This session talked about people with stronger disabilities. They are called people with complex needs because they need more assistance. Often they are denied their rights. With the right support they can also make choices and take part in the community.

This workshop looked at the issue of discrimination against people with more complex needs, and possible solutions to this.  Maria Carmen Malbran (Argentina) was the moderator for this session.

Dr Johannes Schädler (Germany) spoke about the European study on discrimination of people with complex needs.  This study explored the experiences of people with complex needs in 12 European countries, using the life course approach.

The study suggests that we all have an 'institutionalised life course'.  This means that our life paths from birth to death are lived within a series of 'institutions' (schools, families, colleges, places of work, marriage and so on) which provide a 'frame for personal growth'.

People with complex needs are at risk of being denied access to these 'normal' institutions, and so being seen as the 'eternal child' or 'early retired'.  These risks are greatest at the points of transition in their lives. 

Very often the exclusion of people with complex needs is taken for granted, yet it is a complex interaction between their impairment and the attitudinal and environmental barriers they face that actually hinders their participation.

Beverly Dawkins (UK) spoke about the fight for the rights of people with very profound and multiple disability (pmld) in the UK.  The European study revealed that the greater the progress to mainstream services, the higher the risk of exclusion and segregation for this group.  This arises because of poor understanding of their numbers and their needs, lack of representation of their interests, failure to plan services that take account of their needs and their voices not being heard due to the difficulties they have with communication.

Policy makers in the UK simply do not know any people with pmld, and so they remain invisible.  The PMLD network in the UK has been working to fight this, and has been successful in getting specific actions to meet the needs of people with pmld written into the English government's most recent policy paper, Valuing People Now.  However, we must continue to fight hard to ensure that people with pmld are seen, valued and given rights and choices over their lives.

One recent success story is the Changing Places, Changing Lives campaign to have fully accessible toilets provided in public places in the UK, so that people with pmld can be more included and visible in their communities.

Sadly, Mencap's Death by indifference report highlighted the stories of 6 people with pmld who died because doctors and nurses did not understand their needs, so there is still much work to do.

In order to achieve full rights and inclusion for people with pmld we need to: challenge policies, attitudes and physical barriers; involve families and people with pmld; and demonstrate good practice in inclusion.  In doing so, we must remember that the needs and circumstances of each person with pmld are highly individual to that person.  There can be no 'one size fits all' solutions, rather we must be prepared to really listen to each person with pmld and the people who know them well, such as families, friends, teachers or supporters.