Barriers to accessing services and the problem of discrimination

In this section I will be focusing in on how service user’s access services and the various barriers they will be faced with. And how these barriers have an effect on them but also how these barriers can be overcome.

A care organisation and care practitioners provide access to their services through referrals. Referrals are in three different ways;

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A Self-Referral – This is when the service user wants to apply or directly applies for access to a care service. This can be done in various ways, either if the service user turns up in person to the service or makes a phone call, writes a letter, or can fill in a self-referral form. For example a service user can make a phone call to their GP for an appointment or turn up to the health centre in person.

A Third-Party Referral – This may occur when a person applies for a care service for another person. For example, a parent might take their child to the hospital or GP because they are concerned about the child’s sickness.

A Professional Referral – It is similar to a third-party referral, but there is a difference, which is the person referring on someone else’s behalf is a health or social care professional. For example, if a social worker thinks that a child should be taking into care or foster care, then they would be making a referral for this. Or if a GP thinks that a service user should be referred to the hospital for treatment then they would have to make a referral.

In this section I will talk about the different barriers service users face while trying to access services.

The different barriers will include

* Language/communication

* Organisational

* Emotional barriers

* Geographical

* Physical

Language Barrier

As the UK is a multi-cultural society, it has a range of people from different countries all over the world which speak different languages, and English may not be their first language. But even people who do speak English as their first language may struggle as they may be unable to speak verbally or written as they may have a speech or hearing impairment.

Cedar Foundation clients may feel that there are faced with this barrier if they aren’t given the attention or being listened to by the staff, or not having the trained staff available so that the service user is able to tell them what help they need. They may be socially excluded from activities because they can not speak the same language that the activity is being spoke in. They may feel not valued and are being discriminated against and this could cause them to have low self-esteem and anger problems, and may be frustrated as they are unable to speak what they want to.

However the Cedar Foundation organisation have staff trained to help understand messages from service users, they have a communication bored were service users who are unable to speak or move parts of their bodies, can point to things on the board and are able to communicate with the care workers, and also they have a computer system in Ballymena, which help service users gain skills in ICT. The technology is called My-Tobie, which allows you to use the computer using your eyes to control where you want to go on the screen or type a message, it may also be used to go on the internet and and using SMS on a phone.

Source: A video made by the Cedar Foundation about this technology at http://www.cedar-foundation.org/find-a-service/employment-and-learning/ Date accessed 24/02/12

Organisational Barrier

The success of a organisation often depends on communication to its members, and staff. They need to have a structure to understand a message being received. Organisations need to not make assumptions that service users will have the same needs as them or for example assuming that service users will understand what the care worker is trying to tell them. Often an organisation needs to work around its service users to be successful and providing help when they need it. As for example some of the services or classes could be on during the day when people are busy and doing things or parents who have children and don’t have anyone available to watch their children to be able to attend the classes.

It would affect service users as they feel that they unable to take part in any of the activities or services available because the organisation does not have it on at a suitable time.

However the Cedar Foundation work with their services and make sure that they are focused on them and making services and activities available to suit them, for example, they would have activities and youth work available for teenagers and children after school hours as they would be unable to during school. Also the Cedar Foundation work to provide exciting and events that will give the services users something to look forward to, for example, they had got tickets to go and see the MTV EMA Awards in Belfast last November, this was an exciting event and day for the young children that attended the youth matters service in Belfast within the Cedar Foundation that went. One of the service users made a comment about the night event “Glenn, 18, said, “This was the best activity we’ve ever done and I really can’t believe we were lucky enough to be there. Thank you so much Cedar for making it happen.” Source: http://www.cedar-foundation.org/news/item/517/young-people-experience-mtv-emas/ Date accessed: 24/02/12

Emotional Barriers

This type of barrier is based on suspicion, mistrust and fear. They stop people from having inadequate care. For example elder people don’t like feeling dependent on other people and usually accept the help when needed. Also people on benefits tend to set up emotional barriers, usually refuse to be helped, as they feel it’s shameful. Emotional barriers tend to separate people away from others, this is where stereotyping may come into place, when people label people as “emo’s” as they are different and unique in their own way, where as some people might see them as “weird” and discriminate against them.

For example a service user may express anger and because of this they might get rejected from doing things. This makes service users not want to express anger as they don’t like to be rejected, which may lead to frustration as they are unable to express their emotional feelings, and might not be able to take part in activities because of their disability, which can cause them to get low self-esteem.

