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1 Disclosure issues and entering the professions Jill Manthorpe, Nicky Stanley, Jess Harris & Julie Ridley.

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Presentation on theme: "1 Disclosure issues and entering the professions Jill Manthorpe, Nicky Stanley, Jess Harris & Julie Ridley."— Presentation transcript:

1 1 Disclosure issues and entering the professions Jill Manthorpe, Nicky Stanley, Jess Harris & Julie Ridley

2 2 DRC Formal Investigation into Fitness Standards in Nursing, Teaching and Social Work 2006-07 To investigate how health and fitness standards operate for disabled people in the professions of nursing, teaching and social work Elements of investigation: –Analysis of law, and regulatory frameworks –Research into employers & educators decision- making –Written evidence and case studies –Research into disability disclosure (Stanley et al 2007)

3 3 Disclosing Disability Qualitative research into views and experiences 60 students and practitioners Focus on unseen disabilities Sample covered England, Wales & Scotland Limited time-scale

4 4 Study sample Type of interviewee Profession Social Worker NurseTeacherTOTAL Practitioner 10171138 Student 104822 TOTAL 20211960

5 5 Sample by Disability Category CategoryNumber% Long term health problems1728 Multiple impairments1017 Physical mobility impairment1017 Sensory impairment915 Mental health problems712 Dyslexia610 ALL60100

6 6 Fitness Standards Generally low levels of awareness of fitness standards and requirements about disclosure: ….in the handbook this year for the BA Social Work theres a very clear passage on fitness levels and its about mental health and physical health and if youre not deemed not to be fit enough then youre off the course but it doesnt state what constitutes not fit enough. Social Work Student Ive heard it apply to, for instance, dyslexic students, as in they may not be fit to practice because they might write the drug name down incorrectly. Student Nurse

7 7 Perceptions of Regulatory Bodies Perceived as remote and threatening, closed organisation, uncertainty about consequences It was a bit unnerving this disclosing to this great big GSCC when you have never met anyone, and dont know anything about other than all the paraphernalia that you get. You know no one really knows what happens if you disclose something … because it doesnt say on that form, it says that they might want to talk to your GP or whoever, and they might want to talk to you, but why, what do you want to know? … Just to put your own mind at rest. Social Work Student

8 8 Awareness of DDA Yea, yea [Im aware of my rights under the DDA], and its a good job I am, thats all I can say, cos I think Id get walked all over if I didnt. I know what Im entitled to, I know what Im not entitled to as well. I think thats why I got…all of what I did, it was because I knew my rights. Student Teacher It gives me confidence that I can disclose, I can tell them that I know that Ive got legal backing should I need it and Ive got some legal rights that they cant discriminate. They cant turn round and say, youre not fit to practice. Social Work Student

9 9 Terminology – Labels & Language Varied readiness to accept labels Labels facilitated adjustments Term disabled = physical disability Divided on term impairment Most acceptable term was long term health condition Mental health difficulties seen as most stigmatised

10 10 On Labels I dont mind disclosing about my back, I guess for me it doesnt carry the embarrassment factor, I mean anyone can get physically ill but mental illness is a different thing, theres a stigma related to it and its not something that you talk about. Social Work Student The word (disabled) itself suggests that youre incapable, the whole stigma that goes with it says you cant function, you cant do something, its negative in itself. Social Work Student

11 11 Experiences of Disclosure Only three participants had not disclosed Some had only partially disclosed Or had understated disability Positive, negative, mixed stories

12 12 Disclosure - a multi-staged process Its a bit like coming out of the closet, its something youre constantly doing, you dont just disclose it once… because youre going on a placement, when you are on placement you might go and spend a couple of weeks with another institution, so each new place you go to, actually means is that youre disclosing all over again … its not just you fill in a form and youve disclosed it, that just tells the University … and for me it means every client I meet Im making that disclosure to, its on-going, its continuous. Social Work Student

13 13 Disclosure – a high-risk strategy If you dont declare and things go wrong then youre dropped in the shit, and if you do declare it and things go wrong, then you get dropped in the ****. Nurse Practitioner The fact that theyre saying…youve got to give this health questionnaire and you may be refused a place on the fact of your health or your disability, but not giving any guide to what theyre looking for, may prevent people with any sort of disability applying. Social Work Student

14 14 Reasons for Disclosing Moral/political choice Pragmatic reasons – I havent got a choice explicit forms – e.g. Are you dyslexic? Confidence –In organisation –Acquired through experience Believe disclosure will lead to assistance and/or adjustments

15 15 Consequences of Disclosure I did disclose to my personal tutor and I was informed … [that] everybody now had to know about it, the university had to officially know about it and my placement to where I was going had to know about it, and I was really unhappy with that … Ive just been diagnosed … it was very personal to me, Id just found out and I just wasnt ready to disclose. Social Work Student It took three months before I got the equipment that I needed… and I probably moaned and groaned my way through that at that time and so then when I got the chair that was wonderful, it made all the difference. Social Work Practitioner

16 16 Consequences of Non Disclosure Practical – takes longer to do physical things Emotional – I feel like people dont know the real me Missing out on support – may be benefits but I dont feel that I would necessarily get that understanding.

17 17 Experience in Placements Placement agencies less flexible than HEIs Differences reported by students with dyslexia Voluntary sector agencies more accepting Some positive experiences in statutory sector

18 18 Preparation for Placements They knew before I went, it was all there and nothing was done and then three weeks before the end of my placement the link worker decided to make comment about my spelling in reports which caused me a lot of distress. Social Work Student

19 19 Career progression Confidence in disclosure increased with seniority Managers attitudes crucial: The boss that appointed me for this job is very, was very good about my depression, so thats why I took the job in the end but hes moved into a different department, so Im back with a new person and I found that very difficult. Social Work Practitioner

20 20 Promoting Disclosure Value of disabled friendly environments Disclosure processes should be clear & transparent Need to communicate with identified individual Disability awareness training Disseminate positive stories

21 21 Maintaining Standards: Promoting Equality (EHRC 2007) Requirement to disclose health conditions – discriminatory and has negative impact on disabled people Diagnosis of mental illness is not a predictor of unsafe/poor practice Health standards do not protect public.

22 22 Recommendations Government and regulatory bodies to abolish health requirements for the professions Regulation should be concerned with assessing conduct and competence Competency for a profession should not be judged at the outset of professional training Failure to disclose should not be linked to bad character / evoke disciplinary response.

23 23 The Response Initial enthusiasm from unions and some regulatory bodies 2008 – GSCC recommends to government abolition of requirement to declare health condition on registration for social work Health and Social Care Bill will enable the regulatory change to be made without a need for primary legislation Await interest of CEHR

24 24 report Full and summary Maintaining Standards reports available at:

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