Problems of Providing Services to
Persons with Disabilities from Minority Groups
Carl Douthitt, M.A.
Graduate Research Assistant
Howard University Research and Training Center
Abstract
This paper presents a number of problems that need to be addressed in order to successfully provide rehabilitation services to minority persons with disabilities. Negative perceptions and attitudes of people without disabilities are identified as major barriers to the provision of these services. Discussion of issues such as cultural sensitivity, group distinctions, changing demographics, and labor force highlights the difficulties of the service delivery system that is oriented to ethics of the majority culture.
Introduction
From what I understand, when a person is asked to speak to a group there are certain obligations or responsibilities that one must adhere to. It seems that one of the first obligations is to tell some kind of joke or story and so, I would like to fulfill that first obligation by telling a story.
There was a man who was driving along a seldomly traveled, hilly, rural road. As he got to the top of one of the hills he got a flat tire. So, he got out of the car and proceeded about the task of changing the tire. He took off the five (5) nuts and placed them down beside him. As he was putting on the spare, he accidentally kicked three of the five nuts down into a gully. " Well," he thinks. "What in the world am I going to do now?" He looks across the road and he notices this BIG facility, with this BIG gate and this big sign on the gate that reads, "Maple Wood Psychiatric Facility." Peering from behind the gate is this middle aged gentleman who looks as though he's been standing there for some time. The guy with the flat tire walks over to the gate rather hesitantly and he asks the gentleman on the other side, "Hey buddy, is there a phone around here? I got a flat tire and as I was changing it I accidentally knocked some of the nuts into the gully over there. I want to call to get some assistance." The guy on the other side of the gate said, "Yeah, there is a phone, but it's way over on the other side of the facility. I have a suggestion for you. Why don't you take one nut from each of the other three tires and put them on the tire that's missing nuts? That should hold you until you're able to get to a gas station." The guy with the flat tire proceeded to follow the suggestion and sure enough the tire was secure enough for the car to be driven. As he was about to drive off, the guy in the car hollered over at the guy behind the gate and in a very condescending manner said, "Hey buddy, if you're so smart, how come you're on the other side of that gate?" The guy behind the gate peered at the guy in the car for a few moments and then he responded, "You know, I may have a mental illness, but I'm not stupid!"
This story depicts the kind of negative attitudes that many people without disabilities have towards those with disabilities. A person with a disability is often seen as being UNFIT, UNABLE, and in essence DEVALUED in the mind of the person without a disability. This kind of devaluation becomes compounded when the person with a disability is also a member of a minority group. In a sense there becomes a kind of dual devaluation. One is devalued because of the disability, and also devalued because of the minority status. This dual devaluation flies in the face of the concept of the "melting pot." That is, the notion that group distinctions between people are unimportant. It does not appear that we have melted entirely. Racism, sexism, and abilism are just a few of the barriers that have prevented many from realizing the American Dream. These barriers must be broken down! They must be broken down because the demographics of this country are changing!
Between the years 1980 and 1990, the Anglo American population has decreased in the United States by 2.8%. However, within this ten year period, the African American population has increased by .4%, the Latin American population by 2.6%, and the Asian American population by 1.4%. If these trends continue, by the year 2000 it is estimated that the Asian American population will increase approximately 21%, African Americans will increase about 12%, and Anglo Americans will increase approximately 2%.
With this type of change estimated within the country's population, it is evident that there are going to be various effects. Probably one of the primary effects will be in the labor force. According to the U.S. Bureau of the Census, it is projected that between 1988 and the year 2000, immigrant females along with native white males will comprise approximately 9% of the labor force, respectively. Immigrant males will make up 12% of the labor force followed by native minority females and native minority males both at approximately 21%. It is estimated that native white females will comprise the bulk of the country's labor force totaling approximately 29%.
The challenge that is presented by this change in the labor force is to maximize and utilize the abilities of persons from minority groups, particularly minority persons with disabilities. Unfortunately, presently it appears that this challenge is not being met. African Americans account for approximately 22% of the unemployed persons with disabilities. For working-age Latin Americans with a disability, approximately 76.8% are out of the labor force, and if they are out of the labor force we are definitely not maximizing their abilities!
With regard to participation in the rehabilitation process, there are many inequalities that exist for minority consumers. There are large percentages of African Americans nationwide who are not being accepted for services. When they are accepted, they are less likely to be rehabilitated. It is estimated that as high as 50% of Asian American and Pacific Islanders who participate in public vocational rehabilitation programs are terminated prematurely. Similar concerns exist for Latin Americans and Native Americans. One of the primary reason for these inequalities is the cultural insensitivity that seems to exist among many service providers toward consumers who are of a different cultural background.
The service delivery system has traditionally been oriented towards the ethics of the majority culture, which espouses individuality, control of one's environment, and a value of the future. When a person, who seeks services is of a cultural background that values group behavior rather than individuality, harmony with the environment rather than control over it, and a value of the past or present rather than the future, it becomes apparent how this individual might experience problems seeking services within a system that has values almost totally opposite his own.
One way of dealing with this disparity is for the representatives of the system, on all levels, from top to bottom and from bottom to top, to become more culturally knowledgeable and culturally sensitive. There are many service providers who see cultural background as being superficial or irrelevant to the rehabilitation process. One reason this may occur is the fact that many of us have gone through practically our entire educational and professional careers without having a word mentioned about "cultural diversity." Therefore, it is not difficult to understand why some individuals do not appreciate the role of cultural diversity in the rehabilitation process. By not giving attention to, or having some degree of understanding of cultural differences, it becomes very difficult to provide the most appropriate level of services to consumers who may be of a different background. It is not to suggest that one needs to know everything there is to know about all cultures - that would be impossible. However, we do need to develop some understanding about the major values and belief systems of the people we service, especially those who may come from different cultural backgrounds. For example, it is important to know that the extended family is held in high regard within the Asian American culture, that there exists respect for authority, and for an orientation toward the past and toward privacy. In the African American culture, respect for the individual is valued. Traditionally, there has been a distrust of big institutions, and there is an orientation toward the present rather than the past or future. In addition, the extended family has traditionally been deemed as a valued asset within the African American culture. In the Latino culture, there is a strong work ethic, orientation toward the present, and the high value placed on the extended family. The few cultural tendencies that are mentioned here will vary based upon socioeconomic status, region of residence, etc. It is important, however, to have at least a basic knowledge and understanding of cultural diversity when providing services to individuals from these cultures.
In the cultures that are cited above, it is noted that the family served as a source of support in all three. Traditionally, the field of rehabilitation has focused on the consumer's treatment, with not much attention being placed on the involvement of the family. However, we are now beginning to see the importance of actively involving the family in the rehabilitation process. There have been studies which show that the involvement of family members in the rehabilitation process can enhance an individual's adjustment to a disability. Furthermore, family reinforcement or support can be vital to maintaining gains made during rehabilitation.
In conclusion, I would like to briefly address one other area of concern. With an increase in minority consumers with disabilities, there should also be an increase in minority service providers at all levels; service providers, administrator, and at levels where decisions are made concerning how services are provided. There is little doubt that changes are necessary for our society to become culturally sensitive and pluralistic. But, I would like to leave you with this Chinese proverb, "The journey of a thousand miles begins with the first step." I think that we have taken the first step with conferences like this one, but there is a need to continue the process. By doing so we will be able to successfully reach the end of the thousand mile journey.
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Page last updated on March 20, 1997 by Mary Kaye Rubin