Around system. For example, one may not acquire a

Around 1.5 million people in the UK experience some
form of intellectual disability (ID) and are often victims of stigmatization (Emerson
et al., 2011; Sin et al., 2009). Goffman (1963) defined stigma as the devaluation of an
individual who has divergent traits to the general population whereas
intellectual disability (ID) is defined as a significant limitation in an
individual’s intelligence and behavior which affects their social and practical
skills (Schalock et al., 2010). Stigmatization occurs in most settings such as
the workplace, education and even in the criminal justice system. For example,
one may not acquire a job after completing their prison sentence because they
have been branded as a criminal although they have already accepted and
completed their sentence.

Thus, this essay will discuss the reasons for
stigmatization towards people with intellectual disability (ID) with an
evolutionary approach by Tooby and Cosmides (1992). However, the system
justification approach and labelling theory also provide some evidence for the
mechanism behind stigmatization (Goffman, 1963; Jost & Banaji, 1994).

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Additionally, employment, health and relationships will be explored as a
consequence of being stigmatized as an individual with ID and how this has an
impact on the people around them as well. 

order to tackle the problem of stigmatization, there are many acts in place to
support and empower people with ID. The Chronically Sick and Disabled Persons
Act was introduced in 1970 and was the first of its kind to recognise and give
rights to disabled people. The act aimed to improve the quality of life for
disabled people by ensuring local authorities provide disability friendly
facilities and services, such as disabled access to public toilets, railway
stations and universities. Following that, the Disability Discrimination Act in
1995 gave disabled people rights to prevent discrimination in the work place,
education and transport. In 2005, the Mental Capacity Act tackled the issue of
decision making by disabled persons by providing a framework to make clear who
can make decisions and in what circumstance. Finally, in 2008 the United
Nations introduced the UN Convention on the Rights of Persons with Disabilities
which aims to promote equal rights and reduce discrimination of people with
disabilities. However, the convention often fails to emphasise people with ID
in their policies, this could be due to the low visibility of ID, contributing
to the lack of prioritisation it deserves (Belton et al., 2016).

 Despite all the
legal acts in place to reduce stigma and to improve the quality of life of people
with ID, stigmatization towards people with ID still happens frequently and are
often in forms of bullying, abuse and harassment (Sin et al., 2009). This can
have adverse effects on the stigmatized: adolescents who were most aware of
being stigmatized had the lowest self-esteem (Dagnan & Sandhu, 1999;
Szivos, 1991). Thus it is important to understand the origins of such behavior
in order to provide effective interventions to reduce stigmatization on people
with ID.

An evolutionary approach by Tooby and Cosmides (1992)
suggests that the mind consists of multiple information-processing systems and
is designed in a way to solve problems with social adaptation, thus causing the
person to socially exclude an individual with ID. As observed by Darwin (1859),
the process of natural selection is to rule out weak individuals – a “necessary
evil” within a community in order for the continuation of the species. Besides
this, Kurzban and Leary (2001) suggests that stigma functions as a mediator and
that it provides a necessary pressure for natural selection.   Taken together, individuals with ID are
stigmatized due to the natural process of filtering and eliminating combined
with the mind processing and solving social problems to ensure the continuation
of desirable genes to optimize the chances of survival as a species.

However, although the theory suggests that humans are
programmed to marginalize a person with disabilities, it does not explain why
some people welcome, accept and even fight for people with disabilities. Does
this suggest that people who are willing to stand up for people with ID have a
defect in their processing abilities? Nonetheless, the evolutionary theory
provides a probable framework of how stigmatization is formed and provides a
first step into the design of the mechanisms in place in order for natural
selection to occur.

On the other hand, the system justification approach
as proposed by Jost and Banaji (1994) aims to describe the psychological
process of justifying the social and economic systems the individual is living
in, at the expense of their personal and group interest. This is accomplished
by judging members of the society by looking at their deservingness and
contributions to the society as well as their positive and negative traits
(Jost & Banaji, 1994). Thus, this theory would suggest that individuals
with an ID might be stigmatized due to their inability to contribute and
fulfill roles in the community due to their disability, and therefore causing
them to be marginalized from the society. Indeed, a study by del Prado and
Bustillos (2009) found that people with disabilities were perceived as threats
to resources and this acted as predictors of their attitudes towards
individuals with disabilities.

