When Getting into the Room is the First Hurdle – Lack of wheelchair access in therapy services

Disabled woman

Blog contribution by Katy Evans

I’ve been turned down by over 100 therapists. Although some turned me down due to lack of availability, a significant number said their venue wasn’t accessible to me as a wheelchair user.

Almost 1 in 5 people in the UK are disabled (ONS, 2015).  Disabled people are more likely to experience mental distress than non-disabled people, yet are significantly disadvantaged when accessing support (Cree et al. 2020).

Growing up, I accepted I could not access certain places because I couldn’t walk. My life changed when I was introduced to the social model. Suddenly I felt rightful anger whenever a design oversight disabled me, through no fault of mine. To use the term disabled people is a political statement, illustrating that we are disabled by society rather than our bodies and minds.

Disabled people are expected to feel grateful for any form of access, as if the ableist world we live in is doing us a favour by facilitating access despite how dehumanising this might be. I’m expected to be grateful I can be in a building even if I enter through dark corridors, past the kitchen and the clutter rather than through the well-maintained front door like everyone else. Every time I venture into public, I ready myself to advocate that my assistance dog is allowed into the building and they’re breaking the law if they refuse. I have sat for over an hour in torrential rain as taxis pulled away because they didn’t want to take my wheelchair. All this takes huge amounts of emotional labour and makes me question the value society places on me. I can never take access as a given but when it came to looking for a therapist, I wasn’t expecting the fight for inclusion I had.

Despite online therapy often being seen as a one-size-fits-all solution for disabled people, I struggle to feel someone’s presence virtually, so when I recently needed a new therapist, I combed through directories for someone to see face-to-face. I quickly received replies saying the therapist’s venue wasn’t accessible. Many were apologetic, but those who displayed no remorse for being inaccessible frustrated me the most. Would it be acceptable to prevent any other minority group attending therapy? Some were willing to try alternative rooms such as in community centres. These were often noisy, cluttered and generally not conducive to therapy. For some, I spent time working out how to get into inaccessible spaces by walking which brought into painful realisation how much my condition had deteriorated in recent years, giving me more difficult feelings to eventually take to therapy. Home visits may solve access issues for some disabled people, although many therapists I contacted were reluctant due to feeling like it overstepped boundaries. Disability often calls for therapists to work outside the box and this is something that needs more attention in therapy training and supervision (see Halacre, 2020). For myself, I highly value the ‘container’ an external room provides and I was unsure about wanting such difficult things being explored and left in my home. However, enforced gratitude meant I felt I had no right to be picky.

I certainly couldn’t be picky when it came to therapists. The simple test of being able to get through their door ruled many out before I got around to assessing our compatibility, their skillset or any of the other qualities people use when choosing a therapist – choice was a luxury I didn’t have. A directory search for local face-to-face therapists generated 505 therapists but when I filtered for wheelchair accessible therapists, just 141 remained, less than 30%. In fact, this was the only directory with the wheelchair access filter – it was non-existent on all the others I tried. This omission echoes Reeve (2004, p.235) who states “this experience of exclusion from services that non-disabled people take for granted, can have an emotional effect on disabled clients because it serves to remind them that they are different and that they are ‘out of place’”.

My experience isn’t unique. I know one wheelchair user whose search result threw up just four accessible therapists. A physically disabled friend was told to go back to the inaccessible therapist when she was “better”. Ashley Cox (2019) made national news when he was rejected by eight therapists for being visually impaired.

Disability affirmative therapy goes beyond accessibility, into fundamental levels of the human experience and the value we place on others. Mingus (2018) explains:

When I say “liberatory access,” I mean access that is more than simply having a ramp…Access for the sake of access or inclusion is not necessarily liberatory, but access done in the service of love, justice, connection and community is liberatory and has the power to transform…I want us to not only make sure things are accessible, but also work to transform the conditions that created that inaccessibility in the first place.

Even when I found accessible therapists, I discovered many didn’t understand my lived reality as a disabled woman and the barriers I face. Instead, they focused on my impairment or congratulated me for doing things they didn’t expect such as simply enjoying my life. When I asked therapists how they would work with my disability experience, many individualised it and explained how they would help me change my thinking to ‘overcome’ my difficulties. Whilst this may minimise my distress slightly, it doesn’t change the reality that inaccessibility and ableism is everywhere. I want someone to hear my anger that so often gets silenced and sit alongside me in the injustice. Reeve (2004) argues therapists need to move away from focusing on the person’s impairment as the source of their difficulties. Instead, she urges therapists to broaden their understanding of social constructions of disability and in doing so, stop pathologising disabled people’s understandable emotional reactions to oppression and ableism.

I am very used to challenging notions of tragedy and having to counteract ableist attitudes. However, I was seeking therapy for deeply personal things. I didn’t feel I had the emotional energy to teach nor did I want to use the sessions I was paying for to do this. In addition, like many disabled people, I have internalised ableism – how would a therapist challenge me on this when they hadn’t challenged their own ableist thoughts?

There are many laws and policies in place ensuring services are accessible to disabled people. As my experience has shown, these don’t stand up in practice. In no way do I think those therapists purposely excluded me from their services but by setting their practice in inaccessible spaces this was the result. I wonder what could have been made of those connections had I been able to get through the door.

For now, my search for a suitable therapist continues…

Note: Spokz People have launched a new Facebook group for networking, sharing good practice and available disability training and CPD. Search for ‘Disability Psychological Practitioners Network’ on Facebook. In 2022, Spokz People are also launching a practitioner CPD and support hub for all things disability related. If you would like to be kept informed of when this goes live, join our Facebook page ‘Spokz People’ or email us on info@spokzpeople.org.uk.

References

Cox, A. (2019) ‘I needed mental health support but eight therapists rejected me for being blind’, Metro, 30 June. Available at: https://metro.co.uk/2019/06/30/i-needed-mental-health-support-but-eight-therapists-rejected-me-for-being-blind-9698621/(Accessed: 24 November 2021).

Cree, R.A., Okoro, C.A., Zack, M.M., Carbone, E. (2020). Frequent Mental Distress Among Adults by Disability Status, Disability Type, and Selected Characteristics. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7499832/(Accessed: 26 November 2021).

Halacre, M. (2020) ‘Working with disability across the counselling professions’. Available at: https://www.bacp.co.uk/media/10780/bacp-working-with-disability-gpacp007-feb-21.pdf (Accessed: 30 November 2021).

 

 

Mingus, M. (2018) ‘“Disability Justice” is Simply Another Term for Love’. Available at:  https://leavingevidence.wordpress.com/2018/11/03/disability-justice-is-simply-another-term-for-love/ (Accessed: 26 November 2021).

ONS. (2015) ‘Nearly one in five people had some form of disability in England and Wales’. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/disability/articles/nearlyoneinfivepeoplehadsomeformofdisabilityinenglandandwales/2015-07-13 Accessed 26/11/21(Accessed: 26 November 2021).

 

Reeve, D. (2004) ‘Counselling and disabled people: Help or hindrance?’ in Swain,J. et al. (eds.) Disabling Barriers – Enabling Environments. 2nd Edition, London: Sage Publications, pp. 233-238.

 

WHO. (2021) ‘Disability and health’. Available at: https://www.who.int/news-room/fact-sheets/detail/disability-and-health(Accessed: 26 November 2021).

 

 

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