Editorial

Editorial

Article Type: Editorial From: Tizard Learning Disability Review, Volume 19, Issue 3.

Sometimes, as I review the articles for a particular issue of TLDR, the (unplanned!) theme underlying the articles is so transparent it seems to jump off the page. This is one such issue with all the papers drawing attention to the relationships between the two groups of people we call “staff” (or “carers”, etc.) and “service users” (or “clients”, etc.). This is perhaps most visible in the paper by Hannu Vesala and his colleagues on staff attitudes to institutional closure in Finland. An important but often overlooked function of institutions was to provide employment for large numbers of the local community (Bachrach, 1978). An institutional closure programme clearly threatens this function and may arouse negative attitudes because of this. But this is not to say that the staff working in the institution are only there for the money. While this will be true of some, as in all jobs, there will be many staff who will have made the lives of the people living in the institution better and who will believe, not just for self-serving reasons, that they are better off staying where they are. Vesala's conclusions and Agnes Turnpenny's commentary draw attention to some of the ways in which those responsible for institutional closure can take account of the impact on staff in a way that may make the process of closure and change better for all.

The paper by Carly Smith and Rachel Forrester-Jones focuses on the experiences of students establishing a brief relationship with a person with intellectual disabilities as part of their university course. We see, a bit like a speeded up film, the anticipation, development and end of the relationship over a few months. There are potential problems with this kind of “speed relating”, some of which are noted in Celia Harding's commentary. It may ultimately be more to the benefit of the student than the disabled person. At the same time, the flowering and withering of these relationships, as expressed through the students’ journals, draw attention to the ways in which even such brief relationships can change and develop the students’ attitudes to a significant and surprising extent.

Smith and Forrester-Jones may be overoptimistic in suggesting that this kind of educational intervention could prevent abuse but it is important to realise that most abuse of the kinds surveyed by Olivia Hewitt occurs in the context of relationships that have gone wrong. Very few of the carers or staff who behave in abusive ways set out, at the beginning of the relationship, to behave in these ways. Rather, over time, perhaps in a culture which didn’t take their own needs seriously or (as discussed by Michelle McCarthy in her commentary) properly respect the worth and value of people with learning disabilities, the relationship worsened and ultimately became abusive.

Support for people with intellectual and developmental disabilities may come, financially, from the State and may sometimes be expressed in material ways such as through the provision of a place to live. But social and health care are mediated through relationships. These relationships are two-way and must, in some sense, meet the needs of both parties. Relationships are sometimes described as “the fourth R” in education (e.g. Witmer, 2005). The design of effective services for people with learning disabilities, whether in education, social care or health, cannot ignore the significance of establishing good relationship skills and good relationships.

Peter McGill

References

Bachrach, L.L. (1978), “A conceptual approach to deinstitutionalization”, Hospital and Community Psychiatry, Vol. 29 No. 9, pp. 573-8

Witmer, M.M. (2005), “The fourth R in education - relationships”, The Clearing House: A Journal of Educational Strategies, Issues and Ideas, Vol. 78 No. 5, pp. 224-8