Still, the justification approach does not take into
account the different types of communities and cultural differences that might
be influencing the extent to which stigmatization is experienced by an
individual. For example, in Japan two thirds of adults do not report their
disability due to a fear of stigmatization by the community (Desapriya &
Nobutada, 2002) whereas in America, the public seem to be comfortable in
reporting their disabilities and mental health issues and are generally more
willing to seek treatment (Mojtabai, 2007). Therefore, the system justification
approach only provides a general view for stigma development and is not
generalizable to all communities.

Stigmatization affects the individual in multiple
aspects of their life. The labelling theory suggests that self-identity of an
individual may be determined or influenced by the terms used to describe or
classify them (Goffman, 1963). In this aspect, a person with ID might
internalize with their label of being “dangerous” and commit a crime. This
might lead the individual to feelings of low self-worth as they are then viewed
as a criminal in the society. Therefore, self-stigma occurs when the individual
internalizes the stereotypes imposed onto them which causes self-prejudice and
negative consequences such as low self-esteem and feelings of low self-worth
(Ali et al.,2016).

However, the social comparison theory by Festinger
(1954) suggests that individuals often compare themselves to others when
evaluating the self and this could be the case for people with ID where they
socially compare with adults of the general population. A study by Thomson and
McKenzie (2005) found that an understanding of their disability does not
necessary cause a person to internalize it in a negative way, refuting the
labelling theory. Besides this, individuals who had a negative social
comparison score also reported low self-esteem and high depression scores as
found by Dagnan and Sandhu (1999). Suggesting that other factors might be
influencing the person to judge themselves in a bad light, and not only the
labels imposed onto them by the society.

In addition to the self-stigma experienced by people
with ID, friends and family of the individual also experience courtesy or
affiliate stigma. Courtesy stigma is a stigma experienced by an individual
because of their relationship with someone who has a stigmatizing feature
(Birenbaum, 1992). In other words, the people around the stigmatized also
experience some form of exclusion due to their proximity with someone who is
deemed socially divergent. For example, mothers are often blamed for their
child’s disability and families are often excluded from fully integrating with
the community in Asia (Fazil et al., 2002; Mirza et al., 2009). Chang (2009)
interviewed 38 disability rights activists and found that mothers are more
likely to be blamed for their child’s condition as compared to fathers. A
survey of 81 mothers with a stigmatized child with ID found that the degree to
which the mother experiences perceived stigma has emotional impacts such as
shame and guilt on themselves (Green, 2003). There are many factors that may exacerbate the
experience of courtesy stigma by the parents of a stigmatized child.

Unemployment, the lack of health and sexual understanding on the child’s part
may add to an increase in perceived stigma for the parents, which contributes to
subjective burden due to emotional distress (Green 2003).

In terms of employment, people with ID reported that
they have high motivation to work and feel that work will benefit them although
they are not employed as often as adults without disabilities (Domin &
Butterworth, 2013; Emerson et al.,2013). People with ID are often stigmatized
and not offered employment, although the few that has been given the
opportunity to work reported social exclusion even though the nature of the
work is inclusive; social inclusion is rare and not desired by people with ID
due to the continued exclusion already experienced by them (Hall, 2004).

Nonetheless, people with ID still desire to work as it promoted social contact
between work colleagues which created a sense of belonging through social
activities such as having lunch together and frequent contact with others
(Lysaght et al., 2016).

Besides this, young adults with disabilities often do
not enter full-time employment after graduation and only enter entry level,
unskilled positions (Hasnain & Balcazar, 2009). This could be an issue as
people with ID often engage in social comparisons and a greater perceived
stigma is negatively correlated to self- esteem, suggesting an upward social
comparison with the general population (Paterson, McKenzie and Lindsay, 2011). However, a study by Monteleone and Forrester-Jones (2016)
interviewed 15 individuals with ID working in a day farm and found that most of
the participants displayed downward social comparisons, suggesting a high self-esteem.

