impact on her mental health. I tried to advocate the experiences she had shared with me and reiterated what she was saying. However, he advised her that the ‘tugging’ she experienced in her stomach was physical and to see a doctor and increased her anti-psychotic medication. Her spiritual experiences were not validated, he individualised the ’cause’ of her ‘illness’ and used a medical intervention.

Western psychiatry tends to separate the mind from the body and spirit (Bailey 2004). According to Bailey (2004) many BME service users find this approach “unhelpful and irrelevant to their experiences of mental distress”. This is because for many BME the mind, body and spirit work in union and the feelings and behaviours behind this is woven into people’s wider existence (Bailey 2004). Kortmann (2010) believes that these types of clinical intervention are often ineffective due to service users non-western origin and tend to quit treatments earlier. For example, some African cultures can believe that seizures are cause by evil spirits (Kortmann 2010) and therefore do not take medication prescribed as they do not believe it to be an illness.

Westwood (2002) writes that the negative impact of racism can have a significant impact on an individual’s mental health. However in a recent piece of research Ayalon and Gum (2011) concluded that black older adults experienced the highest amount of discriminatory events but there was a weaker association with this and experiences of mental health issues. To account for this it was concluded that BME groups experienced more events of discrimination over their life course and as a result have become more resilient to it (Ayalon and Gum 2011).

Some writers argue that to construct institutional racism as the explanation to the disparities in mental health can add to the debate and effectively alienate BME groups even further (Singh and Burns 2006). Singh and Burn (2006) state that, the accusation of racism within psychiatry will give service users the expectation that they will receive a poorer service and this will encourage service users to disengage with services or offer voluntary admission. What Singh and Burn (2006) are speculating is presented by Livingstone (2012) as self-stigma; the stigma that is present on an individual level rather than on a cultural or social. It is the stigma that is internalised that can prevent people from access services (Livingstone 2012) and thus, actively discriminating against one’s self. Therefore, Singh and Burns (2006) argue that individuals to stay away from needed services until it is too late and there are few alternatives but to detain them and enforce treatment.

Although Singh and Burn (2006) make a logical point they fail to recognise BME service user experiences of Mental Health Services. Bowl (2007) conducted a qualitative research to gain the views and experiences of South Asian service users as most literature is through the lens of academics and professionals. The experiences of this South Asian group would certainly suggest the presence of institutional racism within Mental health Services. The main areas identified were their dissatisfaction in not being understood in the assessment process due to language barriers and cultural incompetence (Bowl 2007). This misunderstanding led to misdiagnosis and refusal of services (Bowl 2007).

Racism is often not the only form of oppression that people face. Disadvantage can occur from several areas (Marlow and Loveday 2000). BME groups experiencing mental health issues are already subjected to multiple oppression. There is not enough words in this essay to explore this further but wanted to acknowledge that forms of oppression are not experienced in isolation of each other. For example, links have been made between individual’s lower socio-economic status and experience of mental health issues and how black people can face the added stress of earning less and experiencing higher levels of unemployment (Chakraborty and McKenzie 2002). This begins to illustrate the complexity and how oppression is inextricably intertwined.

Institutional racism has been highlight in a number of Inquiries in practice. It was firstly highlighted in the Stephen Lawrence Report in 1999; a black young person who was murdered in a racist attack and yet again in the David Bennett Inquiry in 2003; a black man who died in 1998 after being restrained faced down by several nurses for nearly half an hour. Lord Laming (2003) also identified issues around racism in his Inquiry into the death of Victoria Climbie. There is not enough words to go into any of these inquiries in any detail but they have been included to demonstrate institutional racism in practice in the police, mental health service and social work.

It may seem that whilst mental health services operate within the medical model that is catered towards the white majority things will not change. Institutions and systems are indeed difficult to change, however social workers can work with service users to empower, advocate, challenge and expose discrimination in services and bring about social change.

Empowerment is complex in general but becomes more complex in relation to ‘race’ and ethnicity (Thompson 2007). Social workers need to firstly be aware of institutional racism before they are able to challenge it (Thompson 2007). For social workers to challenge institutional racism they need to challenge policies that do not address the needs of BME groups. To do this, social workers need to be aware of the complex power relations and deeply ingrained racist patterns in society (Thompson 2007).

In my practice in a mental health setting I have contact with medical professionals and often support services users to appointments. I find that I must hold onto my social work values and not get drawn into the medical model way of working but to remain holistic in my approach.

To conclude, this essay has demonstrated that discrimination is far more complex than treating someone differently. It has focused on a more subtle, covert and indirect form of discrimination: institutional racism. The essay has examined the links between discrimination, racism and power and introduced the idea that ‘mental illness’ and ‘race’ are both social constructs. It is this subtle and covert form of discrimination that can be damaging. It can be hard to recognise as it is woven into the very fabric of society (Thompson 2012). However, the message in this essay is that social workers need to recognise power relations, how they operate, on what level they operate at and to challenge discrimination (anti-discriminatory practice) and work with service user to empower them to overcome these obstacles (anti-oppressive practice). Social workers must ‘swim against the tide’ and not collude with these attitudes no matter how deeply ingrained and embedded they are in society. For the social workers that fail to do so will ultimately become part of the problem.

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This essay will firstly define what discrimination is and what it means to discriminate against something. It will then explain what it means to discriminate against someone or a group in social work practice. This will be a very broad definition that encompasses a variety of different service user groups. Examples will be used to demonstrate what discrimination may look like in social work practice and everyday life. To gain a better understand the essay will critically explore theory and ideas around power and how power manifests between groups. This part of the essay will touch on the idea of ‘othering’. The essay will use social constructionism theory to analyse this concept of power.

The essay will then focus in on mental health. This part of the essay will firstly look at what a mental health problem is and explore the stigma of being labelled with a mental health problem. The essay will then go deeper to focus on how the western medical model can discriminate against Black and Ethnic Minority groups (BME), even if indirectly. The essay will then critically explore why BME adults, particularly men, are overrepresented in the mental health service. Links will be made to institutional racism and the fact that BME children are underrepresented in child and adolescent mental health services (CAMHS).

In in broadest definition, to discriminate means to “differentiate” or to “recognise a distinction” (Oxford Dictionaries 2012). In this broad sense it is a part of daily life to discriminate. For example, an adult may discriminate between lanes on a motorway and a baby will often discriminate between a stranger and their caregiver. Discrimination becomes a problem when the ‘difference’ or ‘recognised distinction’ is used for the basis of unfair treatment. This is the discrimination that social workers need to be vigilant for.

Discrimination is not always intentional (Thompson 2009) and there are various types of discrimination (EHRC 2012). Discrimination can be direct, indirect, based on the perception that someone has a protected characteristic or discriminate against someone who is associated with a person who has a protected characteristic (EHRC 2012). The Equality Act (2010) also aims to protect people with a ‘protective characteristic(s)’ from victimisation, harassment and failure to make reasonable adjustments (Home Office 2012). Thompson’s (1997) PCS model demonstrates that discrimination is not always on a personal level and it is not just solely down to the individual. I will return to the PCS model later on in the essay.

Social workers act as ‘mediators’ between service users and the state. Social workers are in a role that can potentially empower or oppress (Thompson 1997). For this reason Thompson (1997: 11) argues that “good practice must be anti-discriminatory practice”. All other areas of practice could be brilliant and the social worker could have very good intentions but if the social worker cannot recognise the marginalised position of some of the people they are working with their interventions could potentially further oppress (Thompson 1997). Thompson (1997) reminds the reader many times throughout the book that “If you’re not part of the solution you are part of the problem”. I choose to include this because it reinforces that social workers need to challenge discrimination and take action against it. To accept it and to not ‘swim against the tide’ does indeed make us part of the problem.

