Dominant Health Discourses in Action: Constructing People with Disabilities as the "Inadmissible Other" in Canadian Immigration Yahya El-Lahib Faculty of Social Work, University of Calgary

Keywords:

Ableism; Sanism; Colonialism; Immigration; Governmentality; Postcolonial Disability Studies; Social Work, Helping professions; Critical Discourse Analysis

Abstract

This paper reports on a Critical Discourse Analysis study situated within a postcolonial theoretical framework and informed by Foucauldian analysis and the lens of governmentality. The study examined official Canadian immigration documents and guidelines. Findings suggest that discourses of risk and protection are used to mask dominant health discourses that construct immigration applicants with disabilities as the "inadmissible Other". Implications for social work and other helping professions involved in facilitating immigration and settlement for newcomers with disabilities are discussed, and suggestions for future directions in research are offered.


Introduction: Background & Theoretical Underpinnings

Canada praises itself on its "welcoming" immigration policies; yet, when examined more closely through a critical and postcolonial disability lens, this claim can be challenged. Specifically, this paper aims to demonstrate how the use of dominant health discourses acts as an exclusionary mechanism that constructs people with disabilities, especially those from countries located in the global South as inadmissible "Others." This paper builds on the work of scholars in disciplines such as social work, disability and immigration studies who have argued that displacement experiences such as immigration have intensified the marginalization of people with disabilities (El-Lahib & Wehbi, 2012; El-Lahib, 2015; Baynton, 2005; Chadha, 2008; Hanes, 2009; Lacroix, 2006; Mirza, 2011a & b, 2014; Soldatic & Fiske, 2009; Sodatic, Meekosha & Somers, 2012). These scholars have noted the need to address the challenges experienced by immigrants and refugees with disabilities during the settlement process. However, there are currently very few explorations focused on the immigration process and specifically the application stage at which applicants are assessed and constructed as either admissible or inadmissible.

Even within the critical disability scholarship, there is a dearth of attention paid to issues of immigration and other issues touching the lives of people with disabilities from the global South (El-Lahib & Wehbi, 2012; El-Lahib, 2015; Baynton, 2005; Grech, 2011a, 2011b; Meekosha, 2006, 2008, 2011). Critical disability scholars writing from a postcolonial perspective assert that this scholarship has been dominated by global North concerns (Barker & Murray, 2010; Chataika, 2012; Ghai, 2001, 2012; Meekosha, 2011; Sherry, 2007). Indeed, Barker and Murray, Grech (2009) as well as Withers (2012) note that the current dominant understandings of disability were developed in Northern contexts reflecting Western priorities, practices, research and activism, and do not necessarily represent understandings of disability in the global South.

Responding to this gap, postcolonial disability scholars have pointed to the need to examine issues of North/South power relations as they intersect with experiences of disability (Barker & Murray, 2010; Chataika, 2012; Ghai, 2001, 2012; Goodley, Hughes & Davis, 2012; Grech, 2009, 2011a, 2011b; Meekosha, 2006, 2008, 2011). As Grech (2012) suggests:

Disabled people exist, live, operate and are constrained by coloniality in its multiple forms (…) Disabled people are therefore repositioned as neocolonised subjects, or better still neocolonised bodies – the bodies positioned at the anxious intersection of the economic, the cultural and political, the global and local (pp. 54-55, italic in original text).

One such experience of neocolonialism is that of immigration as it puts into play the operation of North/South power relations in the crossing of borders as well as in living in diaspora.

Consequently, an important gap and under-examined area in the critical disability scholarship is that of immigration, specifically during the application process itself. Put differently, while there has been a growing interest in exploring settlement and resettlement experiences of people with disabilities when they do arrive in Northern contexts, there is also a need to explore the immigration process before applicants arrive to their destinations (should they become constructed as admissible). Such exploration would better inform social work practice and other helping professions (e.g. settlement services) as they are implicated in facilitating immigration, refugee and settlement services for newcomers. Responding to these gaps, the study discussed in this paper examines the intersection of disability and immigration by utilizing critical discourse analysis (CDA) methodology to examine Canadian immigration policy guidelines. In this paper, I argue that dominant health discourses and discourses of risk and protection, reflected and reinforced through Canadian immigration policies and practices and specifically medical criteria, construct people with disabilities as the "inadmissible Other."

