Making space for the 'intellectual' in geographies of disability

Unpacking the cultural paradox of attentive care for institutionalized people with intellectual disabilities

This study contributes to the under-researched area of culture in institutional care for people with intellectual disabilities in an East Asian context. Drawing upon in-depth interviews with 20 women frontline care workers for institutionalized people with intellectual disabilities in Taiwan, we examined culture-specific caring relations such as the fictive kinships of Confucian care ethics (i.e., respect for elders and affection for the young), the charity paradigm, and religious compassion, which can induce attentive and respectful care in institutional spaces but also relegate residents to stigmatized subordination in a hierarchy of caring relations and legitimatize the voluntary exploitation of women workers. In situating the relational nature of care and the dis-enabling potentials of culture at the disability-care-place intersection, we promote an ethics of engagement that values and dignifies both recipients and providers of care.

Austerity Britain, poverty management and the missing geographies of mental health

This paper presents the lived experiences of individuals with mental illness as they navigate the benefits landscape in an age of welfare reform in the UK. We focus on the impacts upon their well-being and daily geographies. We articulate the relationship between welfare reform and mental health using the concept of poverty management and its 'missing geographies', in which everyday well-being and routines are dismissed by the restructuring welfare system. We liken this dismissal to a shift towards a narrower and more unforgiving mode of poverty management, where even the smallest misstep can unravel the entire edifice of everyday survival and well-being.

Ageing with a learning disability: Care and support in the context of austerity

Recent work in geography has begun to look at the opportunities for care from siblings, friends and neighbours alongside parents and spouses. This paper examines the daily relationships that middle to older age adults with a learning disability have with remaining kin members, friends, and neighbours, within the context of declining formal day services. Adults with learning disabilities are more likely to have different life course experiences and be living on low incomes and in poor housing than the rest of the population as they have had less opportunity to work and save money through their lives. We draw on two qualitative studies with adults with learning disabilities. Findings suggest that friend and kin networks are anything but certain, as opportunities to meet and socialise shrink, and connections with siblings do not necessarily lend themselves to support. The findings raise the possibility of a space of attenuated care to convey the increasingly limited fronts from which support can be derived.

Equity in social care for people with intellectual disabilities? A cross-sectional study examining the distribution of social care funding across local authorities in England

Many people with intellectual disabilities rely on social care provision, though little research has looked at how access to such provision is distributed nationally. Evidence from children's services suggests that there are large discrepancies between local authorities (LAs) in terms of the resources expended on interventions with children and families, which can be explained by variations linked to geographical location, namely the level of socioeconomic deprivation between LAs, constituting 'child welfare inequalities'. This study explored relationships between resources allocated to community services for people with intellectual disabilities in England and geographical factors, including deprivation, rurality and political leadership in the LAs where these individuals reside. Data were sourced from publicly available reports of spending of 151 English councils with adult social services responsibilities (CASSRs) for 2013-2014 and from CASSR index of multiple deprivation (IMD) scores and rurality for the same period. We found that more deprived LAs supported more people with intellectual disabilities, per 100,000 of population. We did not find effects for rurality or political party. However, it was not the case that more deprived LAs allocated more funds for expenditure on this group. These findings point to inequities in the distribution of social care resources for people with intellectual disabilities in England, as although more deprived LAs support more people with intellectual disabilities, they do not spend proportionally larger sums of money on this group. We discuss possible explanations for these findings and highlight the need for more research, particularly investigations about allocation of resources within LAs and more detailed explorations of how structural factors such as socioeconomic status of service users effects service access at the local level.

A place for the heart: A journey in the post-asylum landscape. Metaphors and materiality

The downsizing of psychiatric hospitals has created a new institutional landscape in the local community to support people with severe mental problems in their daily living. This study explores meeting places in Norway from the users' perspectives. The users used four metaphors to describe these meeting places: "like a home", "like a family", "like a landing ground" and "like a trampoline". The users have decorated the interiors of the meeting places with hearts made from various materials, and these could be considered as symbols of the places. The metaphors used: the hearts and the rooms and interiors, reflect old ideas about calmness and dignity rather than new ideas based on New Public Management.

Caring for independent lives: geographies of caring for young adults with intellectual disabilities

This paper engages with the emerging disciplinary clash between 'care' and 'independence' within disability studies by examining the geography of home care for young adults with intellectual disabilities. The care system as a whole is viewed as central to disablist structures within disability studies (see Thomas, C. (2007). Sociologies of disability and illness: Contested ideas in disability studies and medical sociology. Hampshire: Palgrave Macmillan.). However, despite the theorisation of dependency as being in antipathy to the goals of the disability movement, caregiving at home still continues to dominate community care. The paper attempts to address how family carers are 'caught-in-the-middle' between their 'duty' to care and at the same time, perpetuating dependency; the reality being that parents have to deal with issues of being overprotective and confronting various social assumptions about disability. It examines the narratives from 25 family caregivers in Ireland who provide personal assistance to young adults with intellectual disabilities.

The geography of mental health: an established field?

PURPOSE OF REVIEW

The purpose of this review is to offer an outline introduction to a field of inquiry known as the geography of mental health (or mental health geographies). Since this is the first time the field has been reviewed in this journal, attention will be paid to the history of the field, not just recent findings.

RECENT FINDINGS

Research has chiefly, but not exclusively, tackled (i) the spatial epidemiology of mental ill-health and (ii) the changing locational associations of mental health care.