Where does discrimination come from and why do people, institutions and systems discriminate against people? This part of the essay will critically explore the concept of power and social constructionism in relation to discrimination and social work. Power is defined by Haralambos and Holborn 2000: 540) very loosely as “the ability to get your own way even when others are opposed to your wishes”. This is of course a very simple definition of a complex concept. There are many models and theories around power. Thompson (1998: 42) identified a common theme of “the ability to influence or control people, events, processes or resources”. These common themes of power all have the potential to be used destructively in social work. Social workers have the ability and power to influence and control, whether this is on an individual personal level or as a gate keeper of services or agent of control. Social workers need to be aware of power as they work with people who are marginalised and powerless in comparison; people who social workers could potentially oppress and even worse, abuse.

Giddens (1993) makes close links between power and inequality.

EHRC Equality and human rights commission., 2012. [Viewed 2012.11.10] What is discrimination? [online]. Available from http://www.equalityhumanrights.com/advice-and-guidance/education-providers-schools-guidance/key-concepts/what-is-discrimination/

Giddens, A., 1993. Sociology (2nd ed). Cambridge: Polity

Haralambos, M, Holborn, M., 2000. Sociology themes and perspectives. London: HarperCollins Publishers Ltd

Home Office., 2012. [viewed 2012.11.11] Equality Act 2010 [online]. Available from http://www.homeoffice.gov.uk/equalities/equality-act/

Oxford Dictionaries., 2012. [Viewed 2012.10.19] Discriminate [Online]. Available from http://oxforddictionaries.com/definition/english/discriminate?q=discriminate

Thompson, N., 1997. Anti-Discriminatory practice (2nd ed). Basingstoke: Macmillan Press

Thompson,N., 1998. Promoting Equality challenging discrimination and oppression in human services. Basingstoke: Macmillan Press Ltd

Thompson, N., 2009. Practising social work. Basingstoke: Palgrave Macmillan

Traditionally people with learning difficulties/disabilities have suffered from social exclusion, discrimination and marginalisation. By exploring how successful the Human Rights Act 1998 has been in promoting the rights of people with a learning disability through legislation, policy, advocacy, the care commission and SSSC and personalisation of service provision, will show if services have enabled people with learning disabilities to enjoy these rights and lead a fulfilling live as an equal citizen.

Historically Human Rights have been intricately tied to the laws, customs and religions throughout the ages. The great religions of the world contribute profound ideas on the dignity of the human being, and are concerned with the duties and obligations of man to his fellow human beings. (Brownlie,1992) The earliest rules about standards of behaviour among people were seen as fundamental to the well-being of society, under the influence of philosophers such as Grotius, Hobbes and Locke. Then, these rights were called ‘natural’ rights, or ‘the rights of man’. (Habermass, 1990)

At an international level, human rights are rules that protect people from severe political, legal, and social abuses. They include all fundamental freedoms and are based on mankind’s demand for a life in which the inherent dignity and worth of each human being will receive respect and protection. These rights exist as morals, values and ethics in human society, requiring the government comply and enforce the rights as law at both national and international levels (Anaya 2004)

The Human Rights Act 1998 is a piece of legislation that adopts the European Convention of Human Rights 1950 which has been made British law containing 30 articles which detail rights and freedom, for example Article-8 states that everyone has the right to respect for private and family life. Another European initiative is the Charter of Fundamental Rights of the European Community, signed in December 2000. It is not law, but everyone is expected to respect the charter declaring the rights of all European citizens to ‘dignity, freedom, equality, solidarity, citizen rights and justice.’ (Owen, 2008)

There have been marked improvements in the lives of people with learning disabilities in the last 30 years since the Community Care Act 1990. The current based philosophy of care has changed the instititionalised care that excluded people from the community at the beginning of the 1900’s, to community care that has enabled people with learning disabilities to live in the community as an equal citizen. However people with learning disabilities are still socially excluded, have no control or choice over their own lives and “were “more likely than others to have bad things happening in their lives” questioning to what extent are the rights of people with learning disabilities being met, on their right to ‘dignity, equality, respect and autonomy.’ (DoH 2008)

People with learning disabilities have greater health needs than the rest of the population. As it has been documented that people with learning disabilities are more likely to suffer chronic health problems. Thus requiring more frequent treatments and health care checks. (DoH, 2001). Research has also shown that these general health needs are not being met through lack of promotion and under-identification of ill health of people with learning disabilities. As people with learning disabilities still face institutional discrimination within the NHS. (Mencap,2007)

The launch of Mencaps ‘Treat me right!’ campaign, has brought to light many cases of appalling treatment that people with learning disabilities have had to endure in hospitals around the U.K. Thus bringing to light serious concerns about the way that people with learning disabilities are treated within our healthcare system. Families came forward to tell Mencap charity for learning disabilities about their experiences and the unexplained death of their loved ones that resulted from discrimination and lack of understanding in treatment from health professionals. In the hope of changing, how people with learning disabilities are treated in the health care system for the future. (Mencap,2007)

As Allan, the father of Mark, who died in August 2003 of bronchopneumonia states:

“We believe that Mark died unnecessarily. Throughout his life, we encountered medical professionals who had no idea how to deal with people with a learning disability or what it is like to be a parent of someone with a learning disability – to know their suffering, to see their distress. If only they would listen…” (As cited in ‘Death by Indifference’. Mencap.org: 2007)

Marks father explains that Mark had a severe learning disability and had very little speech, though he had his own way of communicating his needs, which his family understood. Mark was just 30 years when he died. Two months before his death, Mark had been admitted to hospital with a broken femur. While operating he suffered severe blood loss, Mark was discharged and re-admitted twice in two months, finally dying in intensive care eight and a half weeks after the operation. Mark was left suffering in great pain and distress in the days before his death due to lack of knowledge about learning disabilities. As Marks family believe that it was failure by medical professionals to understand his medical needs or the seriousness of his condition that led to his death. Stating that Marks life could have been saved if medical staff had listened to the family in the first place about Marks condition. (Mencap, 2007)

This lack of understanding from healthcare professional goes against the basic rights of people with learning disabilities by breaching their right to life and access to healthcare (Article 2) Hospital staff awareness and knowledge of learning disabilities is very poor. As staff are often ignorant of issues around consent and capacity to the extent that the person with learning disability is often denied treatment, as staff can be unaware of people’s rights. Staff can be patronizing and speak to people with learning disabilities as if they are children, being completely unaware that people with learning disabilities cannot communicate problems to them or use fancy jargon that people do not understand.

Therefore the healthcare system needs to put in procedures that safeguard the human rights of people with learning disabilities. Current Medical staff should be made more aware of the needs of people with disabilities and it should be statutory that all future medical staff should be taught about learning disabilities when they are students. Mencap put forward recommendations to the Government after their enquiry ‘Treat me right!’ and ‘Death by Indifference’ the outcome is ‘Valuing People Now: The Delivery Plan 2010aˆ‘2011 ‘Making it happen for everyone’ indicates the changes the government plans to implement in improving healthcare services for people with learning disabilities. (Mencap,2007)

People with learning disabilities are at greater risk of having crimes committed against them and face greater hurdles to achieving justice compared to other people in society. People with learning disabilities are often targeted specifically because of their disability, making them more vulnerable to abuse. For many people with a disability, this violation of their human right is seen as a normal part of their everyday life. Therefore people with learning disabilities are less likely to report crimes and seek the help they need to stop these crimes happening. Some people with learning disabilities do not know what is being done is a crime or are unable to communicate and tell someone about the crime committed against them. (Crime and Abuse, 2007)

The report Behind Closed Doors states that people with learning disabilities find it difficult if the complaint is about the person providing care as a person with learning disabilities may fear the loss of care, accommodation or other support if they make a complaint or report to the police. Once a complaint has been made, the Crown Prosecution Service state that the complainant with learning disabilities is not capable of giving evidence, or it will be too stressful for them to do so and this may reduce the likelihood of a successful prosecution. (Crime and Abuse, 2007)