Indeed, a quick examination of the history of immigration policy in Canada reveals that no legislative reforms have been made to "accommodate, admit or accept immigrants with disabilities" (Hanes, 2009, p. 93). The Council for Canadians with Disabilities (CCD), a national advocacy body, notes: "Canadians with disabilities realize that if they had not been born here they could never become a (sic) Canadian for the simple reason that they have a disability" (cited in Hanes, 2009, pp. 91-92). Even when they are accepted as immigrants or refugees, they face constant fear of deportation (El-Lahib & Wehbi, 2012; El-Lahib, 2015; CCD, 2012, 2013; Chadha, 2008; ERDCO, 2005; Hanes, 2009; Wong, 2011). Furthermore, the available studies from Canada, Europe, UK, US, and Australia suggest that settlement agencies are not prepared or equipped to deal with immigrants with disabilities because they are not expected to be immigrants (Groce, 2005; Harris, 2003; Harris & Roberts, 2004, Islam, 2008; Mirza, 2011a, b; Mirza & Heinemann, 2012; Sandys, 1998).

Specifically, in his discussion of the history of Canadian immigration legislation in relation to people with disabilities, Hanes (2009) notes that while one can argue that Canadian immigration legislation no longer reflects "racist, sexist and heterosexist ideals" as a result of the many reforms and changes to them, "ableist ideals" (p.93) remain reflected in these pieces of legislation and influence immigration policies and practices. Like Galabuzi (2006), Li (2001), Razack, (2010) and Thobani (2000, 2007), I would argue against the idea that these policies are now free of racism, sexism and heterosexism, but I take from Hanes the idea that ableism is alive and continues to influence immigration policies and practices. Moreover, I would assert that ableism does not exist in isolation and is not compartmentalized apart from other experiences of marginalization and as such needs to be examined through an intersectional analysis to highlight how forms of oppression interplay with ableism to construct the experiences of "inadmissible Others."

Indeed, as several scholars note in discussing the history of immigration policies in global North contexts, disability has been attributed to "undesirable" social groups, as a way of keeping them out. For example, Baynton (2001) argues that not only have disabled people been discriminated against in American immigration, but also that discrimination against other groups was justified by "attributing disability to them" (p. 33) and that the concept of disability "was instrumental in crafting the image of the undesirable immigrant" (p. 45). Indeed, Dolmage (2011) provides the historical example of the intertwining of race, ethnicity and nationality with eugenics and "ideas about bodily fitness" in dangerous ways that shaped health and immigration policies in the United States.

In examples from Canada, Chadha (2009) and Wong (2009) demonstrate the intersections of racism and ableism in immigration through historical analyses. By relying on norms of "mental fitness" and "appropriate behaviour," immigrants from undesirable cultures were constructed as "disabled" and therefore, inadmissible (Chadha, p. 29-30). For example, in the late 19th Century, Black immigrants were attributed the identity of "disabled" because they were assumed to not be capable of surviving the Canadian climate, and therefore inadmissible (Wong, 2009).

The above-mentioned examples offer an illustration of the intersection of racism, colonialism and ableism within immigration. In what follows, I examine contemporary policies through the use of governmentality as a lens of analysis to shed light on how these intersections are embedded within immigration documents. I end the paper with a discussion of the implications of the findings for social work and other helping professions.

Governmentality as a Theoretical Lens of Analysis

Situated within a postcolonial understanding of North/South power dynamics, this study utilizes Foucauldian analysis and specifically the lens of governmentality to illustrate the importance of discourse in shaping immigration policies and the construction of admissibility and inadmissibility of immigration applicants with disabilities. Governmentality, or the "art of government" (Jessop, 2007, p.37) is central to this research because it could assist in examining how governing discourses of ableism and neocolonialism are embedded within immigration documents and guidelines. According to Foucault (1991, p. 102), governmentality refers to:

The ensemble formed by the institutions, procedures, analysis and reflections, the calculations and tactics that allow the exercise of this very specific albeit complex form of power, which has its target population, as its principal form of knowledge political economy, and as its essential technical means apparatuses of security.

Governmentality in this sense refers to the conduct of conduct (Bevir, 2010; Gordon, 1991; Joseph, 2009; Li, 2007) or actions that intend to "shape, guide or affect the conduct of some person or persons" (Gordon, 1991, p. 2). Hence, governmentality refers especially to the "technologies" that govern individuals and societies and highlights the ways in which governments and other actors utilize knowledges to make policies that "regulate and create subjectivity" (Bevir, 2010, p. 423). Governmentality combines the concepts of power, discipline and knowledge (Foucault, 1991). In addition, Murray (2007) notes that governmentality is a "neologism of government and rationality" (p. 162), and it refers to:

government, not as centralized in a single institution, set of institutions, or even a person or group, but rather as the outcome of a multitude of thoughts and practices that shape assumptions about what government is, how it should be exercised, by whom, and for what purposes (p. 162).

