Practice with Diverse and /or

Oppressed Populations

Abigail Bagley
Section 1
The Population

● The vulnerable population I chose is adults with developmental or intellectual disabilities

● Not the primary focus of my agency but is served by this agency

● Not a group with which I personally identify.

About the Population
Adults with intellectual or developmental disabilities did and still are having trouble accessing psychiatric
hospitalization and information about patients being admitted to inpatient units is sparse. (Bakken et al.,
2013)

It is noted that this population may have been harder to work with because of their condition. Having these
disabilities made their mental health diagnoses more complex (Bakken et al., 2013). Dealing with the mental
condition and the disability was a problem area.

Today, people with intellectual or developmental disabilities are usually put in residential care or treatment
centers that provide 24/7 care. These adults are usually have a guardian and have a case manager to help plan
out their personal goals (called person centered planning)
About the Population (Continued)

Throughout the course of an average year, persons with developmental disabilities living in residential
settings are exposed to a variety of potentially significant adverse life events. The most common occurrences
included staffing and housing changes, disputes between residents and staff, relationships and family losses,
and resident injuries or illnesses (Owen et al., 2003).

Negative outcomes of being in residential care and treatment centers have been hard for adults with
intellectual disabilities and have been even worse in the past.
Historical Marginalization
Historical marginalization and history of biased assumptions and stereotypes dates back to the 1800’s.

Adults with developmental disabilities or intellectual disabilities were frowned upon and judged for their
behavior. They were forced into institutions, where they were treated poorly and were abused and neglected.
Not only that, but institutions tried to ‘purify’ them by doing procedures that would help whatever disability
they had (ADL Education, 2017).

Marginalization continued until the end of WW1 (1940’s) when veterans with disabilities pushed the US to
provide rehabilitation services in return for the service they did for the US.
History of Marginalization (Continued)
By the 1960’s people began to voice their opinions and advocate for this civil rights movement.

The Rehabilitation Act of 1973 was passed and provided equal opportunity for employment within the federal
government and in federally funded programs, prohibiting discrimination on physical or mental disability.

In 1975, the Education for All Handicapped Children Act was passed to guarantee equal access to public education for
children with disabilities.

The Education for All Handicapped Children Act was renamed in 1990 to the Individuals with Disabilities Education Act
(IDEA), which further elaborated on the inclusion of children with disabilities into regular classes, but also focused on
the rights of parents to be involved in the educational decisions affecting their children (ADL Education, 2017)
History in Maine

The history of the treatment of people with developmental disabilities, in Maine, is a story of stigmatization and abuse,
like mentioned before.

In 1908, the Maine School for the Feeble-Minded opened in New Gloucester. It is now known as the Pineland Center,
but even with the name change, they still had the same idea of action and that was that the place for people with
developmental disabilities was in an institution, shut away from the rest of society. Abuse and neglect of the residents
was reported was exposed in the middle of the 20th century, a movement for disability rights was born. Advocates and
fought to close Pineland (which finally happened in 1996) and create a system of services that would serve people
with developmental disabilities and not abuse them or ridicule them.

The Maine Developmental Disabilities is in the middle of a multi-year project that endeavors to tell the story of the
history of people with developmental disabilities in our state.
Section 2
Interviewee, Agency, Expertise

Interviewee (wanted to be anonymous), so I will call him John Doe. He works at Skills Inc.

He works as a DSP (Direct Support Professional) and is CRMA certified. He supports 3 individuals in a
residential home who have developmental disabilities.
Developed Questions

1. What services do you provide to the community?

2. What’s one successful program and why? Give me your best example of how you’ve seen your organization’s work
make a difference.

3. What is an area of opportunity for your organization? What could your organization do better?

4. Is there anything that you wish more people knew about your organization or the issues you are trying to solve?

5. Are there requirements for people to use the services you have?
Question Answers
Question 1: “I provide support services to adults with intellectual/developmental disabilities in all areas of activities of daily
living and direct care support surrounding areas of personal care, community inclusion, and social interaction.”

Question 2: “The Driver’s Ed program. It allows these adults to take a driver’s ed class and get their permit and license. This
would allow these adults to be able to go out in the community and have more freedom and independence over their lives.”

Question 3: “Staffing arrangements and communication with all workers, whether they are per-diem or a supervisor.
Communication is something that could be improved because it seems like not everyone is on the same page. Like, some people
know what is going on and some don’t. I can come in one night and there be something that was needed to be done but was not
communicated with me or other workers.”