Everyone person with a learning disability has the right to protection of property and person;(Article 3). Theft from adults with learning disabilities is not uncommon. As many people with a learning disability have to rely on personal assistants or carers assist to them in the management of their financial affairs and this trust can be violated. As the following report states, residents with learning disabilities at Dove House in Kirby Muxloe, Leicestershire became victims of crime, when the care homeowner was convicted for stealing money from residents that lived there. Leicester Crown Court reported that Caroline Rice kept half the money she withdrew on behalf of residents from their bank accounts and used false accounting to hide her crime. Rice was convicted of three counts of theft totalling ?500, and eight offences of false accounting to conceal thefts, totalling ?745. (Community Care, 2007)

People with learning disabilities can suffer abuse in a care setting by losing there right to freedom of movement. (Article 2) As a care inspection carried out in supported living found that staff were unaware that it was unlawful to detain people against their will. The staff, rather than the residents held the keys, which meant residents could not lock their bedroom doors. Staff locked internal and external doors to restrict movement, preventing people from freely entering and leaving and restricting access to communal areas, which they had the right to enter into. (Healthcare Commission, 2006)

However, The Regulation of Care (Scotland) Act 2001 has ensured a system of care regulation in Scotland. The purpose of the Act is to provide greater protection for people requiring care services. The National Care Commission is required by the Act to regulate these care services. By registering and inspecting services against a set of National Care Standards. The standards outline the quality of service that care users have the right to expect. They have been developed with the purpose that the quality of care provided and received throughout Scotland will be consistent. The standards also ensure that all care services will be measured against the general principles of Privacy; Choice; Safety; Realising Potential; Equality and Diversity. (NCSC, 2003) ) This ensures that all people are “safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory, abuse or self-harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance.”(NCSC, 2003) If these standards are not being met, then people have the right to complain with no fear of victimisation or repercussion.

As Marcia Ramsay, Director of Adult Services states ” We are tough on poor practice and use enforcement action when necessary, including closing some services. (As cited on Care Commission.com).

However there are limitations within the Care Commission. In that the care standards are not laws, they are just guidelines that the care commission uses in inspections. Poor practice is not always picked up in care settings when the care commission carries out inspections. What about people who cannot communicate to complain or who might not understand what represents poor practice?

People with learning disabilities face a higher risk of sexual assault, rape and domestic violence than the general population. These crimes are regularly committed in care settings by the very people who are meant to be caring for them. Breaching the persons human right to liberty and security and the right to freedom from exploitation, violence and abuse; (Article 5) (Crime and Abuse, 2007)

The Healthcare Commission reported a case of rape and allegations of sexual assault. The judge described the betrayal of trust when he sentenced Peter Clark to six years in prison. Clark was employed to care for a woman in her 40’s who had severe learning disabilities and a mental age of two years. The sexual abuse carried out by Clark was even more unforgivable as Clark had known that she had already been the victim of sexual abuse by a previous carer. (Healthcare Commission, 2007)

All staff in the care sector are now required to be registered with the Scottish Services Care Council and are unable to work if they are not registered. The Scottish Social Services Council (SSSC) is responsible for registering people who work in the social services and regulating their education and training. Its role is to increase the protection of people who use social services, to raise standards of practice and to increase public confidence in the sector. When a social service worker applies to register with the SSSC, they must agree to abide by the Code of Practice for Social Service Workers, which sets out the conduct expected of social service workers and informs people who use social services and the public about the standards they can expect. The Code supports the human rights of people who use care services. (SSSC,2009)

The SSSC can investigate the conduct of registered social service workers. When an allegation of misconduct comes to the attention of the SSSC, it will consider whether there is an issue about a social service worker’s suitability to remain on the register. If serious misconduct has been found the SSSC publishes information to prevent people deemed unfit to look after vulnerable people from ever gaining employment in another area of the U.K. As The Scottish Social Services Council state in their code of practise “Checking criminal records, relevant registers and indexes and assessing whether people are capable of carrying out the duties of the job they have been selected for before confirming appointments”(SSSC,2009)

However the limitation of the SSSC is that some cases of misconduct might not come to their attention, as people with learning disabilities are dependent on paid or unpaid carers and might not report abuse or misconduct through fear of not receiving care. Also some members of staff might not report misconduct through fear of victimisation or repercussion. It does not prevent abuse, as misconduct can still occur in situations where carers are not registered.

An important step in protecting human rights for people with disabilities is to inform them about the nature of their rights. As people who do not know their rights or understand they have rights are more vulnerable to having them abused and cannot speak up for them selves to complain. (Flowers 1998).

One way of promoting human rights for people with learning disabilities is through advocacy. Which is ‘the representation of service users’ interests in order to improve their situation’ (Thomas and Pierson 1996:11). Advocacy can help can people with learning disabilities be heard by giving a voice to people who would not be able to stand up for themselves. As people with learning disabilities can be ignored if they have difficulty in communicating their views or opinions, leading to them becoming marginalized and socially excluded. If people are powerless at making decisions over what happens in their lives, they can suffer learned helplessness that will impact how they live their lives. Therefore advocacy is a tool than can ensure that people with learning disabilities have a means of gaining the same life opportunities as others in society. The advocate can help the person with learning disabilities achieve equality in society by promoting and helping the person speak up for their human rights.(Thomas, 2003)

However advocacy can have limitations for promoting human rights. Many older people remember being punished if they spoke up for themselves from the past when they were institutionalised and could still scared of speaking up now. Many people also fear services being withdrawn if they try to complain, so might not want to impose. Some people with autistic spectrum disorder do not like interaction and might not talk to an advocate, just to avoid them.

Another way of promoting human rights for people with learning disabilities is to let people take control of their lives by allowing them to make their own choices about how they want to live their lives. As Barber (1996) states that people need to experience feeling in control if they want to achieve a successful outcome in their life. (Thomas, 2003)

A method that allows people with disabilities to achieve equality and lead a fulfilling live is through Personalisation of service provision. ‘Valuing people 2001’ is the Governments strategy for implementing Rights, Independence, Choice and Inclusion through personalisation. By delivering public services in a way that gives people using that service more choice, responsibility and control in relation to the service they receive. Personalisation means thinking about public services and social care in an entirely different way. (SCIE ,2008)

The traditional methods of service provision operated around the individual receiving the service, with health and social care professionals making all the decisions on the type of support the individual received. The traditional model was disempowering to people with learning disabilities as it focused on the persons medical problems, ignoring the qualities of the person as human being. (JFK, 2006)

Personalisation starts with the person rather than the service, reinforcing the idea that the person with learning disabilities knows best. They can be responsible for themselves and make their own decisions about what they require and should be given the information and support to enable them to do so, through direct payments, individual budgets and self directed support. (Stalker and Campbell, 1998)

One of the goals of personalisation is independent living, which means “having choice and control over the assistance and/or equipment needed to go about your daily life having equal access to housing, transport and mobility, health, employment and education and training opportunities” (ODI, 2008)

However there are limitations to personalisation. The philosophy behind personalisation sounds good in theory. However people with learning disabilities have different needs in comparison to other service users such as the elderly or mental health patients. The Government has just used personalisation as a broad term that will fit everyone.

The other problem with personalisation is the time period it takes to implement, in allow everybody to improve his or her life chances through personalisation. As the Government states in the ‘Improving the Life Chances of Disabled People 2005’ that they hoped to achieve pesonalisation for all people in Britain by 2025. (ODI, 2008)

In conclusion people with learning disabilities have historically suffered from social inclusion, discrimination and being marginalised resulting from legislation and policies from the past. However the Human Rights Act 1998 has given people with learning disabilities the right to live as an equal citizen through legislation that entitles them to the right to freedom (Article 8) the right for private and family life (article12) right to protection of property and person (Article 3) and the right to life through healthcare (article 2) Services have come far in enabling people with disabilities to live fulfilling lives. Personalisation has allowed people to make choices and decide which services they would to need to live the life they want. This has given people greater freedom and enabled them to be empowered.

However although everyone is entitled to healthcare in the U.K and it is their right to receive treatment. People with learning disabilities are still being excluded, discriminated and marginalized in this area, with health professional’s breaching human rights of people through lack of knowledge and understanding of learning disabilities and lack of knowledge about legislation.

