Confronting Stigma within the Services System

Stigma is a major problem for many clients of social work services, particularly people who are labeled with mental retardation (Mackelprang & Salsgiver, 1996; Schwartz, 1992; Witkin, 1998). Stigma problems interfere with people's opportunities to succeed and hinder their efforts to become more normalized. Unfortunately, the delivery system that serves people with a mental retardation label is often an inadvertent perpetrator of stigma (Jaskulski, Metzler & Zierman, 1990; Wehmeyer & Metzler, 1995). This article offers three major tasks that social workers can take on to overcome the stigma that the system is fostering. The concept of stigma refers to negative social meanings or stereotypes assigned to a people when their attributes are considered both different from or inferior to societal norms (Goffman, 1963). A major characteristic of stigma is that it is instrumental in restricting a person's ability to develop his or her potential (Coleman, 1986). In the case of people labeled with mental retardation, negative social meanings or stereotypes are assigned to them on the basis of others' awareness of their cognitive challenges. Typical stereotypes assigned to them include being incapable of thinking or speaking for themselves, being unable to live independently, and being unable to become employed in the competitive work world. Historical Context of Stigma The national deinstitutionalization movement, beginning in the 1970s, has reawakened our society to the basic human rights that have been denied to people with a mental retardation label. Over time this movement has discharged tens of thousands of people from large institutions to the community. The movement has been a long overdue response to a previously forgotten segment of our population and has brought them unprecedented freedom, opportunity, and access to a more normalized life. The movement offers a radical departure from the previous institutional era that existed for more than a century and fostered isolation, regimentation, and dependency. This movement has had major success in many areas. Significantly, numerous formerly institutionalized people have been physically integrated into the community. For example, most of their living arrangements are now in apartments and houses in the community, and many travel to a work site in a commercial area for vocational or prevocational activities. Also, this community service system continues to be reasonably successful in preparing its clients with a broad array of basic skills needed for greater independence and self-sufficiency. Many have developed skills, for example, in hygiene and grooming, communication, maintaining a household, and using public transportation. Normalization theory, the predominant philosophy that has driven this movement, has helped establish the belief that all people with disabilities should have the opportunity to live normalized lives to the extent that their disabilities allow (Brown & Smith, 1992; Flynn & Nitsch, 1980; Wolfensberger, 1972). The ambiguities involved in defining a "normalized" environment and the challenges to implementing such an ideal have led to alternative goals as well. The "least-restrictive alternative" is one example (Turnbull, Ellis, Boggs, Brooks, & Biklen, 1981). This concept offers a less complicated set of criteria than normalization for designing residential services, habilitation plans, and support services. The least-restricted alternative also has been used in court decisions to clarify that people with mental disabilities have a constitutional right to protection from "undue restraint." Wolfensberger (1983) crafted another helpful concept, "social role valorization," for guiding the design and practice of service provisions. Creating and supporting socially valued roles for people in the community is highly desired in areas such as employment, family relationships, household management, and community activities. …