“An Environment Built to Include Rather than Exclude Me”: Creating Inclusive Environments for Human Well-Being

Abstract

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.

An Evaluative Study of Services Provided in Community-Based Rehabilitation Centres in Jordan

“…There were limited services directed towards increasing the knowledge and awareness of CBR, disability, and the rights of persons with disabilities among the local community, and at organising activities to increase inclusion. This conclusion is in accordance with the literature that shows that professionals often address only local and individual environmental factors to deliver services, and by that probably neglect systems and societies, thereby limiting equality and restricting inclusion (Layton and Steel, 2015). Efforts need to be directed at the creation of inclusive communities, rather than narrowing the vision of CBR to be focused on individuals or governmental regulations.…”

“…Efforts need to be directed at the creation of inclusive communities, rather than narrowing the vision of CBR to be focused on individuals or governmental regulations. Professionals are encouraged to perceive and coordinate action on environmental barriers based on the standpoint of persons with disabilities, and address aspects of the environment which influence CBR effectiveness and outcomes (Layton and Steel, 2015).Therefore, there is a need to target the media in order to increase the knowledge and awareness of CBR and disability and the rights of persons with disabilities, as reported by 17.03% of participants. Also, there is a need, as reported by 87.23% of participants, for CBR centres in Jordan to organise activities in public facilities, such as schools, to increase the knowledge and awareness of disability and to maximise integration and inclusion of persons with disabilities.…”

“…The promotion of autonomy of persons with disabilities is one of the main objectives of CBR and has a deep impact on the self-esteem and relational capacities of persons with disabilities (Mauro et al, 2014). It has been shown in literature that this can be accomplished by facilitating work opportunities that not only foster autonomy but also promote social inclusion of persons with disabilities (Layton and Steel, 2015;Zaidi and Burchardt, 2005).This also contributes towards counteracting cultural barriers manifested by stigma and negative attitudes towards persons with disabilities, and actualises empowerment in line with the principles of CBR towards inclusion and the human rights framework (Deepak et al, 2014;Grandisson et al, 2014a;Lang et al, 2011;Mauro et al, 2014). Thus, CBR programmes in Jordan need to focus on promoting access to employment (Mauro et al, 2014).…”

“…The literature acknowledges that people tend to spontaneously experience inclusion in mainstream activities when they live in environments that provide and support access to cultural, economic, and social occupations (Baum, 2008;Layton and Steel, 2015). Persons with disabilities and their families are less likely to use services when faced with an increased number of barriers (Maharaj et al, 2014).Barriers to the benefits and effectiveness of CBR services stem mainly from two sources: CBR services, and persons with disabilities and their families.…”

Assistive Technology in Australia: Integrating theory and evidence into action

“…The implications for occupational therapists include advocacy for collective accommodations, although this is frequently outside the scope of individually focussed service provision. At an individual level, making recommendations for ‘those supports which will bring about an outcome’, whether on an equipment funding list or not, is also an act of systemic advocacy for occupational therapists (Layton & Steel, ).…”