A Social Model of Disability and the Restructuring of Ireland's Disability Employment Services through the Service of Supported Employment

Gabriella M. Hanrahan, PHD Student, University of Limerick

Introduction

The language associated with social model theory is widely used by the State and the so-called voluntary sector involved in the delivery of disability services. However, the NDA reported in 2002 that very little research exists in Ireland using a social model framework. This research intends to focus on the restructuring of Ireland's disability employment policies through the service of Supported Employment in order to detect if and how the theory is put into practice.

Aims

  • Broaden our understanding of a social model of disability;
  • Contribute to the development of disability emancipatory research methodology.

Objective

  • Evaluate the services of Supported Employment in terms of producing an analysis that addresses the needs of people with disabilities as described by them.

Methodology

Within a social model framework, the non-disabled researcher is encouraged to immerse himself/herself in the disability movement in order to get a more in-depth understanding of the issues and concerns of people with disabilities. More importantly, it is to prevent non-disabled researchers from misunderstanding, and/or distorting the issues and concerns of people with disabilities. Academics with disabilities argue that decades of inappropriate scientific research and analysis have contributed to the discrimination and oppression experienced by people with disabilities.

As disabled people have increasingly analysed their segregation, inequality and poverty in terms of discrimination and oppression, research has been seen as part of the problem rather than as part of the solution.

(Oliver, 1992:105 cited in Stone and Priestley, 1996)

Immersing oneself in the movement enables the researcher to make connections between the segregation of people with disabilities from mainstream society, their diminished lifestyle, their poverty and the daily undermining of their human dignity owing to acts of discrimination. It teaches the researcher to recognise not only the discriminatory act but also how these experiences are internalised and affect the individuals' expectations. The researcher begins to understand that perpetrators of these acts of discrimination fail for the most part to understand the severe consequences for people with disabilities due to a misunderstanding of the needs of people with disabilities. It becomes apparent that perpetrators believe that the needs of people with disabilities are in someway different to those of non-disabled people. These daily, sometimes subtle, sometimes, blatant acts of discrimination serve not only to reinforce people with disabilities' mistrust of non-disabled people but have taught them to have little expectation that non-disabled people will either understand and/or respect and/or represent them as equal human beings.

People with disabilities who have become politicised about their social positioning through networking and correlating their experiences dream about a better life, and have ideas about how it should be and how it is achievable. A group of people with disabilities have agreed to work with me throughout the research process, while I work with them as a volunteer in organisations that are controlled and managed by them. This way my research benefits from my experience of working alongside people with disabilities and is enhanced because it allows me to see social model theory in practice.

My work with the Independent Living Moving has legitimated my commitment to representing the voice of people with disabilities because members of this group are involved in every aspect of the research, including the literature review, the development of interview questions and the analysis of data.

My voluntary work with other disability groups, such as the disability youth movement in Co. Clare has given me access to a diverse community of people with disabilities and their families outside the control and/or supervision of service providers. Despite the notion that these young disabled citizens are not politicised, they with the support of their families are attempting to create an alternative approach to addressing their social needs. Collectively the disabled community, young adolescences or otherwise are articulating through their actions that as a community all of us have a responsibility to identify difference and deliver services that accommodate diversity. The payback is the contribution people with disabilities have made and will make to the development of Irish society.

Structure of Paper

This paper is divided in three sections. The first section gives a brief history of the United States rehabilitative model of Supported Employment and its impact on service provision. The second section outlines some of the issues raised by academics and activists with disabilities who formulated the social model of disability in an attempt to explain the processes and affect of the oppression of people with disabilities. Finally, the third section focuses on the FAS model of Supported Employment introduced as a market driven initiative in Ireland. My preliminary findings will be discussed in the context of the issues raised in the previous sections.

