human services


I’ve been concerned for some time that the global economic downturn might lead to a resurgence of institutions as models of “care” for people needing extra support to live in the community.  Sadly, I’m seeing that my fears are well-founded.

Today I opened the Wall Street Journal to an article titled “The Best Thing About Orphanages” by Richard B. McKenzie.  The author seems to know whereof he speaks, in that he references with some fondness his own childhood in an institution.  He doesn’t point out, but certainly could, that the child welfare and foster care system in the US can be the stuff of nightmares.

A few moments later, I cam across the Sacramento Bee news item that  financially devastated California is dramatically reducing funding to help support seniors and people with disabilities to stay in their own homes.  The budget crisis is all too real, and unquestionably some painful budget cuts must be made.  This decision, though, strikes me as rather severe.  Nursing home beds are expensive and scarce, the same Sacramento Bee article mentions that many other supports (the nutrition program, among others) are being eliminated.  The vulnerable are becoming increasingly marginalized.

I don’t doubt for a minute that all the people involved are trying to do the right thing–trying to balance competing priorities.  It is up to us, though, to lead the way and remind decision-makers of the practical consequences of policy decisions.  Despite the challenges, we must not return to the days of institutionalization.

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I’ve presented at conferences on the topic of the importance of social networking and social media for human services providers, and I have posted on this blog many times about our efforts at Keystone Human Services.  Now, many human services providers are on Twitter and Facebook, and it has me thinking about social networking and the people we support.  (For an example of the growing number of service providers on Twitter, see my list http://twitter.com/#/list/jbuford/intellectual-disability.)

People supported by human services providers are all vulnerable in one way or another—some only temporarily, others more systemically—and one of our important tasks is to shore up their areas of vulnerability.  Those efforts can sometimes lead to a blurring of the lines from a professional relationship to one that looks more like friendship.  The ethics of that are clearer in fields such as social work, psychology, and psychiatry (i.e. the principles of confidentiality and dual relationships)  than they are for the people who directly support people with intellectual disabilities, mental illness, autism, or other challenges in the community.  In this setting the guide posts are far murkier .

True to form, I have no answers to these myriad ethical dilemmas.  In fact, I don’t even have the questions.  I have a strong sense, though, that those of us who think we have an obligation to make sure our communities are welcoming to all people, need to think through the hazards, and the benefits, of “friending” people we support.    Already the digital divide disproportionately excludes many people from the community we all enjoy in the social media.

In my organization I’m putting together a diverse panel of people to begin to define questions and an ethical framework, but I’d like to have the conversation here in the social media as well.  Do you or your organization struggle to find the right answer to how to help someone with an intellectual disability navigate Facebook safely, without paternalism or odd blurring of lines?  Have you already answered questions about how to respond when someone you support “friends” you?  Please let me know how you are framing the questions, and maybe we can work together to craft answers.

Thanks!

Over a year ago I had the privilege of attending the expo portion of the Clinton Global Initiative annual meeting.  I was very impressed by all the people I had the privilege of speaking with, and  I wrote about it at the time.   (It’s  a little encouraging, actually, to reread that post and see how energized I was.) While there I visited with the good people from Pure Digital and loved that they were putting Flip video cameras in the hands of nonprofits to document their impact on people’s lives.    Wow, I thought, that would be great for Keystone Human Services, and for human services in general.  Self-documentation fits right in with our mission of supporting people in finding their voice in the community.

So, I am happy and humbled to report that Pure Digital has extended the grant to us, and I now have several Flips in my office, waiting for me to get my act together and create the self-documentation project.  This will be very cool, but I definitely didn’t do enough up-front work on the practical aspects of implementation.  Even people who have managed projects for years can sometimes lose sight of the importance of pre-planning.

It will be cool, though.  Thanks Pure Digital and Flip Spotlight;  you’re helping to Advance the Human Spirit.