A few weeks, ago I wrote about the simple changes that can be made within healthcare to reduce everyday ableism I also linked this to previous blogs about systemic ableism. Therefore, this blog isn’t going to be anything new, it’s just going to hopefully link everything together. As said before, sometimes noticing ableism isn’t easy, but it is there and hopefully breaking this down into micro, meso and macro levels will make it a little easier to notice and act upon.
Firstly, a reminder here that this will only include a few examples, there are many micro, meso and macro barriers within healthcare.
Micro:
Blog that directly relates: Do You Notice Ableism Around You?
These are the actions of the individuals so much like we said in the last blog in this series… Do you think carefully about the language and terminology you use? Do you ever reflect on your attitudes towards disability? Do you always consider person-centred practice? I know, I know, you’re probably reading this thinking of course I do and you’re probably almost about to click off this very blog, but how often do you reflect on this? It’s so easy to get into habits of just thinking that we know what’s best for an individual or community, especially if we have compassion fatigue and I’m not saying working in healthcare isn’t physically and mentally challenging. Yet, sometimes we need to strip it back to the basics. Are we doing everything we can to be an ally and are we calling out others that are not?
Sorry, for throwing a lot of questions at you there, if you’re new to this work it is daunting, yes. It takes some time to digest but we can’t just do nothing about it either, we must move forward.
Meso:
Blog that directly relates: Can ‘Compromises’ in an Integrated Care System Perpetuate Ableism?
Here is when we look at what’s happening within wider organisations and services we’re not just thinking about you being an individual ally we’re thinking about your service as a whole being an ally. As services, we should be working together through co-production through forums such as primary care networks and we are all important pieces in getting the cog to turn and turn in an anti-ableist way because what one service does affects another. Therefore, services must have an active relationship with one another. I’ve said it before, if your service has anti-ableist training, yet doesn’t use that training to question what other services you’re working with are doing then you’re service is not using the training correctly.
We are all interdependent on one another and this includes services and that’s okay, let’s work together to address these systemic inequalities because systemic inequalities are going to remain the same if they’re not being looked at by the whole system. Yeah, it’s a challenge but it’s a challenge that can be faced as a whole!
Macro:
Blog that directly relates: The Medical Model of Disability and Standardised Assessments
Now, I’d like to write a blog that perhaps has some wider examples as the blog linked could also be seen as a meso example. But, using the Medical Model is yet again about comparing disabled people to societal norms, focusing on impairment and putting them in a box that they were never met to fit in. No one is made to fit in a box! Therefore, we must consider the Social Model of Disability and look at the social, political and economic impact society has on disability. This directly relates to our first point about not sticking to our own agenda because we don’t know every individual’s and communities macro circumstances and history. We must listen to their stories!
Then we must also think about politics and wider policies impacting their circumstances, do they need to be questioned and do we need to advocate for the individuals and communities we work with? All healthcare professionals and occupational therapists in particular should be advocating for those we work with, and I know you know this. But I don’t just mean advocating within the multidisciplinary team I mean advocating for the wider healthcare system and questioning the political restraints.
Do you know the average disabled person faces an extra cost of £975 a month just to get by with charging their wheelchair and medication expenses etc? This isn’t equity, we have a long way to go before we get there! As occupational therapists, we need to consider this and look at what tools we have to do something about this. I’m not saying the responsibility is entirely on the occupational therapy profession and healthcare professionals, but we have a place in making some noise about it!
I hope some of these examples and blogs I’ve already written make the bigger picture a bit clearer. Yes, it’s important to look at what we as individuals can do every day but we must look at this on a bigger scale to move forward and make change.
Can you think of any other ways?
Thank you for reading,
Georgia x