SUMMARY

This review has concentrated chiefly on contributions to this field of inquiry made by researchers with a background in the academic discipline of geography. While there are 'geographical' contributions made by workers from other disciplinary backgrounds, there is arguably something distinctive, particularly in the most recent scholarship, arising from a theorized sensitivity to the entangled relations of mental health, society, space and environment.

Off the map: a critical geography of intellectual disabilities

A "critical geography of intellectual disabilities" is outlined. Drawing on personal experience and borrowing poetic inspiration, claims about the end of the institutional era for intellectual disabled people are disputed, and the continuing eugenic legacy, complete with its multiple stigmatizing effects, is emphasized. The extent of the social exclusion experienced by many people with intellectual disabilities in the wider community, linked to various poor quality of life indicators, is also given attention. Finally, speculations are raised about how to move beyond the "asylum" and the "ghetto", empowering intellectually disabled people in the process.

The entangled geographies of social exclusion/inclusion for people with learning disabilities

People with learning disabilities (PWLD) are one of the most marginalised groups in Western society. Social policies attempting to redress this situation focus on their 'reinclusion' into mainstream socio-spaces through engagement in 'normal' activities, primarily paid employment and independent living. Drawing on group interviews in Scotland, the paper develops a nuanced account of the lives of PWLD, exploring their experiences of exclusion and seeming 'inclusion', and also the alternative spaces and networks of inclusion developed by many PWLD. The paper argues that the situations and experiences of exclusion/inclusion are complex and 'entangled', shaped by the socio-spatial contexts within which PWLD live. The paper 'reimagines' social inclusion as a transformation of mainstream social spaces to incorporate PWLD, achieved through self-advocacy.

The place of people with intellectual disabilities in Bandung, Indonesia

This report is an attempt to 'make visible' people with intellectual disabilities in Bandung, Indonesia, who have been rendered invisible due the stigmatization of disabled bodies in Indonesian society. The Western concept of deinstitutionalization is not appropriate to the contemporary culture of Indonesia. Returning to the 'special schools' following completion of secondary education resolves some of the problems of social exclusion, while reinforcing other exclusionary aspects of Indonesian society. Institutionalization is seen as a privilege in the Indonesian context, as only the better off can afford the cost of placing people with intellectual disabilities in institutions.

Introduction to theme section on geographies of intellectual disability: ‘outside the participatory mainstream’?

This paper introduces the following theme section on Geographies of Intellectual Disability. It outlines the historiography of geographical work on intellectual disability, noting in particular the contributions of Wolpert (Transactions of the Institute of British Geographers 5 (1980) 391) and Hall and Kearns (Health and Place 7 (2001) 237), before tracing claims made about both the 'institutional' and 'deinstitutional' eras in the changing geographies confronting and experienced by intellectually disabled people. This account, highlighting the tendency for such people to remain 'outside the participatory mainstream' in almost all circumstances, offers along the way an introduction to the four contributions that follow.

Places of social poverty and service dependency of people with intellectual disabilities: a case study in Baltimore, Maryland

In the United States, post-asylum geographies of people with intellectual disabilities implicate the condition of service dependency in their social impoverishment, here defined as "isolation from the community and lack of real friendships and relationships" (The importance of income. The Self-Determination National Program Office of the Institute on Disability, University of New Hampshire, Concord, 1998, p. 2). Social historical geographies of people with intellectual disabilities, both general and local to Baltimore, Maryland, contextualize how one voluntary service organization re/created service dependency and social poverty of people with intellectual disabilities through residential location decisions.

(Dis)abling children in primary school micro-spaces: geographies of inclusion and exclusion

The geography of disabled children's schooling in the United Kingdom (UK) is changing, and this is underpinned by a growing international consensus that disabled children should be educated within mainstream school settings (UNESCO, The Salamanca statement and framework for action on special educational needs. World Conference on Special Needs Equality and Quality, Salamanca, Spain, 1994). As a result, new geographies of desegregation in disabled children's education are emerging, with disabled children being increasingly educated within mainstream rather than 'special' schools. This paper explores this issue, focusing on the (re)production of discourses of 'inclusion' and 'disability' in two mainstream primary schools in England. Empirical findings demonstrate that school actors reproduce meanings of inclusion and disability in different ways within and between school settings. It is shown that discourses of inclusion are frequently based on educational-medical models of disability, and can serve to exclude some children from mainstream schools. With this in mind, the paper highlights the value of a spatially sensitive evaluation of inclusion, that emphasises the importance of schools as unique moments in space and time to everyday practices of inclusion and disability.

The 'three waves' of research in mental health geography: a review and critical commentary

OBJECTIVE

To consider research conducted in the sub-field of mental health geography, concentrating on work published in English.

METHODS

The paper offers an comprehensive, in-depth and critical reading of the relevant literature on mental health geography since the inception of this subfield of inquiry in the early-1970s.

RESULTS

The paper identifies three 'waves' of research within work on mental health geography. It describes these 'waves' in detail, interprets certain strengths and weaknesses of the first two 'waves', which are well-established, and provides suggestions about important questions to be addressed in a future third 'wave'.

CONCLUSION

Much excellent research has so far been undertaken within mental health geography, but there is scope to increase the relevance of this research through widening the focus of research and by being prepared to connect research more directly to mental health policy and politics.