By Bethany Kruger, Senior Improvement Manager, Improvement Cymru.
Since the dawn of time, we have attempted to understand our world and manage our place in it. We have attempted to seek out meaning and understanding. What does it mean to be me? And what does it mean to be someone else?
We apply categorisation or labels both to ourselves and to others to help us make sense of our surroundings, either for comparison or for acceptance. For many of us this provides a sense of belonging or a position of worth in our society which is valued and respected. However, for some this may not be the case.
Assigning labels such as ‘learning disability’ or ‘intellectual disability’ across education, health and social care is common practice and can be seen in a positive light. Often it allows access to resources and appropriate care and treatment, such as Health Checks or specialist services designed solely for people with a learning disability.
Positively, there has been a shift in attitudes towards people with disabilities over recent decades with an emphasis on inclusion and equality. However, we must not be naïve or ill-informed of the influence of applying labels to those we support.
The labels we apply to facilitate, enable and empower can be limiting and have a negative influence on self-identity and behaviour. Stigmatisation, exclusion and discrimination are harmful and can have undesirable lifelong consequences on a person’s wellbeing and prosperity. Labelling has been criticised for instigating and maintaining marginalisation, shame and embarrassment. A colleague of mine in their teaching would often quote ‘label jars and not people’.
Importantly, how do people see themselves or how should people deal with their intellectual disability; which arguably has been socially constructed in an attempt to provide meaning to us all?
Evidence suggests people reject and disregard this ascribed label (1). Sadly, people recognise how others view this label and the social implications, expressing experiences of being treated differently, ignored or rejected (2). Often people recognise labelling as negative and describe feelings of unhappiness, anger and powerlessness, so why do we consider this an important part of a person’s character and how can we inform our own attitudes and behaviours?
Many people when referring to themselves speak of attributes, roles and competencies (3). All the aspects that you and I value and hold dear. As improvers our role is to coproduce health and social care; to create conditions where learning can flourish and cultivate capability and capacity.
However, I am not suggesting to ignore differences, as assumptions of homogeneity may be adopted. What I am suggesting is that we are mindful of how we use labels; how, as improvers we consider how we think and act?
The habits of an improver, The Health Foundation, 2015 (4) offers a way of framing conversations and a set of improvement habits which facilitates a landscape of potential and capable environments and most importantly people. A landscape where we as improvers can promote positive social identities.
So next time you need to consider and include those we seek to support, stop, and ask yourself, am I adopting, amending or abandoning.
- Logeswaran, S., Hollett, M., Zala, S., Richarson, L. and Scior, K. How do people with intellectual disabilities construct their social identity? A review. Journal of Applied Research in Intellectual Disabilities. 2018; (32) 533-542. https://onlinelibrary.wiley.com/doi/full/10.1111/jar.12566
- Monteleone, R., & Forrester‐Jones, R. ‘Disability Means, um, Dysfunctioning People’: A qualitative analysis of the meaning and experience of disability among adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities. 2016; (30) 301-305. https://onlinelibrary.wiley.com/doi/10.1111/jar.12240
- Jahoda, A., Wilson, A., Stalker, K., & Cairney, A. Living with stigma and the self‐perceptions of people with mild intellectual disabilities. Journal of Social Issues. 2010; (66) 521–534. https://onlinelibrary.wiley.com/doi/10.1111/j.1540-4560.2010.01660.x
- The Health Foundation. The habits of an improver. https://www.health.org.uk/sites/default/files/TheHabitsOfAnImprover.pdf [Accessed 18 August 2022].