Question 4: “I wish people knew how hard it is to get individuals out in the community without being judged. No matter how
someone acts, people always seem to be more judgemental before knowing who the person is and who they are as a person.
Judging off of not just looks but also their demeanor and personality. “

Question 5: They have to have an intellectual or developmental disability. Some houses in this community are 18 and up but this
company is trying to implement housing for kids around the age of 14. They also have to be able to financially qualify (like
insurance) as being housed in the company is expensive.”
Impact of Institutional/Structural Oppression on
the Clients Served
From what John Doe explained, clients don’t seem to be bothered by anything. They live their lives normally
and DSP’s are there to support them, but also help them live independently. This agency has input many
policies that allows these individuals to live more independently and have more freedom with what they
want to do. The clients get jobs, they go to community gatherings, and are aided in trying to be as
independent as they can.
Advocating for Clients (Micro, Mezzo, Marco)

Being a DSP is micro work, because John Doe works with individuals in their home and helps them with daily
living,

As for mezzo, he does not do any organizing for things that happen in the community. People who are
supervisors of the house or their HR department take care of that.

As for macro, he does not do any advocating for policies. He would have an opportunity if policies were
detrimental to clients, but it does not seem like that is happening.
Learning Abour Anti-Racist, Anti-Oppressive
Social Work Practice with Clients
John Doe explained the trainings they go through and they have policies on non-discrimination for vulnerable
groups and what to do if those things are violated.

Skills does not discriminate on the basis of sex, gender, sexual orientation, race/ethnicity, or anything of that
nature.

Each month, policies are assigned to workers to go over so they can be culturally aware
New Comprehensions/Insights

One thing I didn’t think of was Adult Protective Services and DHHS. From where I am interning, I am only
seeing the CPS part of it and dealing with families and their children. It made me stop and think what impacts
there are for having APS and pushed me to research the marginalization of these communities. I have only
read about the marginalization of people with ID a few times, but this had me researching about it and even
finding that there was a time in Maine where this population was mistreated.
Reflections of Personal Beliefs

Like I said in the new comprehensions, I never really did a lot of research into the marginalization of people
with intellectual disabilities. I have heard of it through classes in social work, but never researched it more for
myself. After hearing the struggles of people that the interviewee works with and researching hardships, it
made me stop and think about the lives these people may have had before going into residential care. From
what was said, people could have had traumatic experiences before coming to residential care and may have
even came to residential care because they were being mistreated by their families. After the interview, I
better understood the population and it allowed me to reflect over what I had already researched about it
and make connections, like that these people may have more health issues and may have a harder time going
to the doctor.
Section 3
Article 1
Addressing Health Disparities Through Promoting
Equity for Individuals with Intellectual Disability

This scholarly journal by Ouellette-Kuntz et al. (2005) found that physical limitations, mental health issues, visual
impairments, hearing impairments, and communication disorders are more common among people with intellectual
disabilities (ID). They are more susceptible to health inequalities because of their disabilities co=existing with these
types of things. This article reveals the size and kind of health disparities in this community, explores possible
contributing causes to health risks experienced by individuals with ID, and looks at measures to alleviate these
disparities. Their review also found that in terms of some important health indicators, people with ID fare worse than
the general population. These would include the way society has viewed ID, the etiology of ID, health damaging
behaviours, exposure to unhealthy environments, health-related mobility and inadequate access to essential health
and other basic services (Ouellette-Kuntz et al., 2005). There are significant differences in care access for people with
ID, and it can be challenging to separate these differences from discriminatory practices and beliefs. It is
recommended that in order to address the health inequities experienced by people with ID, a clear vision for health
policy and measures be developed.
Article 2
A Pilot Investigation of Safety Concerns Among Direct
Service Providers for Adults with Intellectual and
Developmental Disabilities
Driscoll et al. (2022) explained that they released a survey to evaluate the safety concerns that direct service providers
(DSPs) of persons with intellectual and developmental disabilities (IDD) in community-based group homes (N=59) had.
Out of a list of 25 survey statements, the results showed that respondents had very few safety concerns. There are
other factors that could have affected the results, including the COVID-19 epidemic, the DSPs' safety training, and the
group homes' extensive safety policies. The assessment process is essential for informing prevention and intervention
measures, according to current safety studies in IDD.

