Five Essential Service Accomplishments
Inclusion of people with disabilities is becoming part of the British way of life. Whilst we have some way to go, it is already embedded in our culture to the extent that we are no longer afraid or surprised when we encounter people with intellectual disabilities in day-to-day situations. Recent television coverage of business enterprises run by people with learning disabilities has inspired and enthused the community.
Back in the eighties and nineties, when large institutions were being wound down and people were moving to more ordinary living environments, we used the work of John O’Brien to guide our service designs. O’Brien’s Five Essential Service Accomplishments define the person-centred values that need to be implemented to achieve inclusion. He named these as:
- Community Presence;
- Community Participation;
- Choice;
- Contribution;
- Valued Roles.
I have always maintained that of the five, the first two needed to be in place to achieve the next three. Unless we changed society’s way of viewing people with disability by integration, we would never be able to afford them the right to choose, to be involved or to be valued.
Not Universal
I just got back from a two week trip to Russia, which took me to Moscow, St Petersburg and Volgograd. This enabled me to view life in three very different cities with an opportunity to see how much this enormous country has changed and become more westernized. I was intrigued at the pace of that change; how European it seemed in so many ways.
In walking the miles of streets of these cities, observing not just the standard tourist sites but the day to day activities of ordinary people, it took me a few days to realise something was in fact very different in all this sameness. At no point had I encountered, seen or heard anyone with intellectual disability. Not once. Not anywhere. At the point of realisation, I made it my business to keep a look out over the remaining days of my trip. On the last day in St Petersburg, I finally saw a young woman with Down Syndrome, riding a tandem bike with her father among other members of her family. I was disappointed however to hear them speaking German – fellow tourists, it seemed.
The Past, Present and Future
In Soviet times, and still today, it appears to have been easier and cheaper to put disabled children into care. In April 2015, the Human Rights Watch submission to the Committee on the Rights of Persons with Disabilities revealed that in Russia, approximately 30 percent of children with disabilities still live separately from their families in closed state institutions. Despite the fact that Russian law guarantees equal access to education for all students, disabled children are placed in orphanages by their parents when state doctors pressure them to do so.
If exclusion and institutionalisation starts in childhood, there is no hope of integrating people as adults. Russia is still a country with strong state support for health and employment, but that support relies on citizens being able to contribute. Over the entire country, acceptance of people with disability is slow to improve; facilities are woeful, access is limited and attitudes are entrenched.
There are slow improvements; charities such as Downside Up are increasing awareness of disability right issues, and facilities to assist people with disabilities are gradually being introduced. But Russia has a long way to go before it rivals European neighbours in recognizing and valuing all citizens, irrespective of ability.
