The “Models” of Disability

Empty wheelchair at the bottom of a flight of stairsTraditionally there were two ways of looking at disability – the “charity” model and the “medical” model.

The charity model tended to look at disabled people as those in need of help. Unable to do things for ourselves, others would need to look after us, protect us and make decisions on our behalf. As much of this “care” isn’t state-funded, charities needed to raise money, and traditionally this was done by emphasising the helplessness of disabled people. Whilst charities offer vital services, the danger is that this takes any autonomy, independence and even rights away from the disabled individual.

The medical model focuses on the impairment – on what is “wrong” with the person. It looks at the ways in which the person deviates from the norm, and tries to narrow that gap. The assumption here is that “normal” is automatically desirable and to be aspired to. The “problem” lies with the individual and what they can or can’t do.

Then along came the social model. Brought about by disability activists, this model suggests that the person is disabled by society’s inabilities to adapt to their needs. So, for example, the wheelchair isn’t the problem, the stairs are. In the 1970s, a group called the Union of Physically Impaired Against Segregation (UPIAS) campaigned for the rights of people with impairments to participate fully in society, to live indeopendently, to undertake productive work and to have full control over their lives. They stated:

“In our view, it is society which disables physically impaired people. Disability is something imposed on top of our impairments, by the way we are unnecessarily isolated and excluded from full participation in society.”

The social model removes the focus and “blame” from the disabled person to society in general. Since then, the social model has encompassed not just people with physical impairments, but also people with sensory impairments, learning disabilities and mental health issues. The barriers that society puts in our way include physical (the built environemnt) and attitudinal barriers.

There are critics of the social model (e.g. Tom Shakespeare, 2006), and of course nothing is black and white. Until we as a society provide for the needs of disabled people we will rely on charities (e.g. Whizz-Kidz, who provide electric wheelchairs to enable children and young people with mobility problems to lead more independent lives) to some extent. As a disabled person I sincerely hope we don’t abandon the medical model completely – finding ways to reduce or manage pain more effectively would improve the lives of many people. But we can leave that in the hands of the scientists.

For the rest of us, I believe we have a duty to identify and remove the barriers (physical or attitudinal) which prevent disabled people from fully participating in life. Suitable, appropriate and accessible housing, health care, education, access to buildings and information and inclusive employment practices won’t “cure” the impairments, but will mean society can access and benefit from all that disabled people have to offer.

In particular, employers should be looking to identify any physical or attitudinal barriers that prevent disabled people from working there, and then addressing those barriers.

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11 thoughts on “The “Models” of Disability

  1. My main thought is this, Jane, why do we need all this sociological/psychological “models”? Why can’t people just accept each other as fellow humans and put an end to all the crap various disabled groups have to go through to gain acceptance? Also, as disabled people I believe we are what we are for a very good reason; it’s to show society that we are different as individuals but that shouldn’t mean we are worth more or less than a so-called “able-bodied” person should it?

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    1. I agree with you Aidan – I’d love to live in a society which values and respects all fellow human beings equally. If that was the case there would be no need for models – we could all just get on with living our lives.

      Sadly, ‘tho, there is still much discrimination against disabled people, and it is necessary to explain that the “problem” isn’t the disabled person, it’s the inability of society to accommodate all of its citizens.

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  2. I neither agaree nor disagree fully with the medical or social model, much as some would like to ignore the medicalaspects of disability you can’t. For example the inabilities caused by pain or fatigue, are fromsocietythey are from your condition. Similarly steps, or bad social attitudes are from society, not a factor of your disability.

    The Charity Model,I hadn’t heard of,and in any I wouldn’t differeniate since its part of the attitude that is alive and well within the social model in my opinion.

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    1. Yes I agree Debbie. Whilst I focus my attentions on challenging some of the stereotypes around disabled people and promoting the social model, I’m still hoping that scientists will find an effective treatment to reduce my pain levels with few side effects!

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  3. I don’t like the ‘model’s’ – people use them to tell me ‘I carn’t do this’, ‘should do that’, ‘need to do this’ but none of these well meaning people ever take the time to sit down and say “what can we do to help you be as indepoendant as possible?”

    What I need is for someone to see me as a person ans to engage with me as an equal – asking me what assistance I need and what I can manage for myself and then providing the asistance I need to enhance my ability so that I can do as much as I can to be “normal” whatever normal is these days.

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    1. Indeed, Jean. Being treated as equals, leading the discussion around what assistance we might need, having our qualities valued – it dosn’t seem much to ask, does it?

