Everyone has the right to access healthcare services, whether you have a disability or not, regardless of your needs. But for people with both physical and intellectual disabilities, there can be added barriers to accessing various healthcare services. These include physical access, systematic access, communication, cost etc.
The medical and technological world is improving all the time, and has come a long way since “the old days”, however there are still significant issues in this area that can impact a person’s ability to seek both physical and psychological help. The following aspects are some of the largest barriers a person with a disability can face when accessing healthcare:
Physical access to buildings + equipment
The most obvious barrier in accessing healthcare services is physical access. This can be anything from a medical centre being upstairs, lack of available parking, curbs/sidewalk access that prevents someone from entering a building, high countertops etc. There is also certain medical equipment (or lack of) that a person with mobility issues is able to use. For example, a mammography machine for breast screening requires a woman to stand, there are a significant lack of accessible weight scales in healthcare facilities that do not involve standing, and often eye testing equipment can only adjust to a certain level and cannot accommodate a seated person.
There is also the common issue of communication barriers, such as for the hearing/visually impaired, lack of large print information and verbal communication for people unable to be understood adequately. Further to this, health professionals more often than not, focus more on speaking to caregivers as opposed to the person with the disability, giving little to no eye contact or acknowledgement.
These are just some of the physical issues someone with a disability can face when seeking medical care.
Intellectual disability and mental health support
Nearly everyone has some degree of mental health issues in our society and have a range of service options for support. Those with either physical and/or intellectual disabilities have often been overlooked when accessing mental health services. This could be for a range of different reasons, however, the most common reasons include
Communication barriers of those with intellectual disabilities to express their feelings adequately, and be understood by those around them.
Attributing mental health symptoms as “part of a person’s disability”. This often happens, especially when a support person does not know the person with a disability very well. This type of misdiagnosis often happens with healthcare professionals as well.
Lack of knowledge about how to help someone with both intellectual and mental health difficulties, as there is a lack of information when it comes to this topic, as opposed to the wide range of information one can access without disabilities.
Waiting periods
Waiting periods can often be more problematic for those with any type of physical or intellectual limitations. This can be due to lack of options, lack of specialised services, level of urgency etc. Some people require urgent care from a provider, however the lack of the aforementioned things can prevent this, and often, the more complex needs the person has impacts the length of waiting time.
Transport
Public transport has come along way in terms of accessibility, and has vastly improved over the last 10 years or so, however there are still limitations experienced by the disability world. This includes, but is not limited to, lack of accessible train stations/buses/taxis, a certain mode of transport being unavailable (eg wheelchair access taxis/vans) and inconvenient locations of transport.
Cost/funding
“In Australia, people with disabilities are half as likely to be employed as people without disabilities compared with the OECD average of 60 per cent (Directorate for Employment, Labour and Social Affairs 2009).”
It’s no surprise that people of any level of disability find it harder to find employment, and this only adds to the hardship of being able to access healthcare services and the means to afford it, especially for places that don’t bulk bill.
Lack of training by General Practices
There is currently urgent need for improvement by general practices in the inclusion of those with physical, neurological and intellectual disabilities. There is a huge lack of training, awareness and understanding by general doctors, both in general medical centres and hospitals about complex needs of patients and anyone that presents with a more complex medical background. Doctors are constantly categorizing disabilities as having certain “traits” (especially to those with intellectual disabilities) and therefore fail to recognise any medical issues, are unable or refuse to fill out certain paperwork for a patient, or refer them to specialists, which often results in long waiting periods. There is also the negative stigma attached to disabilities when meeting a new doctor, as assumptions can be very quickly made before getting to know the patient. As previously mentioned, the medical world has come a long way in recent times, however adequate training is needed in this field to improve the overall general care of patients with more complex needs.
Scheduling appointments and timing
Often, scheduling and timing of general appointments are issues faced by everyone, however if you have further complex needs this issue is exacerbated. Inadequate time to fully get to know patient only adds to the lack of understanding faced by those with disabilities. Sometimes, lifestyle and routine medical needs of the disabled interferes with the available time they have to attend appointments, however this is something rarely, if ever, acknowledged.
Overall, these aspects form only part of the barriers faced by people with disabilities when trying to access adequate healthcare. And no matter how little or great our “special needs” may be, we all have the right to the healthcare we require and this industry still has a long way to go.
Written by Liz Thompson a wife, artist, and nature lover, who has been a full-time wheelchair user since the age of 10 years old.
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