Moreover, governmentality, can assist in examining power and its operation in fields and disciplines including social sciences, social policy and social work (Joseph, 2009; Mckee 2009; Murray, 2007; Pollack, 2010; Rose, O'Malley & Valverde, 2006; Turner, 1997; Weidner, 2009). For example, Hughes (2005) notes the importance accorded to language and discourses that contributed to making the body a legitimate site of analysis (emphasis added). The author further notes the use of language and discourses and how they shape and construct people with disabilities' experiences and identities. By examining these discourses, we can understand the links between power, the body and "the medical management of people with impairments" (p. 82) and how such management manifests itself through immigration and the construction of admissibility and inadmissibility.

Furthermore, Murray (2007, p. 163) notes the importance of the concept of bio-power, which refers to the "governmental interest in the regulation of individuals and populations"; bio-power looks at the human body as central and aims to maximize its competency and productivity while keeping its political growth and participation "docile" or at a minimum. Poole (2011) contends that bio-power functions through disciplinary practices to create "categories, standards and desires for what is normal, bio-power renders the individual more docile, useful and productive" (p. 30). In this sense, bio-power becomes engraved in policies, and practices that govern the population (Murray, 2007; Poole, 2011; Rose, O'Malley & Valverde, 2006; Turner, 1997).

In responding to the gaps in the scholarship identified earlier, a Foucauldian analysis is relevant to this study because it offers a way of analysing and understanding the heavy emphasis placed on health and body in immigration policies in ways that significantly shape the construction of admissibility and inadmissibility of immigration applicants. Specifically, a Foucauldian analysis allows for an examination of the construction of the "normal" body/mind and help in distinguishing it from the "pathologized" and disabled body. By applying this understanding of governmentality to inform studying the intersection between immigration and disability, we can explore the mechanisms through which dominant discourses shape and govern how immigration policies are framed and operationalized to determine admissibility and inadmissibility of unwanted immigration applicants including people with disabilities.

Another aspect of governmentality is the importance accorded to context (Jessop, 2007; Joseph, 2009). As Joseph (2009) notes, "governmentality is defined by its social and historical context and has to be seen not as a thing but as a process" (p. 426). This would mean that our understanding of contemporary immigration policies and practices should be seen in relation to the historical evolution of those policies as well as within the current neoliberal context that is shaping not only the construction of the immigration policies but also how they are applied in a way that disciplines potential applicants. For example, as noted earlier, the context within which immigration policies exist is one that has been shaped by a history of racism, sexism and unjust colonial relations. If we adopt governmentality as a lens through which immigration policies and guidelines are analysed, then we can see how this context has shaped the development of these policies and how they are operationalized in ways that reflect racism, sexism, ableism, and so forth, in Canadian society as well as within the broader unjust relationship between global North and South.

Furthermore, adding to this discussion, it is important to highlight the links between governmentality and Foucauldian analysis in general to neoliberalism as a key framework that shapes contemporary national and international migration policies. As DasGupta (2014) emphasizes using the example of the United States, "neoliberalism operates at the intersection of body, population, and the enterprise in order to create the figure of the disabled/diseased alien" (p. 2) that creates health costs for the state. As such, examining the intersection between immigration and disability and troubling the construction of the "inadmissible Other" requires a critical look at the interplay between immigration policies and neoliberal discourses; utilizing a Foucauldian analysis of governmentality is an important tool to do so.

In fact, adopting a governmentality lens would "render neoliberalism visible in new ways, to understand its problematics and how these were linked to its innovative reshaping of liberal technologies" (Rose, O'Malley & Valverde, 2006, p. 97). Specifically, this analysis would allow us to see how under neoliberalism, immigration applicants become categorized and constructed as either potentially admissible immigrants or as inadmissible foreign citizens who might pose a potential risk and become a burden on social and health services, as discussed in the findings section of this paper. This is consistent with Pollack's (2010) argument that "risk thinking" is an essential feature of how neoliberalism governs welfare systems and regulates marginalized social groups (p. 1264). This article argues that this regulation is evident in the discourses that construct admissibility and inadmissibility in Canadian immigration policies; critical discourse analysis allows us to identify and bring to light some of these discourses, as discussed below.