People with learning disabilities are still being victimized and abused because of their disability leading to vulnerability. The Care Commission has ensured that all cares services are regulated to prevent abuse and ensure human rights are not breached. The Scottish Social Services Council code of conduct allows for human rights, through registering of staff, training and making sure severe case of abuse and misconduct from care staff never happen to people with learning disabilities by gathering formation about offenders to make sure they never work with vulnerable people ever again.

Human rights have come far in enabling people with learning to lead lives as equal citizens giving them dignity, freedom, equality, solidarity, citizen rights and justice. Nevertheless although human rights are the law and must be abided, people with learning disabilities are still having their human rights breached through lack of respect, ignorance and prejudice. Suggesting there is still along way to go before everyone with a learning disability enjoys the life they are entitled to.

This chapter first identifies groups or clusters who would be particularly vulnerable educationally in an emergency. This does not catalogue all vulnerabilities in these groups, but tries to restrict it to existing disadvantage which may be exacerbated by emergency or new vulnerabilities created by disaster. It then looks at ‘educational sites’ which are also vulnerable in themselves, or which might contribute to vulnerability. It draws attention to the intersection of multiple vulnerabilities, but also signals the notion of emergency as an opportunity. The chapter also draws attention to hidden or forgotten emergencies.

3.1.1 Gender-related disadvantage

It would be commonly agreed that girls as a broad category are at greater risk during an emergency, because of traditional gender disadvantage. ‘Normal’ patriarchal cultures are strengthened during emergencies, as people seek comfort in routine relations, roles and hierarchies. If girls are routinely left without access to education, this is unlikely to change. Afghanistan, for example, is traditionally seen as a site of educational difficulties for girls (although in Kabul they currently attend schools and projects freely). The links of gender disadvantage with poverty and economic vulnerability are well documented (Mujahid-Mukhtar, 2008). Cultural barriers often cited are limited roles for girls and women, differential treatment of girls in nutrition and health, men viewed as breadwinners, a male dominated education system, gender-differentiated child-rearing practices, low status of women, lack of knowledge of the social and personal benefits of education, gender stereotyping and threat of sexual violence (UNICEF, 2007).

Specific areas related to emergency in many or all countries which have been highlighted in this study would be:

Early marriage (girls are pushed into marriage because of fragile and insecure situations, increased poverty, death of bread-winning relatives, and therefore they leave school). After war, there are fewer men, so girls are pushed into polygamous marriages (as in Afghanistan), but conversely, therefore, men are forced to accept more than one wife. Older people have not adapted their norms to accept single unattached women, as in other post-conflict locations

Child labour (sons recruited in conflict, the need to work, displacement causing vulnerability to be incorporated into trafficking and sex trade). Domestic labour, normally girls, is often not viewed as ‘child labour’ although this can prevent school attendance.
Boys are more likely to receive kits and educational materials because of ‘normal’ male preference in and out of schools (interview data, Nepal).

Protectionism/lack of independence. In the context of the tsunami, in the Maldives secondary schools do not exist on every island, and parents may be reluctant to send their daughters to neighboring islands for fear of pregnancy and also fear of sexual abuse
Abuse. Sexual abuse, rape, gang rape and physical abuse all get worse in the camps and in situations of emergency with the breakdown of law and order and lack of supervision. Men experiencing loss of status are more likely to engage in domestic violence.

Trafficking for prostitution increases, particularly post-emergency when police or security force protection is withdrawn (interview data, Nepal). During conflict, boys may be recruited or taken for enforced labour. Kidnapping and abduction are a threat as well as trafficking.

Religious taboos and misinformation. Oxfam reported that in some cases in the tsunami the heavy and voluminous clothing worn by Muslim women and the cultural barriers that prevent girls from learning to swim contributed to the death by drowning of many women and girls. The same clothing also restricted some women from running to high places or from climbing trees. Anecdotal evidence suggests that many men survived by doing just this. There are reports from many of the tsunami-affected countries of Muslim women who perished because they were too afraid to leave their home with their head uncovered. Conversely, in some cases the waves were so strong that women were stripped of their clothing and there are reports of naked women refusing to climb into rescue boats manned by males from their villages (Pittaway et al., 2007).
Marginalization of females during humanitarian and reconstruction efforts after the tsunami, with lack of consultation about needs and with response efforts almost exclusively headed by male staff. Refuges and camps often showed little regard for women’s health, safety and privacy.

However, gender-related disadvantage does not always mean girls come off worst: in conflict, boys may be more likely to be recruited as child soldiers, and hence lose schooling; in economic difficulties caused by disaster, they may be taken out of school because they have greater earning power. Conversely, there is evidence from Nepal that females joining insurgent groups (e.g. Maoists) may experience higher status there and participation in decision making, and that in this sense, conflict has increased rather than decreased female status. Much depends on their role, whether combatants, supporters or dependents (Plan, 2008a). While an ex-combatant woman may enjoy a more equal status within a relationship or marriage with another ex-combatant, when an unmarried woman otherwise wants to return to her family or community she is a seen as ‘spoiled’, as she would not have been protected in the same way as non-combatants growing up in traditional or conservative cultures.

3.1.2 Internally Displaced Persons (IDPs) and refugees

While these groups which can be caused by an emergency are clearly vulnerable generally, there is sometimes a difference relative to other groupings in that they are identifiable, and that they receive help. In some countries, those formally identified as IDPs may be the more fortunate ones, as they can claim assistance, including educational support. They are visible in the camps, whereas the ‘lone IDPs’ who are fleeing a personal emergency, or who do not have the political knowledge to claim official IDP status, can suffer problems of discrimination or exclusion in a new community. IDPs may not want to, or be unable to, return to their own communities, and have resettled: at what point do they cease to be IDPs, especially in normally nomadic societies where there is much seasonal migration for work?

Specific issues relating to education and emergency are:

Internal displacement exposes children to forced military recruitment; they may become direct targets in the conflict or be subject to unequal or biased educational service provision (Sri Lanka).

Refugees suddenly become a minority, with loss of status and position; there is lack of choice, including educational choice. Afghan refugees in Pakistan complain that they are given very little choice about where to live – the camps nearer Afghanistan cannot guarantee security, and food or shelter cannot be guaranteed in Peshawar. There are the well-documented issues of language and curriculum of their new schools, as well as problems of ‘return’. Afghan refugees in Pakistan for example are now being sent back, causing a highly uncertain situation for them with all this movement.
There is pressure on remaining schools after an emergency to accept more children, which means larger classes, therefore a decrease in quality and in drop-out for all children. ‘Hosting’ refugees amounts to an education emergency in affected communities, with jealousies and feelings that incomers drain resources or hold ‘our’ children back. Refugees may have services that the surrounding communities lack.
Children and families may move several times before settling in one place where they could stay more than six months. If they go to school, children drop out continuously when they cannot keep up or catch up. Older children may be forced to learn with younger children, to match their perceived learning levels, which cause distress and a lack of self-esteem. Security in the camps is a problem (see above), as is health, for example with cholera in Pakistan.
Relocated communities in the tsunami can suffer: in Sri Lanka, various buffer zones in the coastal areas were established to impose limits on where people could live after the tsunami, but some were far from the sea, and parents tend not to send children to school in these circumstances, as this could show acceptance of the unsatisfactory situation.
Refugee and IDP children may be more subject to abuse and trafficking; children living with ‘host’ families are more likely to be abused.
There can be drug and alcohol problems of parents (and children) in IDP camps.

3.1.3 Minority groups/caste/ethnicity

In all countries there are pre-existing patterns of social stratification based on ethnicity, caste, tribe or clan. These are highly linked to social class and socio-economic status. Emergencies will tend to mean that low status groups are further disadvantaged or discriminated against, as power to attract resources is not evenly distributed. Conflict may be between different ethnic groups, or with a majority group and there is rarely a win–win resolution of the conflict; even if the conflict is not directly related to ethnic or other status, as in natural disasters, the lack of capacity to claim rights and resources post-conflict means more polarization. Areas under conflict may find it more difficult to respond to natural disasters, as has been reported for reconstruction after the tsunami in LTTE-controlled areas of Sri Lanka. Recommendations for action suggest projects focusing on a specific group, e.g. safe play areas for children from a specific ethnic group, or education facilities for a specific religious group (Save the Children, 2008a), although there is a danger of focusing, say, on one caste which may cause attitudes to that group to harden.

