The ‘problem’ of abuse in Ontario’s Social Inclusion Act: A critical exploration

Abstract

Employing Carol Bacchi's What's the problem? approach, this article examines the abuse policy recently implemented through the Social Inclusion Act of Ontario, Canada's developmental services sector (DSS), and how it constitutes sexual abuse of people with intellectual disabilities as a policy problem. Politically committed to preventing and addressing abuse, we examine how sexual abuse is 'given shape' in the policy and its compliance training materials, and how the policy's mandatory police reporting requirement 'subjectifies' victims according to a taken-for-granted legal 'worldview' that presumes justice is achieved through criminalisation. We also demonstrate the everyday 'deleterious effects' of this policy in relation to how it leaves both support for sexuality and the long-standing crisis management approach of Ontario's DSS unproblematised. This analysis calls into question the abuse policy of the Social Inclusion Act and demonstrates the pressing need to re-problematise abuse prevention and redress for people with intellectual disabilities.

Integrated responses for people with cognitive disability and complex support needs: Factors and principles

“…The development of accessible information that reflects the cultural specifics of targeted populations (McIntyre et al, 2017) and which, ideally, is created through coproduction with people with disability and complex support needs (Olsen et al, 2016), significantly contributed to the successful implementation of models of care at the person level. The literature also consistently cites barriers to effective support for people with disability and complex support needs as being associated with difficulties on the part of those supporting them to conceptualise individuals as situated within multiple interconnected systems (Day et al, 2016;McCauley and Samples, 2017;Quinlan and Smele, 2017). For example, people diagnosed with mental illness often struggle to find adequate housing, hold employment, gain access to both mental and physical health care and lack transportation, which in turn results in further marginalisation (Brown et al, 2016;McCauley and Samples, 2017;Nicholas et al, 2017).…”

“…Clinical knowledge deficits were exacerbated by the additional complexity of rurality (Caxaj, 2016;Stephens et al, 2014), lack of guidance regarding how to engage necessary additional services to promote intersectoral collaboration (Duffy et al, 2016;Edgren and Barnard, 2015;Mason et al, 2018) and preconceived attitudes pertaining to complex populations, especially those in forensic settings (Davies et al, 2016;Dixon et al, 2016;Dyer and Biddle, 2016). These issues exist within an environment of unrealistic expectation placed on underresourced, time-scarce and often poorly paid staff (Johnson et al, 2015;Mason et al, 2018;Quinlan and Smele, 2017;Rhodes et al, 2013). Professional judgement and an ability to work flexibly to meet the needs of a diverse client base were restricted by organisational structures preoccupied with procedural, managerial and 'tickthe-box' types of assessments (Duffy et al, 2016).…”

“…Also described was a lack of managerial guidance and support around policy and practice (Day et al, 2016;Keller, 2016). Additional interagency blockages included poor communication and information sharing due to untrusting attitudes or 'turf' wars (Dooris et al, 2013;Hoeft et al, 2018;Home Office, 2014;Mason et al, 2018;Stephens et al, 2014;van Rensburg and Fourie, 2016), incompatible communication or information technology systems (Kelly, 2016;van Duijn et al, 2018) and inadequate time allocated to coordinate across services (Day et al, 2016;Mason et al, 2018;Quinlan and Smele, 2017). It was also noted that inappropriate service design and evaluation resulted in the exclusion of users (Kelly, 2016;Michalski, 2017;Whittle et al, 2017), inadequate responses to, or acknowledgement of, diverse cultural needs and 'one-size-fits-all' service models (Bogenschutz, 2014;Caxaj, 2016;Hoeft et al, 2018;Malvaso and Delfabbro, 2015;McIntyre et al, 2017) and geographical challenges that increased resourcing, infrastructure and staffing shortages (Stephens et al, 2014;Hoeft et al, 2018;Whittle et al, 2017).…”

“…The overarching policy, governance and funding contexts within which services operate also presented impediments to good practice. Identified systemic barriers included the marginalisation of specific groups who are disproportionately exposed to risk factors for poor mental health, substance abuse, suicide and injury, such as people with disability and complex support needs (Quinlan and Smele, 2017), Aboriginal people with disability (McIntrye and Townsend, 2017;Stephens et al, 2014;Quirouette 2016) and people from culturally and linguistically diverse backgrounds (Bogenschutz, 2014). This marginalisation was often compounded by social issues including poverty and discrimination (Caxaj, 2016;Gardiner et al, 2017;Henning, 2016;Johnson et al, 2015), which services frequently did not adequately consider (Davidson et al, 2014;Quirouette, 2016).…”

“…The literature also consistently cites barriers to effective support for people with disability and complex support needs as being associated with difficulties on the part of those supporting them to conceptualise individuals as situated within multiple interconnected systems (Day et al, 2016;McCauley and Samples, 2017;Quinlan and Smele, 2017). For example, people diagnosed with mental illness often struggle to find adequate housing, hold employment, gain access to both mental and physical health care and lack transportation, which in turn results in further marginalisation (Brown et al, 2016;McCauley and Samples, 2017;Nicholas et al, 2017).…”