The COVID-19 pandemic-related health and safety issues were the two assertions with the highest rankings. Following
were statements about using public transit, walking around the neighborhood, dealing with emergencies, talking with
strangers, and suffering bodily harm at home. Numerous other poll statements, including those involving abduction,
community issues, self-administration of first aid, safety concerns about handling or eating chemicals, and issues with
law enforcement, were rated rather poorly.

The researchers determined a list of safety concerns that should be prioritized about reasons for the results, and
talked about factors that will help the care of a vulnerable population.The study's practical ramifications include the
need for ongoing safety assessments and the fact that the conclusions are subject to a variety of contextual factors,
including the respondents' prior and current experiences..
Section 4
Agency’s Interactions with Population

DHHS, my agency, is not just CPS. There is also Adult Protective Services too, which deals with adults that are
“ incapacitated or dependent” (DHHS, 2024). Like CPS, there is a intake line where people can call if
dependent adults or incapacitated adults are being abused or neglected and then there is an investigation
done. So, DHHS does serve this population and even advocates for ending elder abuse.
Assessment of ADEI in Services (DHHS)

DHHS has so many policies and even has a policy manual linked to the OCFS Brightspace. Of the ones I have
learned about this year, there are many policies that fit ADEI. These are:

● Indian Child Welfare Act

● LGBTQ+
● Domestic Abuse and Violence
● Human Trafficking and Commercial Exploitation of Children
● Child Death and Serious Internal Case Review
● Staff Safety and High Risk Situations
Culturally Aware Services (DHHS)

DHHS effectively provides culturally aware services and makes sure to make it known if policies need to
change or if something is wrong that it is changed. This year, one of the other interns saw that the LGBTQ+
policy was wrong and they identified as apart of that. She was able to give feedback and for the Program
Administrator to make changes to it.
Recommendations to Agency for Population

1. Listen to this population. Just because they understand things differently and act differently than we
do does not mean they don’t know what their needs are. The interviewee told me that sometimes
needs are not met because the agency doesn’t listen, so listening and communication is key.

2. Try to educate this population and make policies for agencies that have residential care, about certain
things like their rights when it comes to dating, money, or other relationships they had. The
interviewee explained that one person he knows deals with things because he feels like he has to and
does not advocate for himself. Educating these people about what their rights are should be a priority.
Bibliography
Bakken, T. L., & Martinsen, H. (2013). Adults with intellectual disabilities and mental illness in psychiatric inpatient units: empirical studies of patient
characteristics and psychiatric diagnoses from 1996 to 2011. International Journal of Developmental Disabilities, 59(3), 179–190.
https://doi.org/10.1179/2047387712Y.0000000006

Owen, D. M., Hastings, R. P., Noone, S. J., Chinn, J., Harman, K., Roberts, J., & Taylor, K. (2004). Life events as correlates of problem behavior and mental health
in a residential population of adults with developmental disabilities. Research in Developmental Disabilities, 25(4), 309–320.
https://doi.org/10.1016/j.ridd.2004.01.003

ADL Education. (2017, March 5). A Brief History of the Disability Rights Movement. ADL.
https://www.adl.org/resources/backgrounder/brief-history-disability-rights-movement

Maine Developmental Disabilities Council. (n.d.). History Project (DD). History in Maine. https://www.maineddc.org/index.php/projects-initiatives/history

Ouellette-Kuntz, H., Garcin, N., Lewis, M. E., Minnes, P., Martin, C., & Holden, J. J. (2005). Addressing health disparities through promoting equity for
individuals with intellectual disability. Canadian journal of public health = Revue canadienne de sante publique, 96 Suppl 2(Suppl 2), S8–S22.
https://doi.org/10.1007/BF03403699

Driscoll, N. M., Rothschild, A. W., Luiselli, J. K., Goldberg, S., Crawley, J., Fofanah, D., & Wangaga, J. (2023). Brief Report: A Pilot Investigation of Safety Concerns
Among Direct Service Providers for Adults with Intellectual and Developmental Disabilities. Journal of Developmental and Physical Disabilities, 35(5), 775-782.
https://doi.org/10.1007/s10882-022-09880-7

Department of Health and Human Services (2024) Adult Protective Services, https://www.maine.gov/dhhs/oads/get-support/aps