1. DISABILITY To enable students to develop an understanding of: Stereotyping & labelling in relation to chronic illness/ Disability linked to Neurosciences How to challenge prejudice & discrimination Whether problems due to individual or society Carol Forde-Johnston, Lecturer Practitioner in Neurosciences, Oxford UK

2. What do we understand by the following terms  Impairment  Disability  Handicap

3. IMPAIRMENT  “Any loss or abnormality of psychological, physiological or anatomical structure or function”  (WHO 1999)

4. DISABILITY  “Any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being”  (WHO 1999)

5. HANDICAP  “A disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfilment of a role that is normal (depending on age, sex, social and cultural factors) for that individual  (WHO 1999)

6. ASSOCIATED IMAGES  What sort of images are associated with the following conditions, by lay people? And by health care workers?  EPILEPSY, SPINAL CORD INJURY, AUTISM, BLINDNESS, ARTHRITIS, AIDS, GUILLAIN BARRE SYNDROME, SCHIZOPHRENIA, MS, PARKINSONS DISEASE, HEAD INJURY

7. WHERE DO IMAGES COME FROM?  T.V., Magazines, adverts, films, books, personal contact, experiences, seeing people in the street, charities, colleagues, labelling stereotyping

8. STIGMAS  Split into three groups and read the following extracts  Brainstorm your thoughts and feelings as a group  How do these extracts relate to your future practice

9. PATTERNS OF DISABILITY  At Birth: Spina Bifida, Cystic Fibrosis, Down’s Syndrome  Sudden & Unexpected: Teenage paraplegia, schizophrenia, heart disease, stroke  Slow & Progressive; M.S. Parkinson’s Disease

10. ENACTED STIGMA: Actual Experience  Those with various conditions may lose jobs, be excluded from jobs, shops, friends

11. STIGMA  Felt Stigma: what you expect/ the fear of being stigmatised  E.G. epilepsy & schizophrenia (feeling of shame) M.S. (tremors), AIDS (outcast)

12. DISCREDITED: VISIBLE  Arthritis, M.S., amputee, spinal cord injury, these are observable conditions

13. DISCREDITABLE: NOT VISIBLE  Epilepsy, blindness, M.S., only a small proportion of disabled people are likely to use wheelchairs (image of disabled stickers), 3-7 million only 200,000 in wheelchairs

14. Passing: working at appearing normal  Person with Rheumatoid Arthritis puts up with pain & continues as usual, disguises arthritic symptoms to avoid negative stigmatising  Those who use ‘passing’ have to decide to tell or not, do those with epilepsy tell potential employer, may feel ‘on trial.’

15. MASTERING STIGMA  A PERSON WHO IS BLIND MAY DECIDE TO RUN A MARATHON, AN AMPUTEE MAY DEECIDE TO TAKE UP SPRINTING

16. WHERE DO PROBLEMS OF DISABILITY LIE??  With individuals or society?????????

17. SCULLION (1999)  Explores disturbing evidence that health care professional sometimes discriminate against disabled people in their care  Disability Discrimination Act (1995) reflects the facts that the government & the public are more aware of widespread discrimination against disabled people

18. Views of Disabled People  Many disabled people feel that health care professional hold negative views attitudes towards them which reduces the quality of care they receive. Key factors causing this:  Lack of awareness, lack of appropriate provision, hostile built environment & language

19. Challenging Discrimination  Recognise the barriers: how friendly/ hostile is the environment Use of Access Audit  Identify Good Practice: Royal College of Physicians (1998) publishes good practice guide for disabled people in hospital  Consult individuals themselves