I hated it (the hostel). The toilets and showers are no good. It gets all blocked up. The house isn’t straight. The stumps are loose and they got disturbed in the big rain. The hostel was no good. He (the manager) would tell me to do things. I was washing up and cleaning. He wanted me to run his computer.... He said I couldn’t stay if I didn’t. So I made trouble for him. (O’Connor & Fowkes, 2000)
The impact of a person’s living situation on their overall well-being is as significant for people who have an intellectual disability as it is for any other member of the community. In fact, the security and appropriateness of a person’s accommodation can impact more significantly on a person who has an intellectual disability, who may find it harder to negotiate housing challenges (such as difficult neighbours or inaccessibility to transport). Issues related to housing may be due to challenges that are related specifically to the person’s disability, or to multiple social disadvantages that people with intellectual disability often experience, such as poverty, discrimination and social isolation.
People who have an intellectual disability might live independently in the community (alone or in shared housing), in a ‘group home’ or supported accommodation, or with friends or family members. It is interesting to note that only about 15 percent of people with moderate to high-level intellectual disability receive services in Queensland (Irons, 2011), which suggests that the vast majority of people with intellectual disability live independently in the community without the support of service agencies – either alone or with family or friends.
The complexity of a person’s vulnerability is often closely related to their housing situation and level of independence in daily living. For example, people living in group home situations may have less choice and independence, and therefore may be vulnerable to abuse, neglect or exploitation by staff or other decision makers. However, people with ‘mild’ levels of disability who live independently and without agency support may have more choice and independence in day-to-day living, but may have limited capacity to make good choices to keep themselves safe and protected from exploitation or abuse by others (K. Ellem, personal communication, 28 April 2011).
Homelessness is a significant but under-recognised risk factor for people with intellectual disability. One recent study in the United Kingdom found that homeless people are significantly more likely to have an intellectual disability than the general population (Oakes & Davies, 2008). This is presumably due to the other inter-related risk factors that are common for this group, such as:
- Over representation in the criminal justice system
- High rates of alcohol and other drug use
- Poor physical and mental health
- Difficulty managing verbal communication
- Lack of appropriate education and employment opportunities
- Vulnerability to financial exploitation
- Social isolation.
It is extremely important to be aware of the client’s living situation when working with clients with intellectual disability.