Supported Employment

The 1960s civil rights movement succeeded in focusing attention on the unequal position that individuals with disabilities occupied in society when compared to non-disabled citizens. The United States disability movement (sometimes referred to as The Independent Living Movement) with the support of some professionals working in the rehabilitative sector successfully initiated the process of de-institutionalisation, which led to some disabled people moving out of institutionalised care into community residential care. This move understood as a process of normalisation, emphasised integration and/or the assimilation of people with disabilities into mainstream society. By the 1980s another shift in thinking (again influenced by the disability movement) in relation to the provision of community services took place. It is argued that the emphasis on assimilation failed to capture the diversity of the lives and needs of people with disabilities and therefore failed to accommodate difference.

Wendell (1989) writing from a disabled woman's feminist perspective argues:

Disabled people are 'other' to non-disabled people and equally able-bodied people are 'other' to disabled people. The penalty for this otherness is not equal when considering the social, economic, and psychological disadvantages disabled people experience. Oppression as a result of being 'other' than able-bodied is maybe the only thing disabled people have in common because struggles with our bodies are extremely diverse.

Wendell, 1989:121

The introduction of individualised support services in the United States during this period was a response by the rehabilitative sector to these discussions. Supported Employment programmes reflect this shift in terms of their design. Providing individualised support though the assignment of job coaches signifies not only the diversity of the needs of any community but also the learning needed to understand these needs. The job coach works with individual service consumers to identify access, maintain and where possible create job opportunities in the open labour market.

The American model of Supported Employment is developed alongside other mainstream programmes designed to support people with disabilities as part of and through the process of de-institutionalisation. Wehman & Kregal (1994) describe Supported Employment as:

An approach that focuses on helping chronically unemployed persons with disabilities gain competitive employment with the necessary long-term supports. It is an effective service delivery strategy that has proven its ability to offer persons with disabilities and also employers and co-workers, the community, work place supports critical to employment success.

(Wehman & Kregal, 1994: 236)

Salyers, Becker, Drake (2004) et al suggest:

It assists people with the most severe disabilities so that they are able to obtain competitive employment directly on the basis of the client's preferences, skills and experiences and provides the level of professional help that the client needs.

(Salyer, Becker, Drake, 2004:55)

The following is the definition of supported employment in the American Rehabilitation Act Amendments of 1992:

  • Involves competitive work in integrated work settings for individuals with the most significant disabilities.
  • Targets individuals for whom competitive employment has not traditionally occurred or has been interrupted or intermittent because of significant disabilities.
  • Makes available ongoing support services at and/or away from the worksite as needed for the supported employee to successfully maintain employment.

(Wehman & Kregal, 1994: 236)

Many governments are coming under increasing pressure to improve service provision for people with disabilities by becoming more accountable for the development and delivery of disability services. The success of Supported Employment Programmes in the United States has attracted interest among many professionals and others responsible for the development and delivery of disability services. However, most of the research describing its success is produced in rehabilitative journals that focus on the individual achievement of the person with a disability and/or the delivery of the service from a rehabilitative perspective.

Such enquiries fail to address questions on the affects of the oppression of people with disabilities due to the ad-hoc nature of service provision in many areas, including education and training, welfare benefit structures, the lack of opportunities for social development, the inaccessibility of the built environment, the lack of job opportunities and cultural attitudes. By directing this research towards the social and political position of people with disabilities, I intend to add this complex array of issues to future discussions on the FAS model of Supported Employment services.

The Social Model of Disability

The 1960s civil rights movement ignited the International Disabled Peoples movement. People with disabilities recognised that their social positioning was strongly correlated with their exclusion from existing, legal, social, cultural, political, economic and structural arrangements in society. In this sense disabled and non-disabled people emerged as two distinct categories of citizens. An analogy between state apartheid and disabled people's citizenship is useful while acknowledging that states legislates against apartheid. However, people with disabilities argue that states have simply ignored rather than legislated against the right of people with disabilities to equal citizenship.

