Chapter 63 – Juliane Reinheimer (D5SOP2)
Domain 5 Standard of Proficiency 2
Understand and be able to apply principles of social justice in one’s work including being able to challenge negative discrimination and unjust policies and practices; demonstrate an understanding of cultural competence; and work towards social inclusion.
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KEY TERMS Social justice Negative discrimination Unjust policies Cultural competence Participation
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Social care is … when the social care worker uses passion, empathy, activism and resilience to fight for social justice for the people they support. |
The focus of this proficiency is on understanding and applying a social justice approach to social care practice. Social care workers work in disadvantaged and marginalised communities within society, who include people with disabilities, older people, people from the Traveller community, children, women and young people. For these marginalised groups, achieving social justice will be a continuous, ongoing struggle because they face barriers such as outdated laws and societal attitudes. The realisation of the Assisted Decision Making (Capacity) Act (DoH 2015) in Ireland demonstrates this very well. Arguably, change is slow; however, with awareness and knowledge, social care workers can promote a more socially just experience for the people in our care. This chapter applies the proficiency to social care services for people with intellectual disabilities, but the information presented here is relevant to all social care settings.
Introducing Social Justice
Social justice can be understood through the four principles of access, equality, rights and participation (Adams & Bell 2016), which are explained in the following table.
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Access |
This reflects the hierarchy in society, where some groups have resources, status and privileges that are denied or rationed to others (Adams & Bell 2016: 33). |
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Equality |
As well as being fair to everyone, equality is a ‘commitment to social justice’ which ‘requires a moral and ethical attitude toward equality and possibility, and a belief in the capacity of people to transform their world’ (Adams & Bell 2016: 42). |
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Rights |
Our basic human rights include access to food, safety, a home, a living wage; and in addition ‘civil rights of educational equity, immigration reform, redistribution of wealth, and against different forms of violence, including hate crimes, violence against women, and police brutality against men and women of colour’ (Adams& Bell 2016: 164). |
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Participation |
‘Our vision for social justice is a world in which the distribution of resources is equitable and ecologically sustainable, and all members are physically and psychologically safe and secure, recognized, and treated with respect. We envision a world in which individuals are both self-determining (able to develop their full capacities) and interdependent (capable of interacting democratically with others)’ (Adams & Bell 2016: 26). This statement encapsulates what is means to participate fully in a life of choice and access. |
Social justice is the practice of active empowerment, enabling everybody to exercise their human rights. In broad terms, social justice magnifies and explores the relationship between the individual and society by questioning if this relationship is fair and just. Additionally, social justice acknowledges the fact that external influences can have an impact on our health and wellbeing, access and ability to exercise our rights in society.
TASK 1
Think of one service user group and give examples of how the four principles of access, equality, rights and participation of social justice may be relevantto their lived experience.
The place where a person lives can also contribute to the social injustices they experience, and one example is residential care settings for adults with mental health issues and/or intellectual disabilities. Irish journalist Mary Raftery exposed our past failings in a two-part RTÉ documentary series entitled Behind the Walls (Raftery 2011). This programme highlighted the many abuses that took place in mostly Church-run mental health institutions in Ireland during the 1940s, 1950s and 1960s. Large institutional services were abolished and people with an intellectual disability were moved to smaller congregated settings.
According to Parker and Clements (2012: 24), ‘an institution is not defined merely by its size’ and the fear with all small congregated living community-based spaces is that they can function as ‘mini-institutions’ if residents have no choices or control over their lives (Fox 2013). There are practices currently in place in residential services for people with an intellectual disability to help with the transition from a larger institution to their community-based home. This is part of the New Directions policy and the National Disability Strategy to promote ‘large scale national change’, inspired by the principles of social justice (HSE 2009: 26). However, resources are needed to support organisations to become more community-based with services and buildings that are more open and inclusive, to help service users access community services and facilities. The situation is not perfect and service users may have to live with people not of their choosing, or have their placement changed due to ongoing funding issues or a lack of suitable accommodation. It is professionally challenging to provide hope to service users who have been moved, or who cannot exercise their choice of living companion or accommodation.