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  4. Firstly, I would say that anyone is at liberty to construct a “model” – a device to explore or examine an idea or argument. They are they simply to allow us to examine ideas and should not be seen as ‘tablets of stone’. I would also suggest many people create ‘their own models’ based on those that originate with Mike Oliver. This means talking about THE social model, for example, might not be exactly true because what is being offered is an ‘interpretation’. This goes, of course, for my comments too!

    Most of the blog I would sign up to, however, there is a problem area in my opinion which has led to utter confusion down the years. Oliver never spoke about a “medical model” and over time neither do I. For Oliver the “models” focus on the ‘location of disability’ – the dominant view is that disability is within the individual’s conformity (the individual tragedy) and the alternative view fostered by UPIAS being that disability is the imposed social restrictions. What the ‘individual model’ does is explore the ideas and practices that stem from seeing ‘impairment as the cause’ of all of disabled people’s “problems”. Our bodies, I would argue, become a battleground because society views them as ‘unacceptable’.

    If an individual views having an impairment as ‘tragic’, that is a personal appraisal, but if society uses this as its baseline then it can have oppressive consequences. Our ‘non-conformity’ (having impaired bodies) has been made sense of through the ‘medicalisation’ of our lives. This is why there’s a tendency to talk about a medical model. Where there’s confusion is over the difference between the policing of what is judged to be “normal”, through medical ideologies and practices, and the role of medicine in the arena of health and well being.

    Thus it’s the ideologies underpinning the ‘individual tragedy’ approach to disability that is the problem within medicine, not the issue of addressing illness, disease and impairment per se. The same applies to charity – it’s the way disabled people are viewed that leads to oppressive practices. In my opinion, “medical” and “charity” models merely highlight specific areas of intervention where the individual tragedy approach towards disability is dominant.

    Finally, I would argue ‘models’ are often taken out of context. Both the ‘individual’ and ‘social’ models address how different approaches to disability operate and can be used as tools to address various issues. They are not about all aspects of disabled people’s lives and shouldn’t be employed in this way.

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    1. Thanks for such a comprehensive comment Bob – there is certainly much food for thought there.

      I’m less concerned about what we call each model than about how we help society view disability. The social model, with all of its flaws, at least takes the emphasis off the individual and back onto society and its obligations to include everyone.

      I work with both employers and disabled candidates, and I’m keen for the employer to see what they can gain from employing the disabled person, whilst putting any required reasonable adjustments into place to remove that aspect of disability.

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      1. As Bob points out, “models” are merely devices which must necessarily be used to analyze and define the nature of the oppression that Disabled people face. To reject the idea of “models” is to dispense with those devices within any discourse relating to the social reality of disability.
        Specifically, your assertion that “employers should be looking to identify any physical or attitudinal barriers that prevent people from working there…” assumes that, having done that, employers would more readily employ Disabled people.
        I don’t believe that this is true. Historically, the reasons behind the reluctance of (most) employers to employ Disabled people has been based on the perceptions that they may have about what Disabled people can do, as well as being reluctant to make the changes in the workplaces necessary to provide an accessible workplace for Disabled employees. This is usually for financial reasons and, in the current economic climate, it would seem highly unlikely that this situation will change.

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      2. I agree with much of what you say, Kev – perceptions of disability and fears around what employing a disabled person might involve are a huge barrier. Education, awareness-raising and help with funding for reasonable adjustments (through Access to Work) should help – sadly, this all takes a very long time. Far too long.

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  5. Why not leave it to each individual sick and disabled person to use which ever model they feel comfortable with. Or all models – pick and mix.

    Let them go to doctors for help using the medical model.

    Let them go to charities for support using the charity model.

    Let them demand employment with reasonable adjustments using THE Social Model.

    But if THE Social Model fails them because they have Impairment that Impairs let them use another version of the Social Model.

    If they find Impairment is a problem when they go head to head with the neoliberal competitive labour market – then let them use another version of the Social Model that identifies the neo liberal labour market as a barrier.

    Paralympians are proud. They achieve amazing things but they don’t compete head to head in mainstream sport. Let people use that model. Women didn’t achieve equality in the work place without massive legislative change around maternity, flexible working and child care.

    Without legislation as women had – the competitive labour force will exclude many sick and disabled people because of real Impairment – not unfounded prejudice – as Tom Shakespeare has always argued.

    Until legislation can sort this out sick and disabled people need to proudly own the problem of Impairment and demand legislation to fix it and in the mean time safe secure benefits.

    The current situation where there are no quotas, subsidies, sheltered working – what ever it takes – and pressurises them to compete in the open labour market with sanctions and time limits is a scandal.

    There is no reason to lose all the gains of Inclusion made under THE Social Model – THE Social Model can be extended to also include the reality of Impairment.

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