Academics and activists with disabilities in the UK dedicated to challenging their unequal position in society began to put together evidence to support this view. The social model of disability emerged within this dynamic. The aim of a social of disability is to shift our focus away from individuals with disabilities and towards the restrictive structural environments and social, cultural, political economic and attitudinal barriers that prevent people with disabilities from accessing the menus of opportunities available to non-disabled people. Social model theorists and activists describe the oppression of people with disabilities as the experience of social, cultural, political and economic institutionalised discrimination. Consequently, to change attitudes and combat institutionalised discrimination they argue for the involvement of people with disabilities in all aspects of mainstream society, in the design and delivery of services for people with disabilities, and for protection of these services through the establishment of national and international accountable standards and procedures.

The social model of disability is a direct challenge to traditional approaches to disability where the problems associated with people with disabilities such as high unemployment and/or underemployment are described and prescribed for within medical discourse. Consequently, those working within a social model perspective argue that solutions presented within this framework fail to link structural, cultural, economic, social and environmental arrangements of the given society. Finkelstein (1998) argues that the body of knowledge created by a traditional approach to disabled people:

crystallised into institutional menus of good practice expected from medical staff in rehabilitation centres, occupational therapists in social services, remedial teachers in special schools and so on. In all this activity the volume of understanding has increasingly rested on what, until recently, has been an unchallenged dogma; that the possession of an impairment leads to social vulnerability.

(Finkelstein, 1998:1a)

Traditionally, disability is theorised and/or understood on the basis that an individuals' perceived impairment is the principle cause of their social positioning in society. For example, the fact that over 70% of Irish people with disabilities remain unemployed or underemployed despite our economic boom has until quite recently been either, ignored or explained away using language couched in medical discourse.

On the other hand, academics and activists with disabilities link the oppression of people with disabilities to the development of capitalist societies and their exclusion from labour markets. The organisation of society mirrors largely the needs of the labour market and in this sense; it is supportive of the productive individual. Consequently, the exclusion of people with disabilities from the labour market (traditionally understood as an inevitable outcome of their social vulnerability) is now utilized as a means of focusing attention on the contribution society makes to the productive and unproductive individual.

For example, Barnes (1994) writes:

The aims of education for all children and young people include the achievement of responsible personal autonomy and full participation in the communities in which they live. In practice, this usually means employment and a relatively autonomous lifestyle. The type of education that the overwhelming majority of young people with impairments receive does not provide them with the skills and opportunities to achieve either.

(Barnes, 1994:28)

There has been a lot of research and debate in Ireland that has focused on the inequalities in our state education system. Lynch's (1987, 1989, and 1999) extensive work in this area clearly outlines the inadequacies as well as the direct and indirect discrimination produced by this system and its affect on the individuals' future cultural, social economic and political opportunities and future societal arrangements. However, these discussions for the most part do not include any analyses on the impact of the education of people with disabilities.

At the outset, social model theorists understand all societies as disabling societies because they fail to meet the diverse needs of its citizens, thus preventing all of us from developing our human potential to the full. The social model of disability is therefore the starting point for understanding the needs of people with disabilities not as individualised problems, but as a means of addressing the social factors that contribute to lost opportunities. In other words, it draws attention to the additional restrictions imposed on individuals living with impairment. Evidence supporting this analysis particularly though not exclusively from the UK points to poor and inadequate delivery of educational and training opportunities, the inaccessibility of the built environment, inaccessible transport and inaccessible language and information.

Understanding disability from the perspective of people with disabilities creates a critical distance between disability and the impaired individual while preserving the relationship between disability and society. In other words, disability is outside the control of any individual but not outside the control of society. The social model demonstrates that society as a collective has the power to disable citizens and/or equally the power to enable citizens.

Proving this theory is the job of those working within a social model perspective. Our job is to unravel the relationship between disability and society. My work as a social model theorist concentrates on why people with disabilities need a service like Supported Employment to access jobs in the open labour market. My work intends to investigate the difference between the position of people with disabilities in Irish society and those who introduced, develop and/or deliver the service of Supported Employment.