3.1.4 Economically disadvantaged

Poverty on its own is not always a predictor of vulnerability, and clearly combines with other axes of disadvantage. Emergencies will highlight these. While homelessness in disasters can affect families in every economic stratum, their social capital becomes crucial, as does the network of relatives and friends who can provide support.

The poor are likely to have poorer quality housing, in poorer or lower lying land (or conversely in steep hills) which does not withstand floods, cyclones or earthquake; therefore they can be displaced or live in the open not near to a school. Animals too are not protected, and subject to loss. Food shortages are made worse by emergency, and may mean migration to urban areas to find work.
Rural children are more likely to be out of school, particularly when poor; natural disasters may mean that distances to the nearest school become even greater.
The rapid recent increase in food prices in Bangladesh and elsewhere has had an impact on school attendance, both because children have become hungry and less attentive and because parents have been less able to meet educational expenses. Parents have also been forced to cut back on the use of kerosene for night lighting thereby reducing the evening study period for students (Raihan, 2008).

3.1.5 The invisible

Children without a formal identity (estimated to be 50 million globally) are never registered and there-fore deprived of access to education. In emergencies, they have no claim to resources or proof of age when relocating. It is more difficult to resist recruitment into insurgent or security forces. Children of different ethnic groups may be deprived of nationality and identity.

Street children may come under the category of invisible, as they are harder to track and monitor, and also may not be in formal school. However, there is a debate as to whether they are particularly vulnerable during emergencies, as they are used to surviving, and have personal and social resources which the newly homeless do not have.
The out-of-school by definition tends to be more invisible. They are more vulnerable during emergencies, since, as in Sri Lanka, most of the educational and emergency provisions utilize schools, and the out-of-school tends to be invisible among service providers. The turning away of children in Afghanistan from orphanages, schools or projects can precipitate them being involved in the sex trade, as dancers or working with truck drivers.

3.1.6 Differently affected

This is a broad category of children who are differentially affected by emergency, or who have pre-existing conditions which may be exacerbated by emergency:

Those with disabilities. Those with physical and mental disabilities are less likely to survive a disaster. Special facilities or education are not always prioritized during emergencies. Schools that refuse to take children with disabilities in ‘normal’ times are even less likely to accept them after an emergency. Children may have been injured by landmines, and all need landmine education.
Traumatized children. Children experiencing conflict and witnessing the violent death of relatives and friends suffer a range of traumatic conditions. Children were scared of going back to schools after the tsunami, and even after four years were reported to be ‘very jumpy’ and emotionally unstable at school.
Orphans, especially where there is lack of social welfare support. Absence of orphanages may be a problem, or conversely orphanages may be a site for abuse or trafficking of children. Agencies such as UNICEF and World Education may be against the institutionalization of children, including orphans, and there can be lack of integration mechanisms and support.
Child-headed households. The child can be of either sex, but additional responsibilities (economic and caring) mean such children are unlikely to go to school.
Child soldiers and ex-combatants. Such children have not just lost schooling, but may be traumatized as well as stigmatized on their return. They may be placed in classes inappropriate to their age.
Drug users (living in badly bombed buildings in Kabul, for example). In the Maldives, there is strong social stigma against drugs and children will be expelled from school if caught with them. There are few rehabilitation centers or organizations to help them.
School failures. Those who were failures before an emergency often use the crisis as an excuse to drop out of school.
War children or ‘lost generation’ need to ‘catch up’ within rigid school systems which make this impossible. They may be jealous of the younger generation whose education was not disrupted, and fear the future.
Children in conflict zones. There may be security checkpoints preventing access to school (also for their teachers) and/or danger of mines.
Children of prisoners (criminal or political). These may suffer low esteem as well as economic hardship.
Children in detention centers and prisons themselves. UNESCO runs a de-institutionalization project in Afghanistan, which also includes children in and from orphanages.
Children of sex workers.
Children of the HIV affected and from homes where there are diseases such as leprosy.

3.2 Educational sites and personnel

Schools were destroyed. Schools (and colleges) can collapse in an earthquake and a hurricane in the worst case with students and teachers are still in them. In most of Nepal, a non- architectural and designing phase the presented seismic safety measures. National Society for Earthquake Technology (NSET) with a modification or restructuring of the school program, but can reach only a few.

But in the actual school vulnerability of particular importance is the contract and the corruption of the materials used to make it easier to make the collapse of natural disasters to the schools. Do not let this corruption in Pakistan and China, is going on the list, and this sustained after a disaster or even. In Bangladesh, which has been identified (interview), “build back on the poor “instead of” build back better.” In China, the authorities have also asked the parents did not cause to complain about the building to ensure the death or injury of their children and financial incentives for them. Poor building standards of experience, but also on their return folded the school itself forms to create an emergency (Harber 2005) anxiety in the child and parents.

Schools as a refuge or a takeover of the internally displaced, disrupting education.

Built schools or on the ground that the social distance is an issue, renovated. If the site is in this sense are people died as a cemetery, still popular. As one respondent said: “The school is a graveyard it.”

Children do not go to school for fear of appearing recruited into armed groups, or to go on the road.

In the Maldives, an island, when the school was destroyed, and it was reported that sometimes reluctant to take on children in other islands of the school, while others welcome.

Child labor and domestic workers in their own home or in someone’s home is difficult to adapt to the standard items or in school. Older children can be destructive, is considered “cute” employees.

Temporary schools (even permanent) can move the missing girls and teachers sanitation special.

To form an important topic in the vulnerability of certain groups, the maintenance management systems and school officials. These are usually male-dominated groups, at least moderately high caste and socio – economic status. You are likely to be, during and after CIES EMERGEN the same group, it may be necessary to change the mindset so that they meet for the child or to seek an appropriate school concept. Now the question is, what incentives could make them to change this mindset. How can teacher’s high caste be persuaded to teach low caste children and interact? How can the person who convinced for the school management committee has been grant equitable distribution? One study examined community-based education system in Nepal, that the use of community based school improvement plan to bring elite processes, the process of creating incentives and equity. Strategy of “education” untouchables girls the opportunity to the majority of the population are less willing to tolerate a direct attack, but would under the heading (Gardner and Subrahmanian, 2005) to agree.

3.3 Multiple vulnerabilities

Although it is possible to a certain group or website, as can be seen above, two important questions are immediately clear: First, within and between the clusters they intersect in various ways, secondly , therefore it is difficult to around the “disadvantaged” or even draw “the most vulnerable” limit. It is commented on how to report in India, even if it is taken out of the equation of sex , the majority of the population is at risk. Caste is said to individual well over 50 % of the population affected , although there are exceptions, generally poor Dalits , disenfranchised , less educated , more abused . The vast majority of the population to be at risk if they are fragile along a parameter, they are more likely to have multiple vulnerabilities . Everyone has a different vulnerability so-called beam ” (Fluke, 2007), from a political, economic, social and ideological complex interactions. Practice of:

The third complex is the time – when they begin and end with emergencies (if they do), for those in danger? Vulnerable orphans temporarily take care of a family, but later at a loss and abandonment and exploitation of resources. Vulnerability often associated with children (Zelizer, 1994), perceived social “value” to work in practice or emergency emotionally as the context “victim”. This can dramatically change the changing social and economic priorities. Schools can a neutral body to maintain and improve the child’s “value” when their environment is sensitive.

Uusitalo 1985 asserted that a commonly discussed point about state welfare is its ability to redistribute wealth. However, there are other commentators who do not agree with this assertion and feel that State Welfare (SW) has failed to redistribute wealth and create equality (Miller, 1994; Clegg, 2010; Osborne 2010; Grice, 2009). SW was instituted to, in a way, give basic human rights such as the right to education, health, social services, housing and social security. It was therefore imperative that all individuals had access to it and were treated equally by the system.

