Karen R. Fisher

Analysing Choice in Australian Individual Funding Disability Policies

The Australian National Disability Insurance Scheme (NDIS) will allocate funding packages to people with disability who are assessed as needing paid support. The NDIS is an example of individual funding, which is currently not the dominant way of organising disability support in Australia. Individual funding aims to increase opportunities for personal choice. We present a framework for understanding current individual funding policies in each Australian jurisdiction according to two policy dimensions that potentially enable greater personal choice for people with disability: who holds their allocated funds and where support can be purchased. The findings show wide disparities in choice across the country, particularly due to constrained funds and the shortage of support to purchase in regional areas. The analysis demonstrates that NDIS implementation will need to consider that, while individual funding can be empowering for some people with disability, enabling choice can be challenging for administrators and service providers

Chinese disability independent living policy

Despite strong statements on disability rights in Chinese legislation since 1990, independent living policy as experienced by disabled people falls short of the social inclusion goals expected from such a policy commitment. Analysis of empirical research about disabled peoples experiences shows that responsibility for independent living rests primarily with disabled people and their families. Only when they have no family does the government provide support, in the form of institutional care. Very little personal assistance or community‐based housing is available. Minimum income support and the introduction of social services are slowly addressing the social exclusion of disabled people in China.

‘I didn’t like just sittin’ around all day’: facilitating social and community participation among people with mental illness and high levels of psychiatric disability

People with mental illness can be profoundly disabled and at risk of social exclusion. Transitional models of supported housing have limited effectiveness in improving community participation. Stable, individualised psychosocial housing support programmes have been found to assist in improving mental health and decreasing hospitalisations, but little is understood about whether or how these programmes facilitate social and community participation. This article argues that, if certain supports are available, supported housing models can assist people with high levels of psychiatric disability to participate meaningfully in the community. To make this case, the article uses findings of a longitudinal evaluation of a supported housing model in Australia: the Housing and Accommodation Support Initiative Stage One (HASI). HASI is a partnership between the New South Wales Government Departments of Health and Housing and non-government organisations. It is a coordinated approach that provides clients with housing and community-based clinical support, as well as support with daily living skills and community participation. An analysis of questionnaire, database, interview and clinical data is used to demonstrate how HASI contributes to increased social and community participation. The article concludes with policy implications for supported housing models that aim to facilitate meaningful community participation for people with mental illness.

Will Policy Makers Hear My Disability Experience? How Participatory Research Contributes to Managing Interest Conflict in Policy Implementation

Financial education is viewed by both policy makers and the public as an increasingly important tool for developing financially capable citizens in an era of increasing individual financial responsibility. This paper considers the recent history of school involvement in teaching financial education. It then draws on research undertaken in summer 2010 at two Birmingham primary schools to explore childrens understandings of key financial issues. The paper concludes that there appears to be a groundswell of momentum behind making financial education a compulsory part of the National Curriculum, but, even if this happens, there will be challenges in delivering such education in practice. For example, the role of values in financial education makes it a contested subject and teachers will need training and support to deal with this. They will also need to be supported to deliver financial education in a way which recognises diversity and sensitivity issues in the classroom.

Access to health and therapy services for families of children with disabilities in China

Abstract Purpose: China has more than five million children with disabilities. According to national statistics, most of them (63%) do not receive the health and therapy services they need, which threatens their lives, wellbeing and opportunities in adult life. Method: The article applies mixed methods (secondary data analysis and case study interviews) to analyse the efforts of families of children with disabilities to obtain health and therapy services to understand why most children do not receive the support they need. Results: The findings are that reasons include poor information, shortage of services and affordability. While these reasons are common across China, the local context, such as resources and social policy implementation, affect the degree to which families obtain the support they need. Conclusions: These circumstances will not change until local communities and government policies at all levels prioritise policy implementation to fulfil the rights of children with disabilities in China. Implications for Rehabilitation Most children with disabilities in China do not receive the health and therapy support they need. Access to support is hampered by poor information, shortage of services and affordability, which are accentuated by local resources and local policy implementation. Central and provincial government resource allocation and local government policy commitment to implementation are critical to children receiving the support they need in their local communities.

How can non-clinical case management complement clinical support for people with chronic mental illness residing in the community?

The recovery of people with chronic mental illness who reside in the community requires integrated support services. Yet evidence of poor collaboration in the mental health system abounds and there is little understanding of how non-clinical case managers can work effectively with clinical services. This article analyses an example from the mental health Housing and Accommodation Support Initiative in Australia. Using interviews (42 consumers, family members and mental health workers) and consumer care plans (20), the article explores how clinical and non-clinical case managers worked together in consumer care planning and examines the perceived influence of support. The research found they worked effectively in care planning when the planning was consumer-driven; there was active participation from consumers, non-clinical and clinical case managers; and when planning was treated as a process, with incremental goals, reflective practice, as well as shared understanding and commitment to the collaboration.

Informal Kinship Care of Orphans in Rural China

This study examines kinship care of orphans throughout China. It finds that in addition to children becoming orphaned if both parents die, some children are treated as orphans when their father dies and rural traditional kinship care obligations restrict the viability of widowed mothers continuing to care for their child. When mothers are forced for socioeconomic reasons to leave the paternal extended family, children effectively become orphans, dependent on ageing grandparents. Girls and disabled children are most at risk. Implementing financial and other support to orphans, widowed mothers and kinship carers could improve the sustainability of these family relationships.

Barriers and Enablers to Accessing Mental Health Services for People With Intellectual Disability: A Scoping Review

ABSTRACT Background: It is well established that people with an intellectual disability have high rates of mental health problems, yet rates of uptake of services do not match need. Aim: To identify the current literature pertaining to the barriers and facilitators to access to mental health services for people with an intellectual disability. Method: A systematic search identified English-language articles that addressed barriers or enablers to access, mental health services, and intellectual disability from 2005 to 2016. Results were synthesized according to Gulliford et al.’s four dimensions of access: availability, utilization, relevance and effectiveness, and equity. Results: Barriers and enablers were identified across all the dimensions. Organizational barriers, lack of services, and poor-quality services related to deficits in knowledge were among the barriers discussed in the literature. Facilitators included emphasis on interagency collaboration, and training and education. Substantial gaps were also identified, particularly in relation to the lived experience of these barriers. Conclusions: Further research and evaluation across all aspects of access to mental health care for people with an intellectual disability is needed.

Participatory and Inclusive Approaches to Disability Program Evaluation

Abstract Some evaluations of disability programs now apply participatory methods to include people with cognitive disability in the collection of data. However, more inclusive approaches that engage people with cognitive disability more fully in the decisions about the evaluation remain rare. We examined why this may be the case, using Weaver and Cousins criteria for inclusive evaluation to measure the depth of inclusion of our methods in an evaluation that we did that included people with cognitive disability. We found that the participatory methods in the design supported some of the dimensions of inclusive evaluation–diversity, depth of participation, power relations, and manageability. Relying on other people to represent the interests of people with cognitive disability in the governance, data collection, and dissemination compromised the control dimension of inclusion. Resources and commitment to build the capacity of people with cognitive disability as team members, mentors, advisers, and direct participants is required to make inclusion feasible and an expectation in disability program evaluations.

Gender, Social Policy and Older Women with Disabilities in Rural China

The gendered experiences of inequality of older people with disabilities1 in rural communities exemplify the effect on families of the rudimentary ageing and disability support systems in China.2 This chapter examines inequality related to disability within a Confucian cultural context from a social policy perspective. It investigates the experiences of older people with disabilities in rural communities by analysing a national dataset about people with disabilities and interviews with older women with disabilities in rural communities.