The paper ends with the recommendation to develop an international standard for assistive technology provision. Such a standard can have a major impact on the accessibility of AT for people with disabilities. The paper outlines some the key elements to be included in a standard. Implications for Rehabilitation Assistive technology is a key element in rehabilitation, but many people have no access to affordable AT solutions. The recommendations in the paper aim to inform policies, systems and service delivery procedures on how to improve access to AT across the world.

Purpose – This paper studies the experiences of asylum seekers in Australia. The purpose of this paper is to explore the relationship between mental wellbeing, living conditions, and Australia’s detention policies in light of human rights. Design/methodology/approach – Using grounded theory, data were collected via observations, semi-structured interviews, key-informant interviews, and document analysis. Participants included seven asylum seekers and three professionals working with them. Findings – In light of a human rights framework, this paper reports on the mental distress suffered by asylum seekers in detention, the environments of constraint in which they live, and aspects of detention centre policy that contribute to these environments. The findings highlight a discrepancy between asylum seekers’ experiences under immigration detention policy and Australia’s human rights obligations. Research limitations/implications – This research indicates human rights violations for asylum seekers in detention in Australia. This research project involved a small number of participants and recommends systemic review of the policy and practices that affect asylum seekers’ mental health including larger numbers of participants. Consideration is made of alternatives to detention as well as improving detention centre conditions. The World Health Organization’s Quality Rights Tool Kit might provide the basis for a framework to review Australia’s immigration detention system with particular focus on the poor mental wellbeing of asylum seekers in detention. Originality/value – This study links international human rights law and Australian immigration detention policies and practices with daily life experiences of suffering mental distress within environments of constraint and isolation. It identifies asylum seekers as a vulnerable population with respect to human rights and mental wellbeing. Of particular value is the inclusion of asylum seekers themselves in interviews.

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More effort should be put into integrating research and resources from European projects into practice. Use of the International Classification of Functioning, Disability, and Health model and terminology may support coordination of service delivery systems. The AT research and practice communities in Europe may be able to learn from developments in North America, while continuing to work together, sharing resources and strategies, and communicating results internationally.

If human rights begin in small places close to home, technologies that enable people with disability to access and control their home environments are an important human rights instrument. Smart homes exemplify recent advances in design, building construction, and integration of technologies within the built environment. They draw on multiple social and technical disciplines that share a broad vision but lack a common language, creating ambiguity and limiting the usefulness of the evidence base in determining optimal ways to integrate technologies and housing design to meet diverse needs. The convergence of mainstream and assistive technologies offers the potential of accessible and affordable strategies for inclusion, but also risks further exclusion of marginalized sections of the population. Coordination of efforts might accelerate translation of knowledge and diffusion of innovations into the practices of planning, designing, building, and sustaining housing that promotes independent living. This conceptual paper reviews the theoretical frameworks and terminology from fields of research involved in the design and use of technologies in the home environment to enable people with disability and older people. It considers approaches to design and interventions that could inform policies and practices as well as further research and development activities.

Contemporary discourses which challenge the notion of health as the “absence of disease” are prompting changes in health policy and practice. People with disability have been influential in progressing our understanding of the impact of contextual factors in individual and population health, highlighting the impact of environmental factors on functioning and inclusion. The World Health Organization’s (WHO) more holistic definition of health as “wellbeing” is now applied in frameworks and legislation, and has long been understood in occupational therapy theory. In practice, however, occupational therapists and other professionals often address only local and individual environmental factors to promote wellbeing, within systems and societies that limit equity in population health and restrict inclusion in communities. This paper presents an in-depth analysis of the supports and accommodations identified by a cohort of individuals (n-100) living with disability. A range of environmental facilitators and barriers were identified in peoples’ experience of “inclusive community environs” and found to influence inclusion and wellbeing. The roles and responsibilities of individuals, professionals, and society to enact change in environments are discussed in light of these findings. Recommendations include a focus on the subjective experience of environments, and application of theory from human rights and inclusive economics to address the multiple dimensions and levels of environments in working towards inclusion and wellbeing.

Background:Occupational therapists use a range of strategies to influence the relationship between person, environment and occupation and facilitate people's participation and inclusion in society. Technology is a fundamental environmental factor capable of enabling inclusion, and occupational therapy models articulate a role for assistive technology (AT) devices and services, but there is a gap between theory, research and practice. The context of AT provision in Australia presents systemic barriers that prevent optimal application of AT devices and services for societal health promotion and in individualised solutions. Methods:The Integrating Theory, Evidence and Action method (ITEA) was used to answer the question "How can occupational therapy support AT provision to enable older people and people with disability?" A wide range of sources were systematically analysed to explore the complexities of AT provision in Australia. Results:The International Classification of Functioning, Disability and Health (ICF) and IMPACT 2 model are used as frameworks to reconstruct evidence into statements that summarise the theory, process, and outcomes of AT provision. Analysis of the influence of the global disability rights and local policies and AT provision systems is used to highlight important aspects for occupational therapists to consider in research and practice. Pragmatic recommendations are provided to enable practitioners to translate theory and evidence into action. Conclusion:AT provision can be improved by focusing on evidence for and congruence between theory, process and outcomes, rather than isolated interventions. Occupational therapists should consider the influence of contextual factors on practice, and work with consumers to improve access and equity in AT provision systems.

Assistive technology was once a specialised field of practice, involving products designed for populations with specific impairments or functional goals. In Australia, occupational therapists have, at times, functioned as gatekeepers to public funding, prescribing products from a predefined list. An expanding range of accessible mainstream products available via international and online markets has changed the meaning and application of assistive technology for many people with disability. In the policy context of consumer choice and cost-effectiveness, have occupational therapists been left behind? This paper describes the change in context for access to assistive technology resulting in expanded possibilities for participation and inclusion. A case study of environmental control systems is used to explore the overlap of mainstream and assistive products and the funding and services to support their uptake. The analysis describes a future policy and practice context in which assistive technology includes a spectrum of products decoupled from access to independent advice and support services. A broader scope of occupational therapy practice has potential to enhance the occupational rights of people with disability and the efficiency and effectiveness of assistive technology provision.