Thane (2010) asserts that although UK is perceived to be an accommodating society, inequity and prejudice has long existed in the country. Legislative Acts such as the Discrimination Act 1995, Equality Act 2010 and the UN Convention on Rights of Persons with Disabilities legally give disabled people civil rights, yet disabled people remain at a disadvantage. Massie (2007) claims that disabled people of working age are still living below the relative poverty level. This is affirmed by disabled activists such as Mike Oliver, Colin Barnes and others (Barnes, 1981; Oliver and Barnes 1991). It is alleged that SW has not only failed to ensure disabled people’s basic human rights but it has also infringed and diminished some of these rights.

This essay will examine the assertion, first by defining what State Welfare (SW) is. Second, it will briefly discuss the theory and history of SW in the United Kingdom and critically examine how SW has enabled disabled people to exercise their rights, especially in recent times, through Independent Living, Direct Payments and Basic Income. Third, it will examine the Human Rights Act 1998 and the UN Convention on Rights of Persons with Disabilities in the light of Human Rights principles. Fourth, it will explore how SW has infringed on the rights of individuals relative to education, housing, employment, health and social security. Last but in no means the least; it will highlight the role of professionals in perpetuating dependency, and discuss the role of the Disabled People’s movement in challenging SW provision and developing alternative policies and services to remove disabling barriers. It will conclude by drawing the arguments together relative to the question.

Definition of Welfare

Academicians, historians and social commentators have all attempted to define State Welfare (SW). Lowe (1993) however, purports that there is no formal definition of the term State Welfare. Wedderburn (1965) defines SW as a government obligation of some level which alters demand and supply to ensure fair income distribution. Lowe (2005) has also defined SW as not just a case of providing an isolated human service but a community where the state embraces accountability for the well-being of everybody. The Cambridge dictionary (2011) has described it as a form of tax collection that allows the state to provide basic human rights such as health, social security etcetera to those who require it.

Briggs (1961) contextualizes SW by arguing that the state uses its’ sovereignty to manipulate demand and supply for labour in three ways. The first is to make sure people receive a basic income regardless of the price of their labour or amount of their assets. The second is to minimise uncertainty by meeting people’s basic needs to alleviate social deprivation and the third is to give people access to good quality services regardless of their social standing. While Marshall (1950) purports that welfare rights and social citizenship are closely connected, rendering SW worthless without welfare rights. Esping-Anderson (1990) also points out that social citizenship is made up of the essential notion of SW.

Theories of State Welfare

State Welfare (SW) does not exist on its’ own, like any other system it is underpinned by various theories. O’Brien and Penna (1998) explain that theories are not intellectual concepts taken out of this world but ideas which give guidance and explains behaviour. SW in United Kingdom (UK) is underpinned by four main theories and they are as follow:

Liberalism

Liberalism takes the view that individuals should support themselves with the state interfering only when they are not able to do so. Gray (1989), a proponent of pluralist liberalism, maintains that there are different kinds of liberals. Firstly, there are those who take individualism to the extreme and rely on themselves alone, with the state intervening only when it comes to their freedom. Secondly, there are those who although are dedicated to their freedom, do not mind communal plans for socio-political progression. Finally, there are those who also see any state interference as evil. Liberals are said to have created the basics of SW (Clegg, 2011).

Marxism

Karl Marx and Friedrich Engels wrote their work during the 19th Century. Marxism concerns itself with materialism. Marx and Engels argued that the antagonism among social classes lead to social change, which finally culminates into capitalism: the common ‘evil’ predominant in today’s socio-economic structures. They see capitalism as ‘evil’ because they hold the opinion that it promotes oppression where the working class are exploited by the ruling class – bourgeoisie (Avineri, 1968 pg 3). The tradition of Marxism does not promote the view of SW as fundamentally the Marxist does not view welfare as the way forward for changing inequalities. (Esping-Anderson, 1998).

Neo-Liberalism

Neo-liberalism is an ideology that sustains an ethical and rational stand for capitalism. It associates itself with economics, social behaviour and social interactions (Thorsen and Lie, 2009). The Neo-liberalists promote the idea of cutting down state debts, reducing state support, changing tax legislation to widen the tax network, getting rid of pegged exchange rates, globalising markets to trade by limiting economic policies that restrict trading among countries, promoting privatisation, private ownership and supporting deregulation. Plant (2010) asserts that Neo-liberalism has produced an open market where the state has ultimate power.

Conservatism

Conservatism is a belief in organisations and traditions that have developed over the years and have shown to be on-going and stable. The term was devised after the 1833 Reform Act by the Tory Party when they changed their name to Conservative Party. The term has origins in Edmund Burke’s 1790 thinking on the French Revolution (Thompson, 2011). The ideology was based on preserving tradition such as the royal family, the church and social classes. Welfare is not paramount on the Conservative agenda as they believe in work, family and patriotism.

History of Welfare

Whelan (2007) states that welfare for the disadvantaged goes a long way back in British history, with individuals and charities such as churches running schools to educate children and charities meeting the housing needs of the working class. The idea behind these benevolent acts was to relieve the social conditions that industrialisation had created (Head, 2009). Poor Laws were one of the first legislations instituted in 1598 to assist the poor and the disabled in the UK by the Elizabethan government (Slack, 1990). The Victorian government continued to uphold these laws, but in the 1900s life became difficult for the working class such that it compelled the liberal government to introduce various reforms from 1906 to 1914.

Some historians’ claim, that state welfare (SW) developed from the 1601 Poor laws (Thane and Whiteside, 2009). Lowe (1993) asserts that the term SW was created in the 1930s, having first been used derogatorily in Germany to describe the Weimar Republic (Lowe, 1993; Gough, 2005). Weimer was a central city southwest of Germany and the first to be associated with SW (Harsch, 1999). In the UK in 1940, during the leadership of Winston Churchill, the conservative government became concerned about the Second World War returnee soldiers and their reliance on the state to earn meaningful living. In view of this, Sir William Beveridge was tasked with examining the already established National insurance schemes. He produced a report which was to establish SW. The key message in his report was the five ‘giant evils’ which were namely: Want (representing poverty); Disease (health), Ignorance (lack of education); Idleness (unemployment) and Squalor (housing) (Timmins, 2001).

The Beveridge report, 1942, brought changes to education that was laudable, such as promoting education for all (Batterson, 1999). This subsequently led to the enactment of The 1944 Education Act which was based on the Education Act 1870 that offered free education to all children in the country. Through the 1944 Education Act, the government intended to give children an equal chance in education by creating three types of schools: secondary modern, grammar and technical schools. Children were select into various school based on the individual ability (Batterson, 1999).

Beveridge’s report was influential and caused the government to start dealing with poverty and instituted constructive measures that resulted in introduction of universal benefits like The 1945 Family Allowance Act (Pleuger, No Date). This act allowed all families in Britain to receive weekly allowances for their children who were under 16 years, regardless of their financial or social status. Subsequently, other systems were introduced such as the National Insurance system that allowed contributing claimants to claim cash benefits from it. The National Assistance Act was next introduced in 1948 and it provided assistance to anybody who needed help or was not covered by other benefits. That same year the National Health Service (NHS) was also introduced and it provided universal health services. Mandated by the 1946 National Health Service Act, NHS operated on the following values: free care, free for all with clinical needs and not based on the ability to pay (BBC, 1998). However, this situation changed in 1951 when NHS started charging for dental treatment and prescriptions.