Defining People with Disabilities

Mike Oliver (1990) one of the architects of a social model of disability argued that disability is about people with disabilities, not people with impairments. His definition of people with disabilities contains three elements:

  1. The presence of an impairment;
  2. The experience of externally imposed restrictions;
  3. Self-identification as a disabled person.

He argues that the social model of disability is not an attempt to deal with the personal restrictions of impairment. He understands a social model of impairment as a separate enquiry but that together both models will contribute to the development of disability theory (Oliver, 1999, 37). Goodley, (2001) advocates an analysis of impairment that he suggests will "contribute to recent theoretical demands for building a dialogue between the 'irrational' (impaired) and the 'rational' (non-impaired)". Social model theorists therefore insist that biological assumptions should not direct analysis of people with medically defined bodily limitations; it should be directed towards their social and political position (Oliver, 1990, Barnes, 1991, Mercer, 2000 et al). This is however not to deny the presence of and restrictions of a bodily impairment. The social model is a political tool with which to analyse the social, political, cultural and economic positions of people living with impairments and/or perceived impairments.

Collectivising the disabled experience therefore is about challenging the ontological, epistemological, psychological and sociological assumptions employed to exclude and consequently prevent people with disabilities from participating equally in society. Conjectures emanating from enquiries that do not use a social model framework secure societies' traditional and current social, structural, political economic and cultural arrangements.

My research is therefore about evaluating the service of Supported Employment in terms of producing an analysis that addresses the needs of people with disabilities. The service from this perspective cannot be an extension of the type and delivery of services that people with disabilities have become accustomed to. In other words, people with disabilities cannot be passive recipients of the service but must be active contributors to its development and the development of other services that enable the employability of people with disabilities. Supported Employment provides us with a real opportunity for dialogue between people with disabilities and non-disabled citizens, people with disabilities and service providers and persons with disabilities and policy makers.

Discussion on Preliminary Research Findings

The acceptance of the thesis that disability is a social construct is detectable in the evolution of the United Nations Disability Human Rights Framework as well as the policies and directives now emanating from the EU. Together these policies and directives and indeed the four hundred and eight recommendations made by the 1996 Irish Commission on the Status of People with Disabilities set the stage for the framing of future Irish disability social policy and service provision while questioning the appropriateness of existing service provision. The relevance of past and current professional practices as well as the balance of power between people with disabilities and professionals working in the disability sector and indeed between people with disabilities and non-professional, non-disabled citizens is being challenged.

This following discussion does not address Supported Employment Programmes funded through the Health Services Executive (HSE) although the structures are similar to the FAS programme. Indeed, the Irish Association of Supported Employment represents both models and members of the consortiums engaged in developing the FAS and HSE programmes also deliver training to consumers of both models. FAS insist their programme is a market driven programme so the assumption is the HSE programme is based on the American rehabilitative model outlined above. Further analysis is needed to understand the different aims and the effectiveness of both models from the perspective of it consumers.

Supported employment was introduced in Ireland by the Department of Trade and Enterprise as part of the mainstreaming of disability services and is welcomed by the disability movement. My preliminary findings indicate that the current structure of Supported Employment fails to accommodate dialogue and discussion between people with disabilities and those responsible for its development and delivery. Indeed the development and delivery of the service clearly shows, despite social model rhetoric delivered through State agencies and the so-called "voluntary sector" (who are in the main responsible for the delivery of the service) that there is no provision made in the organisational structure of Supported Employment to correct the balance of power between people with and without disabilities.

Of course, this is not new as one contributor to the research outlines in a discussion on the inclusion of people with disabilities in the process of mainstreaming disability services that began immediately after the publication of the Commission on the Status of People with Disabilities 1996 report:

On top of that then, having regional coordinating committees, groups weren't used to sharing. For some of them they weren't used to sharing with each other, because part of the old competition was because so much of your funding depended on fund raising, charities, and so forth, you had to kind of...you couldn't show all your cards to the other groups within the sector. So we had to build a lot of trust around that, we had to try to develop that.