Critical Discourse Analysis Methodology

Consistent with a Foucauldian lens of governmentality, the study discussed in this paper adopts a critical discourse analysis (CDA) methodology to analyse official immigration texts. Diaz-Bone et al. (2005) contend that Foucault's work, and especially governmentality, allows us to see how discourses are embedded and shape social, institutional and technical practices. As Arribas-Ayllon and Walkerdine (2008) argue, Foucault's work is of relevance to CDA for many reasons including that this work has managed to "relate discourse to diverse social groups […] linking them to the specific practices in which they were located" (p. 93) in relation to power. Hence, CDA theorists see "discourse as a social practice" implying a dialectical relationship between language, power, dominance, and control as well as social structures and institutions (Fairclough, 1989, 2010; van Dijk, 1993, 2003, 2008; Wodak & Meyers, 2001, 2009). Thus, bringing Foucault's work to bear on CDA in this article is an attempt to highlight the role of discourse in shaping immigration policies related to people with disabilities as a social group. Relying on this understanding, I use CDA methodology to examine how discourses of ableism, racism and neocolonialism collide through dominant health discourses to construct people with disabilities as "inadmissible Other."

Hence, CDA methodology is of relevance to this study because it would allow for an understanding of how dominant discourses about health become legitimate reasons for marginalization and exclusion of people with disabilities in immigration. This methodology encourages researchers to focus on the "role of discourses in the (re)production and challenge of dominance" (van Dijk, 1993, p. 249; italic in original text) within social and political texts. Poole (2011) notes that discourses can play a powerful role in shaping realities and experiences of marginalization and domination. Moreover, in her discussion of the importance of paying attention to language and discourses and the impacts they have on social policies and social life, Taylor (2004) notes that institutions and organizations are consciously controlling the use of language and discourse in shaping the outcomes of organizational policies and in achieving their overall objectives. Hence, a CDA study of texts and documents such as immigration policies and inadmissibility guidelines contributes to an understanding of how people with disabilities come to be constructed as inadmissible, and how policies can be resisted and challenged through the use of counter discourses. Indeed, while it was beyond the scope of this study to examine such counter discourses, I am aware that potentially oppressive policies and practices are resisted everyday by disability activists, settlement workers, social workers, immigration officers and practitioners in other helping professions. These acts of agency and resistance merit their own study where the voices of those engaged in such practices are put forward to further nuance our understanding of how discursive practices are challenged and negotiated, especially in the current neoliberal context and reality.

For the purposes of carrying out CDA, I examined three operational manuals produced by Citizenship and Immigration Canada—referred to as "Operational Manuals-Enforcement (ENF)":

These manuals are part of a larger set of manuals and act as official guidelines for Immigration Officers to determine applicants' admissibility or inadmissibility. For the purposes of this study, I selected the manuals that focus specifically on issues of admissibility and inadmissibility.

In examining these documents, the analysis focused on the use of dominant health and medical discourses that potentially construct immigration applicants as inadmissible. Questions guiding the analysis process included: What are the terms, phrases and discourses that shape and define inadmissibility of immigration applicants? What is the relationship between racism, neocolonialism and ableism and how does it contribute to the construction of admissibility and inadmissibility of immigration applicants including people with disabilities?

In conducting CDA, I was aware of the idea that there is no prescribed way of analysis (Arribas-Ayllon & Walkerdine, 2008; Diaz-Bone et al., 2005) and as such, I adopted the analysis steps suggested by Poole (2011) whose work on sanism is informed by Foucault. Briefly, the analysis steps consisted of the following: First, I conducted a thorough reading of the policy documents; second, I re-read the documents and began to identify and code key words and phrases that reflected the main ideas discussed in this paper (e.g. health, dependency, admissibility, inadmissibility, etc.); third, I sorted the coded sections of the documents into categories and developed a list of categories and sub-categories included within each; fourth, I identified discourses based on the categories; finally, I identified themes that group discourses together related to the main questions of this study (i.e. constructions of admissibility and inadmissibility), as discussed in the next section.