TASK 2
Please watch Behind the Walls, Parts One and Two, available on YouTube: https://www.youtube.com/watch?v=9SkBvTUXN2U and https://www.youtube.com/watch?v=WXtdq1yq1HA.
Negative Discrimination
Negative discrimination is experienced when a group or an individual is treated poorly or is oppressed by another person or group. In Irish law there are nine recognised grounds of discrimination: gender, civil status, family status, sexual orientation, religion, age (except if a person is under 16), disability, race and membership of the Traveller community (O’Duffy 2018). It is worth mentioning that discrimination can occur on more than one ground, they can overlap, and this is known as ‘intersectional’ discrimination. This is the case when various characteristics ‘intersect’ and amplify the experience of discrimination. For example, a woman might be discriminated against not only for her gender, but also because she is a member of the Traveller community, because she is a single mother and/or because she has a hearing impairment. O’Duffy (2018: 11) asserts that discrimination can also be direct or indirect. Direct discrimination relates to experiences ‘when a person is treated less favourably because of who they are’ and indirect discrimination occurs when a rule (this could be a policy, for example), which might be seen as fair, puts a person at a disadvantage on any of the above listed grounds, based on its impact or consequence.
Unjust Policies
An unjust policy could be an unfair rule which might be directly or indirectly discriminatory. Public policy affects us all profoundly and pervasively and can influence every aspect of our lives. A public policy is a rule that guides the way services are distributed or interact with individuals. Public policies are usually determined by governments in consultation with stakeholders and have a direct impact on the way services and supports are provided. Each area of social care work is impacted by policy at various levels and to a greater or lesser extent. As social care workers, it is important to be aware of unjust policies. An ‘unjust policy’ could be, for example, a policy in a community house that the residents are not allowed to have friends over, or that people with intellectual disabilities are not allowed to get married or enter sexual relationships. It is important to note that this is a complex issue and although some policies may appear unjust, they may be written with safety in mind. With an awareness of amending unjust policies and reducing risk-averse practices, services are moving towards positive risk management.
TASK 3
Review Inclusion Ireland’s website (https://inclusionireland.ie) and discuss the recent positive developments that reflect a move towards social justice practice.
Cultural Competence
Rhonda Livingstone highlights that cultural competence is based on our motivation and action to create understanding between people, and to be respectful of different cultural perspectives (DEEWR 2010). Relationship building is fundamental to cultural competence. This is based on providing strong foundations of understanding about each other’s expectations and attitudes, values and beliefs. Underlying cultural competence are the principles of trust, respect for diversity, equity, fairness and social justice. ‘Culture is the fundamental building block of identity and the development of a strong cultural identity is essential to an individual’s healthy sense of who they are and where they belong’ (DEEWR 2010: 21).
Social Inclusion through Person-centred Planning
Social inclusion is a universal human right. The aim of inclusion is to embrace all people irrespective of race, gender, disability, medical or other need. It is about giving equal access and opportunities and getting rid of discrimination and intolerance (removal of barriers). It affects all aspects of public life. Social inclusion is visible through the process of individual planning and designing the service to meet the needs of each service user, irrespective of race, gender or disability. In my professional experience, individual planning is now replaced with ‘person-centred planning’. To ensure this does not become a ‘box-ticking exercise’ it is important that adequate time is provided to meet with service users, work with them in a meaningful way and explore their true needs and wishes, along with identifying their support circle. Service users may feel ambivalent towards this process, especially if the experience feels more like an ’assessment’. It is essential to develop a relationship with the service user before engaging in person-centred planning to encourage information sharing that is not perceived as too personal and invasive and is respectful of the individual’s right to privacy and choice. It is also important to be aware of the culture within the service, and the physical environment, to ensure that every service user feels included.