Beveridge’s report also touched on housing issues. There was shortage of houses after the World War II causing people to live in squalor, but between 1950 and 1955 the government tackled this problem by financing local authorities to build council houses for low income families (Burnett, 1987) The housing shortages compelled the government to take measures to alleviate severity by nationalising utility companies as part of the programme to control living expenses. Thirty years after Beveridge’s ‘From Cradle to Grave’ report, SW became a permanent part of British society. The economy however took a turn for the worse with high inflation and unemployment. People were ever more reliant on SW and there were calls for a change. (Devine, 2006)

Political power changed hands and Margaret Thatcher became Prime Minister in 1979. Mrs Thatcher was of the persuasion that individuals should take care of themselves instead of paying high taxes to support public services like the NHS. Hills (1998), maintains that the Thatcher government emphasised on four things: denationalizing, targeting, disparity and cutting public expenditure. Thatcherism as it was called introduced some far-reaching ideas that produced means testing, selective welfare and privatisation of public services (Glendinning, 1991 ; Hills, 1998). The ‘Right to Buy’ scheme, for instance, encouraged council tenants to buy their homes. All these policies reinforced belief in self-reliance rather than on state ‘hand outs’.

By 1997 Britain wanted a fresh pair of eyes after 18 years under the conservative government. Labour reinvented itself as New Labour with Tony Blair as Prime Minister. He introduced New Labour, announcing the discovery of the Third Way (Walker, 1998). New Labour believed that the route out of poverty was through work and therefore constructed SW on jobs for the ‘able’ and protection for those who were ‘unable’. Hills (1998, pg23) poses the question: ‘is New Labour any different?’ The answer is yes and no as New Labour was seen to have combined conservative ideas of cutting public spending married with a New Labour priority on education. New Labour presented a slightly modified SW as compared to the previous government, the Conservative. They did not however escape criticism, which led to their defeat in 2010.

A Coalition government has been formed and the conservatives and liberal democrats have put their heads together to lead Britain. Their aim is to reduce the state fiscal deficit by cutting public expenditure yet again. The theme for SW reform is making work pay (Turner, 2011). Disability Alliance (2010) has indicated that their organisation is worried about what the coalition reforms mean to disabled people. This is similar to the 1980s, where disabled people faced cuts in welfare benefits, restricted access to work and access to unemployment benefit taken away completely (Glendinning, 1991; Hills, 1998). The Coalition government refers to this change as a move to a ‘big society’ primarily aim to relinquish some of its responsibilities and to give individuals and communities control of services (Sutton, 2011). Reformist Frank Field supports this goal, maintaining that similar arrangements were in place during the 1800s (Sutton, 2011).

Human Rights

The right to health care, education, housing, income maintenance and social services are all fundamental human rights found in state welfare (SW). The United Nations define human rights as an individual constitutional right that should be enjoyed regardless of whom you are and where you are in this world. Each and every one is allowed to have access to these rights without prejudice (United Nations Human Rights, 2011). Amnesty International (2011) define human rights as rudimentary privileges which should be enjoyed by everybody irrespective of whom they are, where they come from, which skin colour they are, and irrespective of their gender, faith, linguistic background or standing. The British Institute of Human Rights (2006) posits that the fundamental human rights are fairness, equality, dignity and respect.

The term human rights was recently coined, but the concept has roots in medieval times. Ishay (2004) asserts that development of the human rights concept has many accounts. Some accounts have said Kings ruled their subjects in such degrading ways because they felt they had the God-given rights to do so. This led people to develop ‘man’ rights to combat the God given rights. Others indicate that the Quran, the Bible and eastern world teachings have all contributed to the development of human rights (Ishay, 2004). Subrahmanyam (2011) also purports that political struggles such as Liberalism, Marxism, Socialism, etc. have all contributed to creation of human rights.

After the genocide committed by Adolf Hitler and his government during World War II, the United Nations General Assembly created the Universal Declaration of Human Rights (UDHR) to prevent that kind of abuse from ever happening again. The UDHR document has become the backbone of many treaties and human rights laws all over the world (Bailey, 2011). Gleeson (2011) asserts that this document was used by the Council of Europe to implement the European Convention on Human Rights (ECHR) in 1953 to safeguard human rights and basic liberties in Europe.

The European Court of Human Rights was also implemented by this convention and anybody who feels their rights have been abused can take their case to this court. Britain joined the convention 1951 even though it was not until 2nd October 2000 before the convention became part of the laws in UK (Jepson, 2004). Another recent treaty is the UN Convention on the Rights of Persons with Disabilities (UNCRPD) which was signed by UK in 2008.

State Welfare enabling Disabled People to exercise their Rights

There have been many policies and laws for disabled people since the establishment of state welfare (SW) in 1945 which have enabled disabled people to exercise their rights. Bracking (1993) states that disabled people’s lives have been transformed since 1939, when disabled people started to speak for themselves. Thornes et al (2000) maintain that there have been four areas of care for disabled people since the establishment of SW. The provision of residential homes, National Health Service (NHS) care, educational services and income maintenance.

There have also been several laws that have assisted disabled people in exercising their rights. The Chronically Sick and Disabled Person’s Act 1970, for instance, was an important law which came to empower disabled people. Through this legislation councils gained authority to provide care, homes and support to people in the community. It also gave disabled people the same rights to leisure and academic services (BBC News, 2010). The Seebohm Report (1968) recommendations also led to the enactment of the Local Authority Act 1970 which gave local authorities the right to set up community care.

The Education Act 1944 recommended that disabled children should school alongside their non-disabled peers (Barnes, 1991). The Warnock Report influenced the 1981 Education Act by recommending that disabled children be educated with their non-disabled peers. The Special Educational Needs Act 2001 gave disabled children, parents and carers the right to be educated in mainstream schools if reasonable adjustment could be made. The Employment Act 1994 made working easier for disabled people even though the quota system did help employers to discriminate against disabled people (Barnes, 1991).

The 1948 National Assistance Act gave assistance and support to people in need and replaced the Poor Law. It also gave local authorities the duty to provide community care services for the sick, disabled, the aged and other people. The 1946 National Health Service provided advice, treatment and care to the nation free of charge (BBC News, 1998). The NHS and Community Care Act 1990 promoted community care which has benefited many disabled people.

The Community Care (Direct Payments) Act 1996, gave local social services the power to make cash payments, but were not effected until 2003, when it became mandatory to offer it to eligible people after assessment. This allows individuals to buy and manage their own care provision. Disabled people also have available to them the Access to Personal Files Act 1987, which gives them the freedom to access any notes or reports about them held by organisations. Access to Health Records 1986, part of the Data Protection Act, gives individuals the right to health records.

The Disability Discrimination Act 1995, which has been replaced in many respects by the Equality Act 2010, safeguards disabled people from being discriminated against in education, employment, access to goods and services, buying and renting. The Equality Duty 2006 demands that public bodies provide services that promote equality. Social security benefits have also become substantial from the humble Industrial Injuries Disablement Benefits and the War Injuries Disabilities Pension to Disability Living Allowance and Carers Allowance which supports extra cost incurred as a result of a person’s impairment. Long term sickness assistance like Income Related Employment and Support Allowance, Severe Disablement Allowance and Attendance Allowance are in place to support disabled people. Further support can be acquired through Working Tax Credit, Income Support, Pension Credit, Housing and Council Tax Benefit (DirectGov, 2011).

Self-directed care schemes like Direct Payments, Personal Budgets and Independent Living schemes also allow disabled people to access opportunities like their non-disabled peers (Barnes and Mercer 2006). Bracking (1993) affirms that Independent Living gives claimants the freedom to live on their own. Furthermore, it allows disabled people to make and be part of decision making processes. Disabled people are able to select and organise services for themselves and not rely on their local authority or other organisations to provide them. The Mobility and Blue Badge Scheme allows disabled people to buy or lease a car and give help with parking. Barnes (2004) purports that independent living can change the value of disabled people’s life.

State Welfare has diminished Rights

British Institute of Human Rights (2006) states that human rights are not simply concerned with legislation but impacts on services provided by the state like residential care, academic institutions, hospitals and support workers in disabled peoples home. Barnes and Oliver (1991) postulate that SW ‘cradle to grave’ promise of safeguarding its participant’s has not worked or else there would not be a demand for a disability discrimination law. The state has therefore not only been unsuccessful in securing disabled people’s fundamental rights, it has impinged and limited some of them. The Socialist (2010) highlights a recent case in which a disabled woman’s UN convention Rights and human rights have been ignored by being asked to wear incontinence pads instead of using a commode at night because of the cost of employing a carer. If the local authority wins this case it will have big implications for disabled people across the nation.

