The meaning of social inclusion
Driving home after finishing
the day's work, I noticed
someone familiar walking
down the hill. There was
nothing unusual about a
middle aged man taking a stroll that
glowing summer evening. But he was
wearing an apron and holding a cup of
coffee in his hand that was spilling over
his clothes. Although there were people
around, no one was paying him any
attention. While driving past, I remembered seeing him before in a residential
home for people with learning disabilities. I took the next turn, came back up
the hill, and approached him after
parking the car. Some passers by ignored
him; some changed their way and went to
the other side of the road. Some drivers
slowed down and glanced in surprise, but
resumed their course as if they had
changed their mind. Although people
realised that something was wrong, no
one was willing to intervene.
It was not difficult to persuade the
man to accept a lift, and soon we were
headed towards the residential home,
where the staff had reported his absence
to the police an hour before. I found out
that he had been discharged from the
institution where he had lived for years.
He now lives at a residential home for
people with learning disability. He had
lost touch with his family and had had
no visits from family or friends, as far as
the staff could remember.
Returning home and extremely sad, I
tried to remember what I have heard
about the social inclusion of people with
learning disability. We have been arguing
for changes in attitudes towards people
with learning disability. But has this
changed their daily problems of prejudice
and social exclusion? Although living in
the community has provided an opportunity for social integration, there are many
obstacles in achieving this, especially in
people with severe and profound learning
disability, who lack the language and communication skills to interact with others.
My experience shows that you can live
in a community but still be effectively
excluded from it. Prejudice and negative
attitudes towards people with learning disability can be reduced by personal contact
in ordinary places and sharing activities
together. Culturally sensitive educational
interventions should encourage people to
support the integration of people with
learning disability. Innovative approaches
using the internet and other media should
be explored to strengthen this.
WILLANDDENIMCINTYRE/SPL
Cri de coeur
Recently, a number of pieces of
legislation such as the Valuing People white paper and the Disability Discrimination Act have brought about changes
in planning and delivering services for
people with learning disability, supporting them to enjoy the same rights as
everyone else. But if deinstitutionalisation is not to turn into reinstitutionalisation, we need a nationwide campaign to
make sure that people with learning disabilities are given enough support to
gain their personal rights and identities,
and to be valuable members of our society. As part of the medical community,
we all have central roles in achieving this.
Competing interests: None declared.
Reza Kiani, specialist registrar in learning
disability, Leicester Frith Hospital
Email: Reza.kiani@leicspart.nhs.uk
studentBMJ 2006;14:309-352 September ISSN 0966-6494
