Nicky StanleyPresentation1

Experiences of Disability Disclosure among Students on Professional Training Programmes: 

Experiences of Disability Disclosure among Students on Professional Training Programmes Nicky Stanley

Professional Regulation v Disability Rights: 

Professional Regulation v Disability Rights Increased regulation fuelled by scandals – Allitt, Shipman Declining public confidence in professions’ ability to self-regulate Regulation acts to exclude some from the professions ‘Fitness to practice’ becomes key criterion HEI staff play role in applying standards

Fitness standards: 

Fitness standards Aim to: protect professional standards protect service users and clients Usually broad and non-specific, much depends on local interpretation of individual case

Variation in fitness standards: 

Variation in fitness standards Wording varies between professions Point at which they are applied varies Variations between different countries

Two studies: 

Two studies DRC Study (2006-07) – 22 students from Nursing, Teaching and Social Work interviewed re disclosure of unseen disabilities PEdDS Study (2003-05) – 50 social work students with unseen disabilities interviewed re placement experiences

Extent of disclosure: 

Extent of disclosure DRC study – Most had disclosed tho’ some only partially disclosed

Fitness Standards: 

Fitness Standards Generally low levels of awareness of fitness standards and requirements about disclosure: ….in the handbook this year for the BA Social Work there’s a very clear passage on fitness levels and it’s about mental health and physical health and if you’re not deemed not to be fit enough then you’re off the course but it doesn’t state what constitutes not fit enough. Social Work Student I’ve 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

Perceptions of Regulatory Bodies: 

Perceptions of Regulatory Bodies With the GSCC it is very difficult because they have foreclosed in their information about what they do with it and...the threat of putting restrictions on your practice. It just seems like a very closed organisation that you don’t know what to expect of your disclosure. Social Work Student It was a bit unnerving this disclosing to this great big GSCC when you have never met anyone, and don’t 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 doesn’t 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

Awareness of DDA: 

Awareness of DDA Yea, yea [I’m aware of my rights under the DDA], and it’s a good job I am, that’s all I can say, ‘cos I think I’d get walked all over if I didn’t. I know what I’m entitled to, I know what I’m not entitled to as well. I think that’s why I got my ….when I was actually in the workplace at the City Council, that’s 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 I’ve got legal backing should I need it and I’ve got some legal rights that they can’t discriminate. They can’t turn round and say, ‘you’re not fit to practice’. Social Work Student

Disability as opening doors: 

Disability as opening doors I ticked the box on the application form around disability because it guaranteed me an interview, it fitted the criteria and I wasn’t sure they would interview me without that (PedDS Study)

Terminology: 

Terminology I would never think of myself as disabled…I would probably use the term impairment because I think people are kind of used to that and…if I wanted them to pay attention to the fact I would use a term like that just because they would listen to that. Student Teacher I really don’t consider myself disabled, so any sort of question that asks ‘have I a disability?’ I always say ‘no’ Social Work Student

Disclosure as a process: 

Disclosure as a process It’s a bit like coming out of the closet, it’s something you’re constantly doing, you don’t just disclose it once… because you’re 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 you’re disclosing all over again … it’s not just you fill in a form and you’ve disclosed it, that just tells the University … and for me it means every client I meet I’m making that disclosure to, it’s on-going, it’s continuous. Social Work Student

Disclosure – a risky strategy: 

Disclosure – a risky strategy I disclosed fully, the reason being that I just think it is a generally good policy to be honest in these things, but it was with a little hesitation, however, because I felt that if I disclose maybe I will be barred from doing a course, which would be quite bad because I really wanted to do the course …so those were the two factors, but the general policy of being honest overtook the other one. Student Teacher I think they are awful. I think they try to tell people you have got to disclose, you are legally obliged to disclose, and then when you do it is like being shot in the face, it is like: ‘oh my goodness right we are going to stop everything’. Student Nurse

Stigma: 

Stigma I don’t mind disclosing about my back, I guess for me it doesn’t carry the embarrassment factor, I mean anyone can get physically ill but mental illness is a different thing, there’s a stigma related to it and it’s not something that you talk about. Social Work Student The word (disabled) itself suggests that you’re incapable, the whole stigma that goes with it says you can’t function, you can’t do something, it’s negative in itself. Social Work Student

Reasons for Disclosure: 

Reasons for Disclosure You get into all sorts of messy situations if you withhold something which is potentially relevant, you find you have negated your contract of employment, so that you have got this cloud hovering around behind you, you may get rumbled at any time. Student Teacher I have told the University because I am having treatment … if I wouldn’t have told the University, like missing every Wednesday from lectures would be a problem … if I had a choice, no, I wouldn’t have informed them, but I haven’t got a choice. Student Nurse

Confidentiality: 

Confidentiality 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 … I’ve just been diagnosed … it was very personal to me, I’d just found out and I just wasn’t ready to disclose. Social Work Student I was told that it was confidential and that for me was a big thing. Social Work Student

Adjustments & accommodations: 

Adjustments & accommodations Actually been quite helpful because it has enabled me to get some computer equipment, that kind of thing. Student Nurse It was up to them to make reasonable adjustments like at the University. Social Work Student

Placements: 

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 But if I tell them that I am going for treatment for post traumatic stress disorder and they see that I am coping well at placement, they will say ‘oh she can cope, although she is going through a hard time she will get through.’ But if they see it the other way round, the placement will not accept me and the university will stop my course. Student Nurse

PEdDS recommendations re placements: 

PEdDS recommendations re placements Need for assessment and adjustments on placement to be flagged up as early as possible Co-ordination between disability support and academic staff Confidentiality policies and whether they extend to placements defined Disclosure promoted

Promoting Disclosure – ‘disabled friendly environments’ : 

Promoting Disclosure – ‘disabled friendly environments’ I had my attitude changed slightly, I went out to work at the University, in their Student Support section on a temporary contract and it was the positive attitude towards supporting students through disabilities there that actually finally convinced me that my own problems weren’t going to be held against me in that way. Student Nurse The University has been really good, I think they have a good system going … they are very high up on having disabled students and disabled teachers working with them. Student Teacher

Promoting Disclosure – clear and transparent processes : 

Promoting Disclosure – clear and transparent processes The fact that they’re saying … you’ve 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 guides to what they’re looking for, may prevent people with any sort of disability applying. Social Work Student

Promoting Disclosure – communicating with the individual : 

Promoting Disclosure – communicating with the individual More emphasis should be on the student and their comfort levels and what they’re comfortable disclosing and you know whether the student feels as though their illness or disability will impact on, on their place as a student or on placement. I think it should be more student led. Social Work Student I think once someone has disclosed to them…you can’t expect everyone to have a knowledge of everything so as soon as someone discloses they should do something to find out something about that condition, and I think that’s where a lot of them go wrong because they don’t know about it, they’re naïve to it. Student Teacher

Promoting Disclosure – disseminating positive stories: 

Promoting Disclosure – disseminating positive stories Having a disability isn’t the end of the world and the Disability Rights Commission can make that positive…it can happen to anyone, you know, it can be anybody from the richest to the poorest person and that was my main point in coming forward for saying that you know even though I do have these health problems, I still am achieving, you know, getting myself into a job. I don’t want to be on Incapacity Benefit for ever. Social Work Student