Findings & Discussion

The analysed immigration documents demonstrate a clear emphasis on the centrality of discourses of risk and protection that shape the construction of admissibility and inadmissibility of immigration applicants. In this article, I further argue that such centrality provides the grounds for dominant health discourses to be used to hide, justify and operationalise ableism, racism and neocolonialism within immigration by constructing immigration applicants, including people with disabilities, as potential risks and danger to Canadian society. Such construction justifies the means used to prevent assumed risks and allows for oppressive protection measures to be prioritized and operationalised. In what follows, I demonstrate these arguments and move to discuss implications for social work. I end the article with suggestions for future directions.

Constructing the "Other" as a risk to Canadian society

My findings demonstrate that risk and protection are corollary discourses that shape inadmissibility and admissibility within the documents analysed. Indeed, the "default position" for immigration applicants is inadmissibility and discourses of risk and protection are used to mask other grounds of inadmissibility. To become admissible, applicants must prove that they do not pose any threat or danger to Canadian society or pose any excessive demands on social or health services. In addition, discourses of risk and protection are complementary: discourses of risk are always accompanied by discourses of protection of Canada or Canadians. Such association of discourses emphasizes the dividing lines along immigration status where Canadians need to be protected from those not yet admitted into Canadian society and who may pose potential risk; the role of immigration officials, policies, and procedures is to protect against, and eliminate such assumed risks.

Discourses of protecting Canadians from health, security and criminality risks perceived to be imposed by immigration applicants permeate the documents reviewed for this study. The documents are replete with words and phrases such as: security; surveillance; violence; terrorism; threat; (en)danger; "danger to the public and the security of Canada" (ENF 3, p. 30); "danger to the public health" (ENF 1, p.5; ENF2, p. 24), etc. This analysis is important particularly because these documents are the main guidelines and the first points of reference for determining admissibility and inadmissibility. Put differently, discourses of risk and protection colour how immigration applicants are perceived right at the outset of the immigration process.

A clear example from the documents can be seen in ENF2 (p. 58) where immigration officers are directed to assess an applicant's admissibility in relation to potential risk to Canadian national interest by asking themselves the following question: "Has the person adopted the democratic values of Canadian society?" By instructing immigration officers to ask themselves such a question, the documents reflect an attempt to regulate and discipline/self-discipline immigration officers to uphold and impose Canadian democratic values. This is consistent with governmentality which emphasizes the processes that shape and regulate not only policies but also their application (Gordon, 1991), such as attempt to discipline officers to adopt and apply specific values in their assessments of admissibility/inadmissibility.

I would argue that the documents reflect an attempt to regulate immigration applicants, the individuals implementing immigration policies, as well as the flow of migration into Canada. As Murray (2007) argues, governmentality is about the process of regulating populations and individuals, and as Taylor (2004) adds, this process is about ensuring certain policy outcomes. Joseph (2009) emphasizes that governmentality needs to be understood within a social and historical context. As such, it is important to understand this control over migration as being shaped by a history of racism and colonial relations with the desired outcome of keeping out "unwanted" populations (Li, 2001; Thobani, 2000, 2007).

Further, Ibrahim (2005) asserts that the "securitization of migration" reflects the "most modern" form of racism, "new racism", which serves to define potential immigrants as a threat that normalizes exclusionary immigration policies and practices. Pon (2009) argues that new racism signals a shift from racism based on biology to forms of racial discrimination based on culture. As opposed to more blatant forms of racism, new racism denies its own existence and acts in subtle and covert ways (Augoustinos, Tuffin, & Every, 2005; Bonilla-Silva, 2003). Of special relevance to this paper is van Dijk's (2000) argument that "new racism" operates in discursive ways that "are expressed, enacted, and confirmed by text and talk" in the everyday including through policies (p. 34).

Hence, by using discourses of risk and protection that attempt to mask blatant racism in constructing who is admissible or inadmissible, the documents see applicants in a hegemonic way that attempts to discipline those who operationalize the policy (e.g. immigration officers) as well as broader society to perceive any applicant through a lens of risk that requires the establishment of protection measures. These discourses of risk imply that it is everyone's responsibility to do their part in order for Canadian society to be protected. Foucault (1991) argues that the operation of power through discourses is central to how we become disciplined and subjugated. While the idea of applying standards per se is not problematic; these standards are constructed in a way that creates a dominant discourse that paints every immigration applicant as a potential threat and risk from which Canadians need to be protected. In turn, the predominance of normative standards reflects and reinforces ableism specifically through the emphasis placed on medical inadmissibility, as discussed below.

