Social Work and Learning Disability

Introduction

After conducting numerous researches on the subject of mental disabilities over decades of painstaking work, researchers are now of the opinion that the best way to deal with mental health problems is the use of processes that take on a consultative approach (Albrecht, 2006).

The consultative approaches in this case involve stakeholders in the sector, namely health care providers, parents of children with mental illness and the government, to engage with law makers in policy and legislation creation so as to come up with legally binding provisions that safeguard the rights of mentally challenged individuals (Zastrow & Kirst-Ashman, 2010). Positive engagement will result in whatever frameworks that are put into place to be effective in guiding government agencies and private institutions that provide care and education to mentally ill individuals.

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In the UK, it is the social institutions and social workers who work for them that are normally tasked with the challenge of ensuring that government policies and legislation concerning the disabled are implemented (Lang, 2001). This essay looks into the critical role that is played by social workers when it comes to dealing with people with learning disabilities. Another aspect that is examined is the effect of social policies and community engagement policies that are used in the design and implementation of effective social work interventions with learning disability service users. The approach that this paper takes is that of analyzing the critical concepts of risk, need, and care with respect to mental disability as referred to in critical legislations that are in use in Britain such as the Disability Discrimination Act (1995). An analysis approach of these concepts will show the importance of social work in terms of legislation and advocacy to deal social exclusion and discrimination of persons with learning disability.

Disabilities and their challenges in the UK

The UK population faces many challenges of disability, both physical and mental. Among some of the physical disabilities that are pronounced in Britain include paralysis of the entire spinal column due to accidents, paralysis due to medical illnesses such as suffering a stroke or paralysis based on genetic conditions that result in the sufferer being basically unable to walk or do anything else by themselves (WHO Europe, 2008). Mental disability is the other form of disability that is experienced by a large number of British citizens. These mental disabilities arise from either genetic predispositions that occur and manifest during fetal or infant growth like Down’s syndrome, or development that lead to learning disabilities or unchecked mental disorders that when left unchecked or even when diagnosed at a late stage where effective treatment is impossible lead to mental disability and irreversible disorders. Conditions such as schizophrenia, anxiety disorders and depression are known to cause serious mental and medical complications that have been known to cause permanent mental breakdown to patients (Hardy et al, 2011).

What constitutes a learning disability?

Herein is where the greatest challenge lies as there has not been any definitive way of exhaustively defining learning disability. The reason for this is the fact that there exist different approaches in determining whether an individual has a learning disability or not (Gates & Edwards, 2007). Among the various approaches used in determining learning disability are testing for impairment in mental intelligence, commonly know as Intelligence Quotient (IQ) tests, observing for significant impairment in adoptive functions of an individual and looking into the age at which a child starts to develop cognitive functions such as speech during their developmental stage of growth (Hardy et al, 2011).

The use of IQ tests has been the most comprehensive way that has been used to define learning disabilities. Government in its legislation and policy crafting has been using the basis for its measure of mental defectiveness (The Equality Act 2010). The mental defectiveness is usually recognized as “a condition that results from incomplete or arrested development of the brain during the developmental period of a child and before they reach eighteen years, whether arising from inherent causes or induced by disease or injury.” (Gates & Edwards, 2007:6). In terms of IQ, the UK, which has a national average level of 100 +/- 15, considers persons with an IQ level of 55-69 as having intellectual functioning impairment while those having a level of below 55 are considered as being severely impaired in terms of intellectual functioning (Hardy et al, 2011). The use of intellectual functioning as a determinant of IQ capabilities is based on the fact that at a certain age during normal development, individuals are expected to conduct certain functions on their own without the help of others such as personal hygiene and communicating. Therefore, a lack of these abilities indicates learning disability (Stalland, 2009).

The criterion that is used in classifying learning disability or mental inadequacies is directly linked to the kind of help and care that social workers can provide (Albrecht, 2006). In instances where the classification is based on IQ test scores, policy dictates that special educators are the best placed individuals to deploy in such cases so as to provide children with learning disabilities the necessary basic skills and knowledge that can enable them to, at the very least, gain the ability of mastering elementary speech and basic comprehension (Gates & Edwards, 2007).

Patterns of incidents of abuse facing persons with learning disability

All individuals living with disability, be it physical or mental face many challenges in their daily lives. Some of the challenges that face them include discrimination, stigma, lack of equal opportunities in various sectors and social exclusion. Discrimination is the major challenge that faces many individuals, especially those with mental and learning disabilities. Cases have been reported of children in school playgrounds refusing to play with their fellow students whom they consider as being different from them. The case of discrimination is not limited just in the school playgrounds but also adults who have been known to publicly avoid any form of physical contact such as shaking hands with mentally disabled individuals out rightly (Stalland, 2009).

Social exclusion is another very real challenge that people with mental disability are prone to experience. In most cases social exclusion is perpetrated by the parents and care givers of mentally ill children as a protection mechanism (Barnes, 2007). In an effort to protect their children from being discriminated against, parents will avoid taking their children outdoors and instead opt to keep them locked indoors where they can monitor their interaction with other individuals. Apart from these parents who keep their children away, there are those who are brave and choose to let their children out to places like public parks; however, other children in the park end up making fun of them or worse still, completely avoiding any interaction with them.