As stated by McConkey and Ryan (2001), staff have significant power and influence when it comes to the lives of people with intellectual disabilities in residential services. It is important to note that this influence occurs both consciously and unconsciously through daily interactions. Organisational policies, the political landscape, domestic jurisprudence, the attitudes, values and beliefs of close family members, societal norms and ethics also play influential roles.
Participation
Participation is a principle of social justice, where service users are given the opportunity to participate in decisions that affect their life. Working as a social care worker with service users day to day, there are many opportunities to support participation. The promotion of meaningful participation of the people we work with is a human right and embedded in international rights law. In some situations, however, participation in social care practice can include the process of making decisions on what is deemed to be in the ‘best interest’ of service users. The Assisted Decision Making (Capacity) Act 2015 outlines that all necessary steps need to be taken to support a person’s participation in the decisions that affect their life. A person is deemed as having capacity, unless ‘he or she is unable – (a) to understand the information relevant to the decision, (b) to retain that information long enough to make a voluntary choice, (c) to use or weigh that information as part of the process of making the decision, or (d) to communicate his or her decision (whether by talking, writing, using sign language, assistive technology, or any other means) or, if the implementation of the decision requires the act of a third party, to communicate by any means with that third party’ (DoH 2015: 17). It is also important to note that just because a person is deemed not to have the capacity to make one decision, it does not mean that they will not have the capacity to make further decisions. According to the 2015 Act, in all cases the person is first deemed to have capacity.
TASK 4
Reflect on past team meetings and think about the different approaches and attitudes that were voiced by fellow team members with regards to supporting service users.
Think about what you read about social justice.
Reflect on the outcomes of the meeting. Were they based on the service users’ will and preference? Was capacity considered for every decision? Why is this discussion crucial in relation to social justice? Have a critical discussion.
Case Study 1
Ronnie is a 32-year-old man who lives in a residential community house with five other people with disabilities. He and his key worker are reviewing the yearly goals of his person- centred plan. Ronnie had in his plan that he wanted to give his room a makeover, and his key worker went out of her way to collect catalogues and measure his room to make sure everything fits. However, Ronnie decided that he would like a red wall with lots of Manchester United posters and he wants to keep everything else the way it is. The key worker is trying to persuade Ronnie to take the opportunity to get all the walls painted and bring in new furniture. Paul is adamant that he only wants the red wall with the posters.
Discuss this case and give a rationale for your opinion.
Social care workers need to be aware of rights, in order to support individuals to participate fully, based on their will and preference, in society. It is a balance between supporting people to live to their full potential, while being respectful to a person’s will and preference. This can be challenging, as sometimes service users do not want to make the decision to act in the way that we deem is in their best interest.
Participation in Practice: Politics and Sexual Relationships
Political participation gives people a chance to develop networks with other people who might experience similar challenges in society. It is the basis of any movement. It empowers disadvantaged groups and creates opportunities to combine skills and talents. Social care workers play an important role here. Often the service user needs the confidence, information, encouragement and an easing of the way to get there. Role modelling, adjusting the environment, travel training, practising speaking in public (for instance at house meetings), are some examples of how social care workers put supports in place for service users to acquire social justice.
Political participation of people with an intellectual disability appears still a challenge to achieve, although this topic has been discussed more in recent years. Political participation is slowly getting more attention within the disability landscape, but there are still many intellectually disabled people, particularly in congregated settings, who are deprived of exercising their right to vote. This demonstrates that social justice is not achieved and we as social care workers can have a significant role to play to change this. Making sure service users are registered to vote is the first step. More and more organisations have good resources to help service users to make an informed choice, for example practising, using made-up ballot papers, how to fill out voting slips correctly; making sure service users do not accidentally spoil their vote. Voting is in many countries interlinked with the condition of legal capacity which recognises people making their own decisions. For example, in Germany, people with intellectual disabilities are not allowed to vote, despite that country’s ratification of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). Therefore Germany is not compliant with Articles 12 or 29 of the UNCRPD. The right to political participation is enshrined in the Convention’s Article 29, ‘Participation in political and public life’.