This suggests that being isolated from other more competent groups protects the
stigmatised group from the effects of stigma. Although some support is given by their employers in
terms of changing job roles to fit in with the individual, just having a job is
not enough to lift the stigmatization on these individuals because it is not
what the general employed population is only entitled to. Low wages, poor
advancement opportunities and limited hours are still problems faced by people
with ID (Lindstrom et al., 2014).

In addition, people with ID often have a poor
understanding of health issues as compared to people with a physical disability
or people with no disability (Pownall, Wilson & Jahoda, 2016). This leads
to a shorter life expectancy for people with ID as compared to the adult
population (Emerson & Baines, 2010). Indeed, Mencap (2007) documented
several instances of negative attitudes of doctors which caused the preventable
deaths of patients with ID. Around 1,250 people with ID die each year due to
preventable deaths in NHS care, despite all the anti-stigma campaigns and
stronger emphasis on the equality of delivering care (Harwood & Hassiotis,
2014). People with ID are often stigmatized in healthcare settings with
professionals documented to be uncaring, lacking empathy and inhuman towards
them (Department of Health, 2012).

The intergroup contact theory by Pettigrew (1998) is
frequently used in interventions to reduce prejudice and could come into play
as a framework to reduce stigma as constructs of prejudice and stigma overlap
each other (Phelan et al., 2008). The theory suggests that frequent contact
with the outgroup (people with ID) will promote greater understanding and will
reduce any misconceptions. An earlier study by Wishart and Johnston (1990)
provided evidence that frequent contact between people with ID and medical
students was successful in reducing stigma as compared to control groups.  Shearn and Todd (1996) reported that although
parents experienced an increase in courtesy stigma in their community as their
child’s disability became more apparent, there was a decrease after a certain
point due to the community getting to know their child. Suggesting that the
intergroup contact theory might be beneficial in reducing stigmatization
towards people with ID.  

Besides employment and health, people with ID are also
stigmatized in the relationship and sexuality aspect of their lives. People
with ID are often seen at both ends of the sexuality spectrum: as child-like,
devoid of sexual desires or over-sexed and dangerous (Gougeon, 2009; Murphy,
2016). This leads to problems such as the lack of sex education by parents and
schools (Gougeon, 2009). Isler et al. (2009) found that parents are less likely
to discuss issues of sexuality with their child with ID as compared to the
general population. This could be that the parents do not have support and
guidance on how to approach the topic, especially foster parents (Brown &
Rodger, 2009).

Therefore, sex education should be made compulsory in
all foster homes and schools; staff should also be sufficiently trained to be
able to react and provide support. Nareadi (2013) conducted a semi structured
interview with teachers who worked at a school that catered for adolescents
with ID and found that a lack of training prompted the school teachers to
overlook the issue of sexual abuse when raised by students. Nareadi (2013) also
found that the parents of the child were unwilling to report instances of
sexual abuse in fear of the courtesy stigma they would experience: rejection by
the community and fear their child would be seen as over-sexed.

From a different perspective, people with ID are
over-trusting, and are not able to judge others or predict motives. They often
do not see themselves as victims and this could cause problems in identifying
sexual abuse in the first place (Grievo, McLaren & Lindsay, 2006). This can
be avoided by providing a trauma based approach to sex education so that the individual
has a better understanding of the effects and signs of trauma. An approach that
emphasizes safety, trustworthiness and empowerment could be highly beneficial
(Ghandour, Campbell & Lloyd, 2015).

Although there are interventions designed to reduce
stigma, there is a lacking in trained professionals to tackle this issue (Griffiths et al., 2017). There should be more support and practical training
as part of courses to prepare professionals such as teachers and medical
students, in the treatment of people with ID. In this regard, a prevention
approach could be more effective than a cure (McLean, & Gibbs, 2010). Future research is also needed to provide a better
understanding of the definition of stigma so that the interventions are
effective and target appropriate groups. 

discussed above, stigma does not leave the stigmatized with positive effects:
low self-esteem, self-stigma and courtesy stigma are all negative consequences
of being part of a marginalized community. Although multiple theories have been
put forwards such as the evolutionary theory, system justification, labelling
and social comparison theory, all are seen with equal importance as and it is
thought to play a part in the reason for stigmatization. Besides this, people
with ID have shown to be stigmatized in multiple aspects of their lives such as
their employment, health services and intimate relationships which has negative
effects on both them and their families.