Most of these social exclusions and discrimination are in the most part due to stigma that is brought about mainly by poor information (Stalland, 2009). True, many efforts have been undertaken by government and other institutions involved in social work to sensitize the society on the needs of mentally challenged individuals. Stigma is the only true challenge facing these individuals that social workers can actively participate in its eradication. This is by encouraging parents not to feel ashamed of their children simply because they are different, but instead encouraging them to actively be involved in their children’s lives so that these children can feel that they have the complete love and care of their parents. Due to these active participations, social workers and indeed learning disability service providers can have more positive effect on individuals with learning disabilities and by extension on public perception, which in time will reduce or completely eradicate the stigma that they are associated with (Rogers & Robinson, 2004).

Learning disability services

Learning disability services are in a nutshell those services that are involved in the direct or indirect care of individuals with learning disability (Evans Montgomery & Hunter, 2010). Such services may include social services such as specialized schools for those with learning disability, to training schools for the social workers who are directly involved in providing care to these individuals. These training schools are significant in that they provide social workers with the necessary training that is required to cater for the very specific needs of people with learning disability (Collins & Wilkie, 2011). Training is mainly undertaken in the form of part time or full time courses, events such as seminars, workshops and conferences or via consultancy services that are offered in order to bring competence to the social workers by constantly keeping them up to date with the latest in strategies and techniques of care giving for these sensitive groups of individuals with learning disability.

Apart from social services, there are also medical services that are availed to persons with learning disability. Such medical services include specialized hospitals that are set up to deal with the inevitable medical complications that these particular groups of individuals are prone to (Heenan & Birrell, 2011). Services also include the establishment of healthcare homes which are aimed at providing both social and medical services to those who suffer from extreme conditions and full time care from family alone is not sufficient to cater for their needs (Kerr et al, 2005). In essence, most of these learning disability services in the UK are mostly aimed at people living at the low end of the socio-economic divide. The reason is because many people in this economic group are faced with high and rampant unemployment levels and research has shown that the majority of persons with learning disabilities belong to this category (Venter et al, 2002).

Indicators that Influence Strategies of Dealing with Learning Disability Risk

In simple terms, risk is the likelihood of a process or event with adverse effects taking place (Lancaster & Lumb, 2006). In the life of a person with learning disability, the occurrence of risk is not an accident but is rather a harsh reality. The simple fact that most of the sufferers are not able to effectively take care of themselves and hence are not independent means that they face inevitable risks of bodily harm and danger anytime that they are left on their own (Venter et al, 2002). What this means is that since persons with learning disability find themselves with inevitable risk of injury, steps should be taken to prevent this from happening to them (Gerrard, Lambe & Hogg, 2010).

According to Gates & Edwards (2007), it is the duty of any social workers that are tasked with the innocuous task of taking care of individuals with learning disability to carry out comprehensive risk assessments that are aimed at identifying the various scenarios and possibilities through which these individuals can come to any form of risk to their physical and mental well being. It is only after the identification of imminent risk factors in a risk assessment exercises that relevant risk management strategies can be developed (Willgoss, 2010).

Need

People suffering from learning disabilities are frequently referred to as special needs patients when in hospital, special needs students when in learning institutions or as special needs persons when in general public places (WHO Europe, 2008). The reason as to why they are referred to as ‘special needs individuals’ is because they normally require above average attention just so they may get through with normal activities in life such as crossing the street for instance. It is this need that sets apart mentally challenged individuals, and hence the need for specialized care that they may require in places likes school just so they may have a normal life as possible (Social Care Institute for Excellence, 2009).

It is this need that truly distinguishes persons, and more specifically children, with learning disabilities from the rest in society. Government has gone a long way in ensuring that there are appropriate policies and legislation in place to safeguard and guarantee their rights. It is therefore the duty of social workers to ensure that these rights are adhered to and enforced to the letter so as to eliminate any form of discrimination that they may face (Topss England, 2002). The importance of social workers with regards to special needs of these individuals cannot be over emphasized especially in their infant stage. It is the kind of approach that is adopted in early childhood that determines future response to any initiative that is eventually taken up in the long run.

Care

The issue of care for persons with learning disability goes hand in hand with the special needs that they have as a result of their high risk factor (Gates & Edwards, 2007). It is no surprise therefore that the British education system in an effort to address these care concerns has set up special schools that teach these pupils at a pace that suits their mental capacities. Establishment of these schools is the best policy as it ensures that by them learning from a tender age, many challenges that they face such as their over dependence on their parents and other care givers are at the very least reduced as they impart on them basic knowledge that will improve their social functioning (Rogers & Robinson, 2004).

