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What is inclusion really? I mean really. As a society we generally believe that all people should be able to access spaces, activities, services, and resources they need. But access is more than installing a ramp, promoting programs as open to kids or people with disabilities  or welcoming of 2SLGBTQI+, faiths, cultures, races etc... It’s not just saying “I treat everybody!” Inclusion is being intentional about making your space and service accessible and culturally safe to meet the needs of the individuals you are saying you welcome.

The Accessibility for Ontarians with Disabilities Act, 2005 (AODA)provides the legal requirements, it doesn’t address what it means to be truly  nclusive in your business and practice. The AODA can’t possibly provide direction for every single scenario as true inclusion requires adapting for each person. Inclusive practice requires that we all start from a point of acknowledging our biases and what we don’t know, only then are we open to learn what an individual needs and adapt to best suit them.

To start, we need to acknowledge that not all spaces are culturally safe or truly accessible and ask, “how can we do better?” To be truly inclusive we must move beyond equality and ensure equity. Equality results in everyone being treated the same, regardless of uniqueness of need. Equity means everyone is provided with what they need as an individual. Truly understanding the needs of inclusion can sometimes be complex and take time to do well.

Acknowledging a need to learn and change can be uncomfortable, but as individuals and healthcare providers this is where it begins. To start, believe that people will not ask for accommodation they don’t require, and often don’t ask at all out of fear of discrimination and experiences of stigma. Approach each client and situation with openness and transparency about what you know and don’t know. Approach this work as an opportunity vs a problem to solve. Ask “how can I make this experience safer, easier, and more accessible for you?”

Here are some examples of barriers, and some ideas that demonstrate how we can do better at developing inclusive practices.

Small businesses often good intentioned, miss critical details. Installing a ramp at the door makes a business open to some one with mobility issues using a wheelchair or mobility device, but unless you go the extra steps of making the isles large enough and  without obstacles, then it’s not accessible. To take this example a little further, if everything in the store is too high for someone in a wheelchair to see, then it’s not accessible. There are ways to both maximize store space and make it accessible; it just requires flexibility and imagination.

It is widely known that many individuals have chemical and fragrance sensitivities, yet stores such as pharmacies and department stores locate perfumes and scented cosmetics at the front of the store requiring people to pass through heavily scented areas to reach prescriptions and other needed items. Move the basic needs to the front of the store!

I have always been open to different people including those from the 2SLGBTQI+ community personally, but to have a truly inclusive practice, I had to acknowledge that I probably had more to learn, more to understand. To help bring my practice more inline with the needs of the community, I took additional training from Rainbow Health Ontario. I learned a lot in the two courses I took, decided to update my health history, and can still acknowledge the need for improvement.

Working with kids from a variety of communities means being open to learning from those communities, and their families. Many of the kids I work with require me to find creative ways of communicating with them, more steps, more time, and more tools. Some kids may use a communication board, or a special computer program. Inclusion and adaptation mean it’s my job to make it work, not the other way around. A child who runs away during recreation programs or class, may just need change or more breaks in their programs. It’s the duty of the programs to make this work, not the other way around.

There is reason why people look for healthcare providers from their own communities. My practice is focused on children and youth, but I have heard adults speak of similar experiences as well.Inclusive practice requires an openness to acknowledge the need for improvement, to ask, listen and act. True adaptation requires a willingness to shift from the structures and ideas we’re comfortable with and recognize the needs of the individual vs the dominant culture. Equal is not the same as equity. Equal doesn’t help people who need something different or unique to have their needs met. We should respect each person’s right to self-determination and support them in achieving their goals. We should all strive to be the best allies we can be.

Whether adults or children, we tend to make people jump through hoops to prove they need something. Assessments, documentation, IEPs in school settings. Why not just allow for flexible seating, extra time on exams, more breaks, opportunities to move, sensory and snack breaks, quiet rooms or noise cancelling headphones. Why would we not just make this openly available to everyone, instead of making people work for the help they need. Change and flexibility is not as hard as we think.

The common belief is that inclusion is the norm, and everyone is welcome everywhere. The reality is that inclusion is often performative and not responsive. How often do businesses consult with the diverse communities to ensure they have created truly inclusive space. How often do we ask our patients if our space is comfortable for them or whether our interaction was culturally sensitive. There is a long history in healthcare of not only neglecting the needs of people from communities but harming them because of bias, or lack of interest in seeing another perspective.

The best thing we can do, is to ask how we can do better.


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