Introduction

This chapter is concerned with supported housing options for people with disabilities. A broad scope of issues is covered by the heading of disability, including both mental and physical health and illness, learning disability, physical impairment and disability. The categories used in policy making have varied over time. In Britain, the community care legislation was couched in terms of people with a physical disability; people with a learning difficulty; and people with a mental health problem (as well as frail older people who were covered in Chapter Six). The key legislation in Sweden is the Act Concerning Support and Service Provision for Persons with Certain Functional Impairments 1993, which covers three groups of people: people with an intellectual disability, autism or condition resembling autism; people with a significant and permanent intellectual impairment after brain damage in adulthood; people who have other major and permanent physical and mental impairments which are clearly not due to normal ageing and which cause considerable difficulties in daily life and consequently an extensive need of support and service.

The rationale for covering these diverse categories in just one chapter is partly one of space, but it also registers a concern that the usual categories are restrictive and hide similarities in the needs and characteristics of the individuals concerned. Also, the categories hide the overlaps that often occur. For example, many people with learning difficulties may also have physical impairments, and many older people with dementia or other chronic diseases may have physical and mental health and disability issues. In addition, the categories themselves are contentious. For example, the definition of learning disability in Britain is laid down in the government document Valuing people in 2001 (Department of Health, 2001) and includes a significantly reduced capacity to learn new information or skills, or to live independently, and which started before adulthood. This definition emphasises the functional capacity of the individual and relates this to permanent brain dysfunction rather than to the societal barriers that may hinder independence or functional capacity. The overlaps between the needs and attributes of disabled people and others means that some of the relevant issues have been covered in previous chapters (such as Chapters Six and Seven).