Social workers in special care homes are without doubt some of the most involved individuals when it comes to the lives of these individuals (Social Care Institute for Excellence, 2009). Any sort of government policy or legislation has to be met by positive reinforcement from those who are involved in the implementation of said guidelines. Workers in municipal and other local social services have been known to be providing such positive reinforcement by conducting awareness campaigns that have sensitized parents of such children and encouraged them to enroll their kids to special care schools at tender ages (Llewellyn, Agu & Mercer, 2008).

Risk minimizing in learning disability services

Ideally social workers exist in their duties so as to provide sufficient care to persons with learning disability in the various learning disability services, such as special schools and care facilities. This however is not normally the case due to the various unaccountable scenarios that theoretical approaches do not consider (Social Care Institute for Excellence, 2009). Among the most difficult hurdles that social workers face in their efforts of risk minimization is that of the willingness, especially in the case of young children, of parents and guardians to accept their input (Willgoss, 2010). The main reason for this is that these parents fail to recognize that their children have mental inadequacies and instead burry their heads in wishful thinking that the condition is temporary and see that allowing a social worker to examine their child amounts to accepting the permanency of the condition.

The most visible aspect of social work in learning disability services is that of minimizing the risks that these individuals and their families face in their daily existence (Willgoss, 2010). One of the major risk that persons with disability face is that of delayed access to treatment which is normally brought about by confusion of what the position of the law is with regard to consent of care and treatment of these individuals (Mitchell & Glendinning, 2007). Another risk that they face is that of being overlooked in health screening exercises due to their condition. For instance, screening for sexually linked medical conditions may not be extended to them due to a perception that they may not be sexually active. What this does is that it in fact puts these persons at a higher risk of these conditions due to neglect (Hardy et al, 2011).

A very crucial role that is often played by learning disability institutions is that of preventing diagnostic overshadowing. This practice of diagnostic overshadowing is mainly due to medical practitioners often jumping to conclusions and attributing almost every health complication that people with learning disability suffer from to their condition as opposed to other equally logical causes such as ill health (Kurunmaki & Miller, 2004). The risk of these presumptive diagnoses is that in most cases doctors end up using the wrong course of treatment, which usually ends up failing and putting the lives of these persons at even greater risk (Morris, 2011).

Learning disability services also end up providing a very critical service when it comes to the recovery of individuals with learning disability. It is well known that these individuals in some cases use self injury to demonstrate discomfort and hence the reason why surgeons are usually skeptical when it comes to giving invasive procedure that involve complicated recovery and rehabilitation processes (Gerrard, Lambe & Hogg, 2010). The fear is that without proper and qualified care from an expert in social work, these individuals will end up putting themselves at risk by not complying with the process of after care. In addition to putting themselves at risk, materials of health promotion may not be readily accessible to persons with learning disabilities (Rogers & Robinson, 2004). Due to their diminished mental capacities and the consequent paying of too much attention of their normal day to day lives, these individuals and their primary care givers, who in most cases are their parents, may lack the time or capability to access information on health promotion sources and materials. It is therefore up to persons involved in social work to look into it that persons living with learning disability and their families have access to these materials so as to improve their livelihoods and existence (Topss England, 2002).

Social work and the development of social policy

According to Heenan & Birrell (2011), the relationships between social work and community engagement in terms of social policy development has a long intertwined history. The genesis of this association is the existence of a similar and common value base which promotes wholesome communal and societal participation. The main thing about community engagement with the development of social policy though is the conservative nature of social work which tends to out rightly believe that any social policy that is shaped should be in concurrence with traditional values of equality and justice for all (NPIA, 2010). It is this traditional value system that has governed the form of engagement of social workers in the drafting of policies and legislation that aim at squashing all forms of discrimination, stigma and abuse that individuals with learning disabilities face in the society (Seden et al, 2011). Mental illness and learning disability in extension were initially viewed as conditions that could not be treated and managed effectively. However, developments in the pharmaceutical sector in the mid 19th century all the way through to the 20th century ensured that medication in the form of antipsychotics and other drugs used to manage mental conditions ensured these conditions could be taken care of (Abraham, 2008). These developments made social workers to take note of the discrimination that individuals with diminished mental capacities faced. It was now no longer proper to segregate these individuals with the pretext that they did not fit in the society. Further research in the fields of psychology ensured that even those with natural mental conditions could be effectively integrated into society via specialized care institutions. These were some of the reasons that were instrumental in the passage of laws like the Disability Discrimination Act, 1995. In the present, however, the UK continues to face these challenges with an increased number of the populace subject to learning disability, hence the need for more social workers to be involved in shaping legislation (4NI, 2012).

Conclusion

The role of social workers and the various institutions and agencies that they work for in safeguarding and securing the rights of persons with learning disabilities cannot be over emphasized. The fact of the matter is that learning disabilities, just like other forms of disabilities in Britain, continue to face many challenges the most significant being that of discrimination and abuse that these persons with disability experience. In order to minimize these vices, social policies that aim to curb on discrimination and abuse have to be enacted and implemented by government and social workers through the provision of appropriate care to the disabled and conducting sensitizing campaigns that educate the public on ways of living in harmony with the disabled, via the concepts of proper risk assessments and risk management.

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