Geographical Barriers

This type of barrier means that some services might be miles away from where a service user lives and they are unable to access the service as they may not have the money to travel or be able to travel far because of their disability. This may be hard for people particularly living in rural areas. Most of the specialist services that service users may need are situated in only a limited number of regional centres and are unable to get there. This may lead to the service user feeling excluded and marginalised as they are unable to access the service because of where they live. Also for example, if a young adult that has a disability and is looking to go to university are unable to go to the university they want to because they don’t have the travel costs or the university does not have the right facilities needed for the service user.

The Cedar Foundation tries their best to overcome this type of barrier as they would try and go out of their way to get the service users to the services that they need. They would provide travel arrangements for them. They would provide activities and services that they are able to access by providing a bus to collect the service users and return them home.

Physical Barriers

A physical barrier can be when a service user has an impairment that could also affect their mobility, and therefore they are unable to get about easily. One of the physical barriers would be access to buildings and workplaces, as some do not have the facilities for disabled people. Some services that they would need to attend may not have for example ramps for wheelchair users or braille for service users or have a sight impairment. Physical barriers can also occur in communication when a service user needs to communicate to a worker about a service, and they do not understand because the care worker is talking to fast or not pronouncing their words properly, or using inappropriate gestures.

The effects of this barrier may make the service user feel excluded and unable to access services because the buildings or centres do have the right facilities for people with disabilities to access. They may feel angry and disappointed, as they are not able to do the things they want, and may feel disempowered as, they can’t do things themselves or access buildings themselves.

In this section I will talk about Discrimination and the effects and types of discrimination with respect to people with disabilities.

Discrimination means discriminating against someone because of their, race, religion, culture, disability, gender. It also comes from the term “prejudice” meaning pre-judging someone or labelling and stereotyping people because they belong to different groups of people when really there are all individuals and have different needs.

Organisations and people providing health and social care services must not discriminate against anyone through their services because of their race, disability, belief or religion. For example of race discrimination, if a doctor refers clients or service users that are black to a black doctor because he doesn’t not want to treat them not because of their sickness but because of their colour.

The Disability Discrimination Act 2005 says organisations providing health and social care must make reasonable adjustments to enable service users to make use of their services.

Anti-discriminatory law in the UK can come in different ways;

* Direct Discrimination – this means treating someone in a bad way than treating another person because they have a disability or because they may be a different colour from them, or belong to a different religion, for example a care home not allowing or accepting a person with a disability because they were black.

* Indirect Discrimination -this can occur if a workplace or service sets a requirement and can only be done by particular people, this may disadvantage some social groups because they are not able to take part or complete the requirement.

* Victimisation -this can occur when someone treats someone unfairly and singling out someone and treating them bad for no reason. This can happen if someone has a different religion or belongs to a different race or has a disability. It’s an illegal action and some cases of it can be taken very seriously.

* Harassment – this can be defined in different ways, it means to irritate someone or torment them constantly. It may also mean to abuse another person and it is the type of behaviour that has the intention or hurting or upsetting the person that is being harassed. It can come under different types;

Legal Harassment

Sexual Harassment

Verbal Harassment

Psychological Harassment

Hate Speech

Protection from harassment has been further extended so that the employer can be held liable for harassment by a third party, such as a customer or contractor” Source: http://www.bbc.co.uk/news/business-11453052 Date accessed 25/02/12

People who may face discrimination can come from a different number of groups that may be either deaf people, people with a learning disability, or that aren’t able to walk and have a physical disability and may have to use a wheelchair. They may feel disempowered, excluded, embarrassed as they are unable to take part in things, they may feel upset which could lead to depression as they may be called certain names or labelled as a certain group. For example people that have a learning disability and have to have help or that they are slow at doing things are stereotyped or labelled as “retards”.

Disabled people may feel excluded from certain buildings or centres as they do not have disability access, for example cinema’s, shops because they do not have lifts or ramps, or have the use of braille for people with a vision impairment.

Marginalisation – To make someone feel “less than” they are, to make them feel bad about themselves and that they are unable to do certain things or apply for particular jobs because they may have a disability which could lead them to think that they aren’t worth anything because they are unfit for certain jobs, when really workplaces do not have disability facilities so therefore they do not employ people with disabilities.

People with disabilities may feel that they are being disempowered and that they are unable to do things for themselves and care workers or parents are doing it for them when really disabled people just want to have independence.