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taken on their behalf, nor are they provided with a choice of service provision. Recognising
people’s status as ‘full citizens’ is therefore an important part of social work. The needs-led
assessment should address a range of activities geared towards reducing risk, maximising
independence and improving quality of life. Support services for people with epilepsy should
include the promotion of employment, education and leisure opportunities as part of a
programme of developing independence and life skills.

Disability and management of risk of harm

The Report of the Inspection of Scottish Borders Council Social Work Services for People
Affected by Learning Disabilities outlines substantial failings in services designed to protect
vulnerable adults.9 The report looked at the prolonged financial, emotional, sexual and
physical abuse of a woman with a learning disability over a lengthy period. The woman’s
case was opened to both health and social work.

There are increased risks of many forms of abuse and exploitation where people have any
form of impairment in cases where their disability presents as a barrier against them taking
action to protect themselves. The report also implied that disablement factors may
discriminate against a person obtaining appropriate services and protection. Unfortunately
there are areas of the service provision where the person’s need for care, support and
protection in the community is not met. It is apparent that this is not due to a lack of legislation
in place to protect people however. Practitioners need to be aware of the increased risks posed
to people with epilepsy where people can have more than one impairment, and the risk to the
person of failing to meet those needs.

Sexuality

A social worker working with service users with epilepsy has to look at all aspects of that
person’s life. Sexuality is included in psychological measures of quality of life, such as the
World Health Organization’s Quality of Life Scale. However, sexuality is often omitted from
the representations of disabled bodies and therefore excluded from the identities of disabled
people. It has been suggested that disabled people are treated in an asexual way by their
parents, healthcare and social care workers,10 and that this is fuelled by the belief that disabled
people are incapable of having or being interested in sex.

Berman et al11 examined sexual knowledge, sexual behaviour and beliefs about sexuality
among adolescents with congenital physical impairments. The authors felt that the lack of
research in this field was disturbing because sexuality is a central concern of adolescents and
their families, and because its absence in the literature reinforces the myth that disabled
people are not sexual. They found that adolescents with physical impairments are generally
uninformed or misinformed about sex and sexuality and how these relate to their impairment.

A social worker can assist a person with epilepsy and/or a learning disability access specialist
dating agencies which help a person find a partner, while providing support and assessing
risk. A social worker can also support a person with epilepsy and/or a learning disability
during pregnancy and assess any risks to the mother and baby, though this can lead to what
is normally a ‘private/personal’ experience for an able-bodied person becoming a publicly
controlled experience for a person with epilepsy.

Employment and economic contribution

The social model of disability also relates to economics in that it proposes that people can be
disabled by a lack of resources to meet their needs. The model looks at the underestimation
of the potential of disabled people to add economic value to society if they are given equal