Models of Disability

By Aimee Jones

INTRODUCTION

There are various models of disability, but today we are going to focus on just two of them. The two that we are going to look at are;  The Medical Model and The Social Model. 

It is important to note that while models are useful tools for helping people to discuss and think about topics; they can sometimes be overly simplistic and therefore appear more straightforward than they truly are (Ombudman, N.D.)

These two models take very different approaches towards disabled people and the reasons why they may struggle to achieve certain things in their day-to-day lives. For example, why the lady in the wheelchair is unable to access a building. 

Both models are still very much present in today’s society. With most organisations sitting between the two and using aspects of each of them when interacting with disabled people.

THE MEDICAL MODEL OF DISABILITY

This model shows how disability and mental health disorders were seen many years ago and sadly, still by many today. The Medical Model places the individual at the centre and refers to them as ‘the problem’, stating that they are ‘defective’ or ‘not normal’ and therefore they are the reason why they are unable to have access to certain things (MDPAG, n.d). As a result of such thinking, this model focuses on what can be done to ‘fix’ the individual or provide ‘special services’ for them such as:

  • Special needs schools
  • Special transportation 
  • Educational Psychologists 
  • Occupational therapists
  • Benefits 

Taking a look back in history, we can see the dramatic difference between how disabled people were treated back then, compared to how they are treated today.

One of the biggest examples of this is insane asylums. For many years people with disabilities and mental health conditions were sent to asylums and/or workhouses. Sadly, these places were not where people wanted to be. People were treated poorly, with extreme work regimes and poor living conditions; and this was not solely for people with impairments, but also the ‘able-bodied poor’. 

The workhouses were designed to make poverty look even less appealing to people that it already did. Their aim was to drive out the ‘scroungers and the shirkers.’ (Historic England, n.d) Those in such asylums were often referred to as ‘lunatics and idiots’, a very negative approach to vulnerable people within society.

One physician, Benjamin Rush, who worked at one of the asylums in the U.S and has been referred to as the ‘father of modern psychiatry’, believed that using a technique called Bloodletting was the best way of treating individuals with mental health illnesses. 

Bloodletting is a surgical procedure to remove some of the patient’s blood from their body as a means of cleansing. This appeared to make the patients much more calm (although this is now believed to be due to them feeling weakened.) Although this form of treatment was done in kindness and was truly believed to have been helping people; it would now be seen as unkind and cruel (Tartakovsky, M, 2018)

The opinion of such asylums has changed over the years and are very much frowned upon today. In 1866, Physician Sir George Paget stated that asylums are ‘the most blessed manifestation of true civilisation that the world can present.’
130-years later, they were described as ‘museums for the collection of the unwanted.’
Today many people are shocked that asylums and workhouses existed in the first place. 

The medical model of disability, typically blames the individual and their impairment for any barriers that they may encounter in their day-to-day life. 

Thomas Szas, a psychiatrist, is believed to have coined the term, ‘medical model’ back in the mid 1950’s, although people were treated in such a way for many years prior to this. 

Szas is the author of a rather infamous piece of work called ‘The Myth of Mental Illness’ (1960)
In this piece, Szas argues that mental illnesses are in fact a myth. He stated that illnesses in the modern scientific sense, applies only to the body and not to the mind. 

He believed that people could not develop a ‘mental illness’ based on their experiences in life, and that no matter what course their life takes, the illness would have surfaced regardless.
He referred to mental illnesses as being ‘metaphorical illnesses’ and stated that if the individual’s symptoms turned out to be a disease of the brain; then this would be a physical illness and not a metaphorical one.

Thomas Szas stated that he does not deny that people have difficulties, but he preferred to conceptualize them, not as mental illnesses, but as ‘problems in living.’ (Benning, T. 2016)

Szas did not challenge people’s choice of treatment for their symptoms, such as medication, Electroconvulsive Therapy (ECT) or, the more invasive, psycho-surgery. However, he believed that even if these treatments made the individual feel better, they did not, in any way prove that they had ever been ‘ill’ in the first place. 

His views on mental health are seen as quite shocking today, yet to think that this piece was published just 60 years ago, shows that we have come a long way in a short period of time. Even though there is still a long way to go. 

THE SOCIAL MODEL OF DISABILITY

In the 1960’s and 1970’s, disabled people began to question their life experiences and why so many disabled people had been institutionalised and excluded from everyday life. This was inspired by the Great Civil Rights Movements of the time.
Disabled people came together to challenge the assumptions made by society about the things that they could and could not do, as well as challenging the exclusion, discrimmination and the lack of choices that they have been faced with by both the government and society. This saw the beginning of the ‘Disabled People’s Rights Movement.’

At the beginning of this movement, disabled people started to form organisations such as ‘The Union of the Physically Impaired Against Segregation (UPIAS)’ as well as The Liberation Network of People with Disabilities. These organisations were very important for their time; they were run and directed by disabled people, allowing them to enhance their political views and campaign for the radical changes that they wanted and needed in society. Many of the members of UPIAS were within institutions and they wanted to get out and return to society so that they could lead a normal, fulfilling life (Inclusion London, n.d)

The social model sees the problem as being the ‘disabling world’. There are two main problems that disabled people face; one is their impairment, people’s intrinsic problems, sensory impairments, mobility impairments and/or mental impairments. Two, is society’s response to their impairments (Beresford, Nettle and Perring, 2010)  

The social model states that the only thing that disables people, are the obstacles presented to them by society. For example, it is not the person’s impairment that is restricting their access to a building, but the fact that that building does not have a ramp or an elevator. 

Some more examples to illustrate the social model, would be to train all teachers and educational mentors about disabilities and impairments so that disabled people can attend mainstream schools and share experiences with others, whilst still receiving the support that they need. 

We should also be making sure that all buildings are fully accessible for all people, all books should have an audio and a braille version and so on and so forth. 

I am a firm believer of the social model and I believe that we have come a very long way in terms of equal rights for disabled people and there have been some huge changes and breakthroughs in regards to mental health. However, I also think that there are still many things that still need to change in order to fully support people with disabilities and mental health conditions.

RESOURCES:

Introduction to the Social and Medical Models of Disability

Manchester Disabled People’s Access Group – The Medical Model of Disability

Historic England – Disability in the 19th Century

PsychCentral – Margarita Tartakovsky 2018 – The Birth of the Mental Asylum

Szas, T (1960) The Myth of Mental Illness

Benning, T (2016) No such thing as mental illness? Critical reflections on the major ideas and legacy of Thomas Szasz.

Beresford. P, Nettle. M, Perring. R (2010) Towards a Social Model of Madness and Distress?

Hogan, A (2019) Social and medical models of disability and mental health: evolution and renewal.

Scope – Social Model of Disability

Inclusion London – The Social Model of Disability

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