Lisa,
I agree in the main with your thoughtful reply to Felicity.
However, I am interested to note that you back away from "homogenising"
disability. Doesn't the imposition of the NSW Disability Services
Standards, as the only way to interpret the NSW Disability Services Act,
effectively "homogenise" services for people with a hugely diverse range of
ambitions and needs? I ask you this because I know that you play a
signficiant role in the evaluation of services according to these Standards?
Michael Bleasdale
At 13:19 29/10/99 +1000, you wrote:
>Felicity
>
>I agree with what you say on the subject of intellectual disability, autism
>and acquired brain injury - by all means let's not homogenise all disability
>types and resources needs for people with different needs. Also that a
>psychiatric disability will have a number of very specific impacts on a
>person who has a concomitant intellectual or cognitive disability.
>
>However, before we reify the mental health funding system and set of
>resources in Australia, let's be realistic about the set of resources
>offered by health to people with psychiatric disability/mental illness.
>They are mostly in the realm of health interventions rather than social
>support or living habilitation resources - which is most likely to underpin
>someone's 'success' (and what this means is questionable, I know) in living
>in your local neighbourhood. And when you look at the cost of health
>interventions given comparative salary scales of medical personnel in
>relation to human service worker wage scales, it is no wonder that Health
>are spending lots of money on people with psychiatric illness. The health
>interventions I an referring to are: psychiatrists, psychiatric
>wards/hospitals, community mental health teams that "case" manage people and
>Mobile Assertiveness Treatment Teams (MATTs) which "administer" medication
>to "involuntary patients" in the community. Unfortunately, as these are
>health interventions, these are mostly episodic in nature and continue to
>disenfranchise that section of the population of people with mental illness
>who require ongoing support in their daily living. Not to mention
>inappropriate discharge plans which do not offer even the person with a
>clearly diagnosed 'episodic' mental illness basic social, living and
>community support (even if it is time-limited, as many may prefer) to
>'re-integrate' and pick up the sometimes tenuous strands of their lives.
>
>Furthermore, we should not forget that the 'deinstitutionalisation' of large
>psychiatric hospitals (read: closing down of large psychiatric hospitals)
>led to most of those people entering the scarified world of the
>'private-for-profit' boarding house operators in New South Wales and being
>further marginalised and invisibilised for 15-20 years at least. (Apart
>from the world of psychiatric hospitals where people were characterised as
>either 'mad' or 'bad' anyway). Apart from people who ended up living on the
>street. But this is not to say that closing large psychiatric hospitals is
>not a good thing - it is. But commensurate community support monies need to
>be simultaneously committed. The - soon to be defunct due to conservative
>Federal government destabilisation programs -Human Rights and Equal
>Opportunities Commission (HREOC) report entitled 'Human Rights and Mental
>Illness' ill bears this out, as does the report done by the 'Private for
>Profit' boarding house taskforce - both in the early 90's.
>
>Community resource commitment had not happened until the last few years.
>And...it has been the generic 'disability funding sector' who has promoted
>and implemented funding programs to move these people out of the
>'private-for-profit' boarding houses into which they were shunted as a
>result of the 'deinstitutionalisation' of large psychiatric hospitals.
>
>In terms of getting heads together and resiling from explicit or implicit
>promotion of a 'divide and conquer' attitude - by all means, let us do so.
>I believe "collaboration" is the latest buzz-word. But let's also not lose
>the wonderful energy that can be harnessed by a system not completely geared
>towards the co-option of consent and unquestioning agreement. I mean, this
>isn't happy families! Let's use the politics of dissent to best advantage.
>
>Lisa
>
> -----Original Message-----
>From: Felicity Maddison [ mailto:[log in to unmask]
><mailto:[log in to unmask]> ]
>Sent: Friday, 29 October 1999 9:44
>To: [log in to unmask]
><mailto:[log in to unmask]>
>Subject: A comment
>
>
>
>Good Morning from Australia,
>I have been absent from my computer for some time and have now eventually
>waded through some of the 400 e-mails awaiting my return. I have been
>fascinated and somewhat confused by the interchangeability of terminologies
>and the physical vs other disability debate. Also somewhere in amongst the
>flow intellectual disability particularly seems to have been subsumed under
>the umbrella of cognitive impairment and psychiatric illness. For the sake
>of clarity I believe clear distinctions must be outlined such as people with
>an intellectual disability will require an habilitative approach to the
>learning process of acquiring skills, as will young children within the
>Autistic Spectrum, however those with an Acquired Brain Injury will seek
>rehabilitation with the aim of regaining previously learned skills lost as a
>result of their injury. There also needs to be a clear understanding of the
>boundary where acute episodes of mental illness impact to the degree whereby
>a permanent psychiatric disability manifests itself. Before everyone starts
>screaming foul (or fowl) this is important as regards the Almighty dollars
>available to fund both disability and health. In this country disability has
>very definitely been the poor relation in the funding battle with health the
>major winner. Mental illness and the deinstitutionalisation of people with
>a mental illness is funded through Health Department budgets and is directed
>specifically at people with a mental illness. It should also be noted that
>there are no discretionary categories of mental illness identified and
>funded separately, the funding is based on the individual having a mental
>illness not the "type" of mental illness they display. On the other hand the
>diminished pool of disability funds covers all disability "types" physical,
>intellectual, cognitive,sensory,psychiatric, ABI etc.etc. Each of the
>disability groupings identified have discrete, distinctive and definitive
>needs to accommodate their particular disability "type" and it is on the
>basis of meeting those distinctive needs that competition is set in place in
>order to secure funding in order to meet those specific disability needs.
>The result is a bun fight amongst organisations that represent, or provide
>services, to each discrete group are vying with each other attempting to
>establish their "our people are worthier" supremacy in order to secure
>maximum funding. The only one who benefits from this division is government
>who having implemented the "divide and conquer" process sit back and tell
>the disability sector that they cannot help as the disability sector
>themselves can't agree on what is needed. Thus the reality for many,many
>people with a disability is that they receive little or no assistance to
>meet their most basic of daily needs. I shouldn't have to reinforce to list
>members that people with a disability who are in full employment and
>financially independent are very much in the minority amongst the disability
>community, nor that the ability to debate,articulate and rationalise is
>within the capacity of many other people with a disability. We all bring
>different and individual perspectives, usually based on individual
>experience, to debates but surely the most "Social Model" of disability
>would be to take a leaf from the Mental Health strand and work under the
>umbrella assumption of individuals with a disability -regardless of
>disability type- and put collective heads/ideas together on ways and means
>that individuals with a disability can have their individual needs met.
>Regards
>Felicity
>
>
>
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