Dear Lisa,
You said
----Original Message-----
From: SAMPSON Lisa <[log in to unmask]>
To: [log in to unmask]
<[log in to unmask]>
Date: Friday, October 29, 1999 1:19 PM
Subject: RE: A comment
>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.
But at what point does a mental illness become a psychiatric disability?
For instance my son and daughter have a severe immune deficiency that
requires constant medical interventions and this is regarded as an illness
and is treated as such. Their intellectual disability and blindness rightly
falls under the banner of disability and their need for personal support is
as the result of a disability not illness. It is my understanding that
depression is the most common form of mental illness experienced here in
Australia. Is it realistic to suggest that all mental illness be regarded
as a disability or does the disability occur as a result of
prolonged/permanent affects of the illness?
>
>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.
I am sure you are aware that the same social and fiscal constraints are
faced by people with a disability who have fought long and hard against the
"medicalisation of Disability". Queensland enjoys the dubious title of
being the most underfunded State in Australia in regard to the provision of
support for people with a disability.
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.
Human service workers in this State enjoy the benefits of Award conditions
which include workers compensation,superannuation,38 hour week, penalty and
overtime rates, plus SALARY SACRIFICING which was initiated as a means of
offsetting the perceived relatively low wages they were at the time being
paid. However it should be noted that recently a community based
organisation in this State recently advertised for a CEO offering a salary
package of $93,000:00. This included a fully maintained vehicle, employer
contribution to superannuation and a 30% salary sacrifice. The people this
organisation is funded to represent enjoy an annual income of $9260:00, do
not receive employer contribution to superannuation, and rather than salary
sacrifice have sacrificed their salaries in order to become the basis of
governments social policy.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.
I would suggest that it is the way in which government funds "community
organisations" that causes the "blow out" in costs as between 85% - 87% of
funding money goes on infrastructure -premises, computers, phones,cars,
administration, co-ordination etc.
>
>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.
People born with disabilities have been invisible also and government's
disatncing of themselves from direct provision of services has seen more and
more for profit organisations springing up ready to reap in the disability
dollars. The lack of resources available for people with a disability is
also seeing an upsurge in homelessness and inappropriate entry into the
Criminal Justice system particularly prevalent for people with an
intellectual disability.
>
>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 think my responses have identified a number of shared issues and concerns.
The bottom line in what I was trying to get across in my posting is that the
individual should be funded in order to meet their individual needs but in
order to get this message through to government it will require a
collaborative approach that acknowledges each individual as having unique
needs for support not a "my needs are greater than yours" and fighting for
crumbs from the table approach.
I mean, this
>isn't happy families!
It certainly isn't a case of happy families as they are the ones being
exploited and emotionally blackmailed by government into providing the
cheapest form of care in the community. One could even be cynical enough
to say that it is on their backs, through the savings they generate for
government, that the Human Service industry and government bureaucracies
have flourished.
Let's use the politics of dissent to best advantage.
>
>Lisa
How about we use the "pragmatic model" approach through acknowledging that,
unless someone requiring support with the basic necessities of daily living
is supported in their activities, and that they have a roof over their head
and food in their belly, all the theories of social vs medical models are
irrelevant. The " pragmatic model" would look at ways and means of
achieving an individual funding focus for meeting the individual and unique
needs of ALL people with a disability. The poltics of dissent would still
be available as providing support in an individual way does not mean that
individual perspectives and perceptions will be lost. Personally I'd rather
use the Political to further these aims.
Felicity
>
> -----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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