Application of the International classification of functioning, disability and health in Taiwan: victory of the medical model

Abstract

Since July 2012, eligibility for disability benefits and services in Taiwan has been assessed based on the International Classification of Functioning, Disability and Health. This study examines disabled people’s experiences of this new assessment system: does it incorporate the social model or a multidimensional understanding of disability and assess the needs of disabled people adequately? In-depth interviews were employed with 24 disabled persons to answer these questions from the perspective of disabled people. The findings show that the new assessment model is still medicalised: social roles and social participation are not considered, the assessment process is dominated by professionals, users’ perspectives are not included and only those who are assessed to have a high level of disability are satisfied with the new system while many others would prefer the old assessment system. These findings have relevance for the analysis of needs assessments of disabled people in different countries.

Keywords:

• International Classification of Functioning, Disability and Health
• medical model
• social model
• participation
• needs assessment
• Taiwan

Acknowledgements

Special thanks to Qi Zhi Vocational Training Centre Chairperson Mr Chun-Shin Lee who sponsored a part-time research assistant to help in transcribing the interviews. The authors would like to thank all of the participants for sharing so much.

Notes

1. A flat or a house located in the community with a maximum of six residents with intellectual/mental difficulties living together, provided and managed by a non governmental organisation (NGO).

2. Although these four persons had not yet been assessed by the new system, they had been involved in pilot testing of the new system or otherwise had experiences of it.

3. In this study we missed the opportunity to interview service users with LD and thus to make their voice heard (e.g. concerning their attitudes towards the new assessment system). This is a limitation of our study, and further studies are warranted to focus on this group of people’s own perceptions in this regard.