The other thing as well was, that am... some of the groups found us (disabled people) very hard to come to terms with, and they wondered how we ever got into this and they hadn't realised in a sense that it was their own groups, the people that they were serving through the 'Strategy for Equality' had brought this about. So... that took a little bit of learning.

(Participant 2 own emphasis)

People with disabilities clearly understand the process of mainstreaming services provides an invaluable opportunity for non-disabled people to learn and understand the lost opportunities of both communities due to the institutionalised model of segregation forced upon them. They welcome the service of Supported Employment because it offers people with disabilities choices but in its current structure it offers non-disabled people many more opportunities and choices.

All of the research participants working in and/or developing the service are non-disabled people. Few of these had any prior experience of working with people with disabilities and fewer again had any experience of working as job coaches. FAS in their own words describe Supported Employment as a market driven initiative not a rehabilitative service like the United States model. It is therefore an evolving concept, and as the service grows and develops those working in it and those responsible for it are shaping and influencing its development.

In its current structure the consumers remain passive recipients of the service and are not active participants in its development. Yet the underpinning concept of this service promises people with disabilities accustomed to traditional services that it will be very different from services that had gone before. Social model theorists would suggest a change in structure if it is to meet it's objective of enabling people with disabilities to be productive members of society. In addition, it is important to pose the question: why are people with disabilities not at the table? The following comment gives us some indication of the challenges ahead.

Seriously to change the direction of policy am...giving disabled people and their families real choice and some access to...well what I understand to be mainstream opportunities...you really have to take on thee total dysfunctional organisational structure politically in...I think because of the particular scale of Irish society, it is difficult politically to do that because of the voluntary structures that evolved and operated out of a dysfunctional space and within a complete different economic state that hasn't been acknowledged in current structures.

(Participant 1)

Focusing on the structure of Supported Employment as a starting point for my analysis opens up a whole series of questions about the social, economic and political position of people with disabilities in Ireland. Throughout my fieldwork, evidence to support the thesis that disability is a social construct was constantly presented by job coaches and consumers of the service. Job coaches have an enormous workload as they straddle the divide between the objectives of a market driven initiative and traditional disability services. Nonetheless they are learning about the ability and lives of people with disabilities and some are very clear about the issues that need to be addressed. This group have an enormous contribution to make to the development of disability services aimed at preparing people with disabilities to work in an open labour market. However due to the organisational structure of Supported Employment these employees cannot afford to be too critical of services that supply them with consumers.

Why are people with disabilities the most disadvantaged group in the labour market? They spend longer than the average non-disabled person in training centres. This is turn creates its own economy, particularly in rural communities where training centres for people with disabilities are often the largest employer in the area. Not only does my research direct me towards this issue but it also directs me to investigate the affects of long-term institutionalisation and segregation experienced by people with disabilities and their opportunities for mainstream social development.

Equally, I am directed towards the structure of welfare supports for people with disabilities as they attempt to become non-welfare recipients. The question then arises as to the type of jobs people with disabilities have access to and the opportunities for job progression that will allow them to sustain the non-welfare status. Being employees of Supported Employment for example would suggest good opportunities for job progression and future employment prospects, however they are not present as employees in a service designed to promote their employability.

As I begin the process of extracting the findings and developing an analysis of these findings, some of the reasons for higher than average unemployment and underemployment people with disabilities experience should become clear. The introduction of Supported Employment in Ireland provides a valuable opportunity to ask critical and difficult questions about the effectiveness and the structure of services designed to enable people with disabilities to opt for open labour market employment.

Acknowledgements

Thanks to all those who participated in this research particularly people with disabilities who gave their time freely and members of the disability movement for their constant support and encouragement as well as their insights and analysis. A special thanks and appreciation to Team Leaders and Job Coaches for their warm welcome and support for this research. I would also like to thank the staff at the Department of Sociology and my Supervisor Dr. Orla Mc Donnell, at Limerick University.

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