Federation of Disabled People (2011) purports that the Education Secretary, Michael Grove, was recently informed that not dialoguing over the idea of cutting school building schemes resulted in not considering equality concerns. Centre for Studies on Inclusive Education (CSIE) (No Date) propound that inclusive education is part of the international human rights law. Disabled people have been fighting for inclusive education since SW began and the 1944 Education Act was enacted Although it was stipulated in the Act that disabled children should be educated alongside their peers it never materialised. The Warnock Report in 1978 found that one in five children would need special educational support at one point or another during their school life. The report therefore recommended unit are created on school premises to accommodate such needs (Warnock Report, 1978).These recommendations influenced the 1981 Education Act which also asked for children to be ‘statemented’ before being placed in special schools. It furthermore, gave parents the right to appeal against their children special needs assessments. The 1981 Education Act also failed to establish inclusion, integration and accessibility breeching disabled people’s right to access educational institutions at any given time.

Rieser and Mason (1992) indicated that not much had been changed by the 1990s. Disabled children were still being educated with the medical view instead of a curriculum. This led to many completing their schooling without proper qualification (House of Commons, 1999). This breeched their right to obtain official recognition for a course they have completed. The 1993 Education Act tried to give parents more rights to appeal against decisions by the Local Education Authority (LEA) to send their child to special needs school. The Act also extended LEA’s time frames for assessing children with disability and encouraged inclusive education. Part of the subsequent 1996 Education Act identified and modified certain sections in the law allowing parents to choose if their children were to attend main stream schools.

The enactment of the Special Educational Needs and Disability Act 2001 brought disabled children close to inclusion. LEA were now under duty to provide mainstream education for children if that was the wish of their parents but this should not be to the detriment of non-disabled students (Vaughan, No Date). Disability and Equality Duty 2006 gave public services the duty to improve equality in all their services delivery. The most recent Equality Act 2010 also demands that all those providing services like education to provide fair and equal services to people.

The conceptualisation of moving towards an all inclusion option for education for people with disability has made in roads with the introduction of the Education Act (Virvan 1992). Policies and Green papers such as ‘Excellence for All Children: Meeting Special Educational Needs, 1997’ and the advancement of technology have not been able to address significantly the challenges that face disabled people in education. Johnson and Cohen (1984) suggest that challenges in the classroom, communication levels and total social inclusion are still not fully addressed leaving disabled people’s right to effective education breached.

The Office for National Statistics Labour Force Survey 2009 indicates that UK presently has 1.3 million disabled people ready and free to work. 50% of people with disability at employable age are actually employed as equated to 80% of people without disabilities. It is also noted that the type of disability also influences the figures significantly. For example, only 20% per cent of people with mental health difficulties are in work. About 23% have not got any educational credentials in comparison to nine per cent of people without disabilities. Non-disabled people get roughly ?12.30 in equation to ?11.08 that disabled people get (Shaw Trust 2011). These figures evidence the disadvantages disabled people face in employment.

Lindbeck (1996) states that Keynesian idea of full employment and Beveridge universal state welfare (SW) system stem from the same roots. In Britain for instance, the government’s committed to providing employment, universal state welfare and well-being to its citizens but disabled people had less chances of being in work than their non-disabled peers in the 1970’s. These figures improved in the 1980’s because a lot of non-disabled people were out of work. By the 1990’s things had become worse with 21% against 7% of non-disabled people were out of work. Fagin and Little (1984) assertion that people have dignity, sense of belonging and responsibility in working hold true. Most disabled people however, are stuck on state benefits because of unemployment and under employment situations. Where is their right to respect for their private and family life, home and correspondence if they cannot be involved in community life?

Barnes (1992) propounds that reasons given about difficulties that disabled people face in employment is out-dated and no longer acceptable. Although the 1944 Employment Act was designed to give disabled people opportunities in paid work the quota system undermined it. The Disability Discrimination Act and Equality Act 2010 were all designed to combat employer attitude and discrimination but there remain barriers like medical screening, age, education, experience, transportation, appearance and environmental factors that need to be addressed to allow the disabled person to participate actively in employment.

Berry (2010) advocates that the idea of state welfare (SW) was to eradicate divisions amongst people, but seems like the impact of the SW has made these divisions even more noticeable. He further asserts that the property division among property holders and renters is emphatic than ever. Equality Human Rights Commission EQHRC (2011) state that there are certain rights a person has in relation to housing and home ownership. One of them are to have and delight in the possession of property, but clearly owning your own home is something that most disabled people do not have the power to acquire. Derbyshire Coalition of Disabled People (DCODP) (1986) state every person has the authority to dwell in a home in any average place but critics have said this is not possible because there is lack of houses in UK more so accessible homes.

Although the 1970 Chronically Sick and Disabled Person Act requires local authorities to provide the housing needs of disabled people, most councils have sold their properties and have little stock left (BCODP, 1987). Some Local authorities have to work with other organisations to meet the housing needs of disabled people. Accommodation and supported housing are usually few and farther away from town centres, thus isolating disabled people and breaching their right to independent living. Disabled people also usually have to go through a medical assessment to get into social housing. This practice has been slammed by disabled commentators advocating that it is discriminatory (BCODP, 1987). The Housing Act 1988 did not include disabled people in purchasing council flats and houses in the 1980s. Peck (2011) submits that a lot of people with disabilities cannot get assistance to enable them avert being homeless. Those who do get housed sometimes face houses with adaptations that are not up to standard (Heywood, 2001).

State welfare (SW) amongst other things was to provide financial assistance that will relieve poverty and create social protection for all citizens. However, disabled people do not seem to have experienced this relief. Carvel (2005) asserts that three in ten disabled people who are employable are poor and this gap is widening regardless of what the state is doing to combat societal handicap. Smith (2008) advocates that the charity Leonard Cheshire Disability’s recent report reveals three million disabled people in UK in 2008 lived in relative poverty.

Palmer (No Date) states that about a third of people with disability falling between ages 25 and 65 onwards live in poor families, half of Non-disabled peoples figure. Disabled people are poor because they often do not work. Statistics indicated that about 60% of disabled people are not employable in contrast to 15% of non-disabled people (Palmer, No Date). A large percentage of disabled people are willing to work but cannot find employment. Disabled people often do not have the credentials required for working. 75% of people who are of employable age and on benefits are either ill or have a disability.

The 1988 disability survey conducted by the Office of National Statistics confirms this deprivation. The survey recognised that most disabled people rely on social security benefits, but the 1988 benefit reforms did not consider these findings and cut social security spending which in turn affected disabled people. DisabledGo (2010) advocate that Equality Human Rights Commission (EHRC) is apprehensive about the governments Work Capability Assessment test and the impact it is having on Employment Support Allowance claimants. Cooper (2010) asserts that the 2011 housing benefit reforms will make a lot of people homeless. The government’s plan to cut public spending and relieve itself of some its responsibilities will undermine schemes and programmes that support disabled people. This will inevitably corrode disabled peoples right.

The National Health Service posits that disabled people have intolerable challenges accessing their services (Department of Health, 1999) The National Health Service’s core value is to provide health care for all in UK but it is apparent this not the case. Wide spread discrimination has been reported by various organisations and the media. Brindle (2008) and Triggle (2007) submits that an official inquiry has found that NHS discriminates against people with learning difficulties. They further alleges that the main shortcoming of the NHS is the lack of knowledge in learning disability issues. Disability News Service (2009) state a recent report by Every Disabled Child Matters indicates that disabled children are being let down by the NHS despite having the resources to support them.

Aspis (2006) alleges that disabled people’s right to life is in today threatened, as medical staffs are allowed to make life and death decisions about disabled people without making clinical references. He further alleges that scientific experimentations like gene manipulation and pre-natal screening could wipe out disabled people in the not too distant future. F