Participating in a full life includes equal enjoyment of sexual relationships between intellectually disabled people in congregated settings. This is a subject which has been seen as ‘the pink elephant in the room’, evident from the lack of policy and legislation to support people with disabilities. In my practice I have experienced organisations trying to address this issue by developing policies which acknowledge the equal rights, sexual needs and desires of people with an intellectual disability. While people are still living in congregated settings in Ireland, opportunities for privacy can be challenging. When we look at jurisprudence in Ireland one needs to point out the Criminal Law (Sexual Offences) Act (DoJ 2017), with its disability-specific offence approach. Section 21 describes the different situations deemed unlawful when a person has sexual intercourse with a ‘protected person’ or someone who lacks the capacity to give consent to the sexual act. People are deemed to lack capacity if ‘by reason of a mental or intellectual disability or a mental illness, incapable of (a) understanding the nature, or the reasonably foreseeable consequences, of that act, (b) evaluating relevant information for the purposes of deciding whether or not to engage in that act, or (c) communicating his or her consent to that act by speech, sign language or otherwise’ (DOJ 2017: 17-18). It is important for social care workers to be aware of the legislation and to remember the Assisted Decision Making Capacity Act (DoH 2015) which means that all persons are deemed to have capacity first.
Please discuss the following case example in class:
Case Study 2
Anna is 46 and is going out with Patrick (32). Anna and Patrick both use a day service and they have known each other for a long time. The day service used to be a workshop, but it is not any more. Anna and Patrick enjoy holding hands and kissing. They both tell each other that they would like to have sex. Anna lives with her sister and Patrick with his parents. Patrick is not allowed to visit Anna. Anna has been invited to Patrick’s house for dinner twice. But Anna does not go to visit him any more, because her sister does not want Anna to be with Patrick. Anna and Patrick say that they are engaged. Once Anna was out with her key worker and stopped at a jewellery shop because she wanted to have a look at the engagement rings. The jeweller said that she must grow up for that and smiled at the care worker, who answered, ‘She is forty-six’. Anna left but did not really understand why the jeweller said she would have to grow up. Anna and Patrick have been together for the last ten years.
TASK 5
Discuss this case study, keeping in mind the four principles of social justice and the relevant legislations. If you were Anna’s key worker, what would you do to support her to live a full life?
Knowledge about one’s rights, for example an understanding of the UNCRPD, and making this information accessible is vital. There are many organisations (Inclusion Ireland, NDA, Mencap, IDA) who have accessible resources for service users and social care workers to tap into. These documents are available as ‘easy read materials’ and can advise service users, for example, on how, where and to whom to complain if there are violations of any rights. It is worth mentioning that social care workers need to support service users to become self-advocates, so they can step back and give people the chance to develop and use their own voice.
Role of the Social Care Worker
The social care worker plays a vital role in the lives of many marginalised groups. In other words, they become an ‘advocate’ for social justice. The aim is to try to support people to access and participate in a fair and equal way in the day-to-day life in ‘mainstream’ society, just as others can. Social justice underpins a social care worker’s practice on many levels. For example: to have access to health care, to be able to make informed decisions, to discover choices and alternatives, and to try new things out or to support change. The social care worker can also support relationships service users have with partners, families and friends, can enhance a person’s access to education or recreational activities, support people to look after their finances, and be aware of and provide opportunities to integrate cultural diversity within the setting. Social care workers also facilitate the exercise of rights, for example by supporting people to get the right information, to speak up for themselves and to participate in the political landscape, depending on the individual’s wishes. We need to continue to engage with service users to ensure their voice is included in all matters related to social justice.
Tips for Practice Educators
Possible tasks to complete on placement under the guidance and direction of the placement supervisor:
- With service users, visit the local Citizens Advice Bureau, meet the person who is responsible for advising people with disabilities, get a contact number, say hello.
- Network with NGOs – find out what organisations are in your community and organise a visit.
- Encourage service users to become involved in local advocacy groups or community organisations.
- Promote opportunities for service users to meet peers from other services, advocacy groups, for example.
Student social care workers will find it very beneficial to keep up to date with what is going on within the organisation, external organisations, self-advocacy groups, NGOs, government initiatives and university projects. What is on offer? Where could the service users piggyback on existing projects?
Introduce the student to social stories, timetables, travel plans, picture keyrings, memory markers, visual diaries, which are a great support to many.
Look at extra training, e.g., computer skills, phone skills, internet safety, upskilling, QQI courses, appearance, speaking in public, how do I present myself, how do I want to present myself, makeovers, learning how to hold and participate in a meeting, note taking, what information to keep, how to get to decision makers, knowing my TDs, knowing how the government works.
Assist the student in supporting service users to use technology, explore different apps which can help people to write a letter or to take notes, or learn how to use social media and about the dangers involved in using the internet.
Find out what courses are offered in the local colleges. Are they interesting, suitable, inclusive, accessible?
References
Adams, M. and Bell, L. A. (2016) Teaching for Diversity and Social Justice (3rd edn). New York: Routledge.
DEEWR (Department of Education, Employment and Workplace Relations) (2010) The Educator’s Guide to the Early Years Learning Framework. Available at <http://files.acecqa.gov.au/files/National-Quality- Framework-Resources-Kit/educators_guide_to_the_early_years_learning_framework_for_australia.pdf>.
DoH (Department of Health) (2015) Assisted Decision-Making Capacity Act. Dublin: Stationery Office. Available at <http://www.irishstatutebook.ie/eli/2015/act/64/section/3/enacted/en/html#sec3> [accessed 19 January 2020].
DoJ (Department of Justice) (2017) Criminal Law (Sexual Offences) Act. Dublin: Government Stationery Office. Available at <http://www.justice.ie/en/JELR/Pages/Criminal_Law_%28Sexual_Offences%29_ Act_2017>.
Fox, N. (2013) ‘What’s Fair? Realising the Right to Independent Living for People with Intellectual Disabilities: What Ireland Needs to Do’, PhD thesis, NUI Galway. Available at <https://aran.library. nuigalway.ie/bitstream/handle/10379/3784/What%27s%20Fair%3F.pdf?sequence=1&isAllowed=y>.
HSE (Health Service Executive) (2009) New Directions: Report of the National Working Group for the Review of HSE-Funded Adult Day Services. Dublin: HSE.
HSE (2011) Time to Move on from Congregated Settings. Report of the Working Group on Congregated Settings. Dublin: HSE.
McConkey, R. and Ryan, D. (2001) ‘Experiences of staff in dealing with client sexuality in services for teenagers and adults with intellectual disability’, Journal of Intellectual Disability Research 45: 83-7, doi. org/10.1111/j.1365-2788.2001.00285.x.
O’Duffy, A. (2018) A Guide to the Law in Ireland in Relation to Disability. Dublin: Independent Living Movement Ireland. Available at <https://ilmi.ie/wp-content/uploads/2018/12/ILMI-guide-to-the-law-in- relation-to-disability.pdf> [accessed 17 May 2021].
Parker, C.H. and Clements, L. (2012) The European Union and the Right to Community Living: Structural Funds and the European Union’s Obligations under the Convention on the Rights of Persons with Disabilities. London: Open Society Foundations.
Raftery, M. (2011) Behind the Walls, RTÉ Prime Time. Available at <http://www.rte.ie/tv/programmes/ behind_the_walls.html> [accessed 16 August 2017].