Ableist dominant health discourses: Constructing the inadmissible Other

The document analysis revealed the blunt presence of ableism and ableist discourses; I had to dig deeper to see how discourses of racism and neocolonialism were reflected and reinforced. This is consistent with Wolbring (2008) who argues that ableism continues to be socially accepted and embedded within public discourses. I would argue that because of the history of resistance and the constant critiques and writings against racism and colonialism within immigration (see for example Galabuzi, 2006; Li, 2001; Razack, 2010; Thobani, 2000, 2007), official public documents would be condemned if they included any clear or direct neocolonial or racist references. This does not mean that there has been no history of resisting ableism, but as suggested by Wolbring, (2008), ableism continues to shape fields such as social policy, and as Hanes (2009) adds, ableism is still accepted within immigration policies and practices.

Ableism has been defined as a socially constructed site of oppression that is based on the process, values, beliefs and structures that privilege certain abilities and constructions of normative bodies (Campbell, 2008; Cherney, 2011; Eisenhauer, 2007; Kumar, Sonpal & Hiranandani, 2012; Wolbring, 2008). Ableism could be found in statements and phrases that reflect and reinforce pathologizing discourses that emphasize health as a central ground for admissibility in a broad sense that automatically excludes people with disabilities. Such discourses could be found in phrases that outline health inadmissibility in ENF1 (p.5), repeated as grounds for medical inadmissibility in ENF2 (p.24):

CIC has the policy responsibility with respect to medical inadmissibility [which] bars entry into Canada to persons with three types of medical conditions:

  • people with health condition that is likely to be danger to public health
  • People with health condition that is likely to be a danger to public safety
  • People with health conditions that might reasonably be expected to cause excessive demands on health or social services.

Besides the protection claims that the above inadmissibility criteria are making, these guidelines use health and medical discourses interchangeably to define and construct inadmissibility. A key point worth making here is the generalization and ambiguous use of medical and health conditions to construct and define inadmissibility. A unifying element within these documents is the tone that sets these medical inadmissibility guidelines as measures to protect Canadian society as well as social and health services from "excessive demands" assumed to be imposed by potential immigration applicants.

Put differently, the starting point of statements about health is the danger assumed to be posed by immigration applicants and the purpose of inadmissibility on medical grounds is to reflect Canada's need for protection. The emphasis on discourses of risk and protection here clearly shadows any attempts to look beyond how health and medical inadmissibility are defined. Indeed, there is no specification in any of the documents as to what health or medical conditions are being referenced, thereby eclipsing unique experiences of disability under a generalized umbrella. In fact, I would argue that if these inadmissibility grounds were to truly reflect an interest in responding to health or medical concerns, perhaps discourses of risk and protection would have been replaced by discourses that reflect the right to health and medical care as stipulated within the Declaration of Human Rights which is claimed to be the foundation of Canadian immigration policies (Immigration and Refugee Protection Act, 2001). However, this could be an illustration of what Ibrahim (2005) calls the shift of focus from human rights to "human security" that dominates the contemporary context of immigration policies and practices. Thus, consistent with a governmentality lens, the use of discourses of risk and protection becomes an efficient tool using medical and health grounds to construct inadmissibility and justify the exclusion of unwanted social groups such as people with disabilities.

Moreover, the emphasis on danger and dependence on services are of particular relevance to marginalizing constructions of people with disabilities. Danger, threat, and risk are familiar terms that echo dominant constructions and perceptions of people with mental health histories (Poole et al., 2012). Indeed, immigrants and newcomers who have received mental health diagnoses or treatments are dealt with in a way that not only ignores but also negatively impacts their mental health in their everyday (e.g. work, housing, access to services) as well as in immigration and settlement processes (Ontario Human Rights Commission, 2010; Schizophrenia Society of Ontario, 2010).

People with histories of psychiatric diagnosis continue to face detention and deportation as a result of their mental health status (Chadha, 2008; Patel, 2014; Schizophrenia Society of Ontario, 2010). Chadha (2008) asserts that the history of Canadian immigration policies and practices has "perceived immigrants with mental disabilities as deviant and defective" (p.39). This is consistent with Poole's et al. (2012) as well as Reid and Poole's (2013) observations that link the oppression and marginalization of people with mental health histories to sanism and the dominance of pathologizing medical discourses that construct them as "unpredictable", "violent", "incompetent" or unable to care for themselves.

Here, I am reminded of the argument that distinguishes between the "normal and pathological" body that makes it possible to construct disability discursively as "physical or mental deficit" (Hughes, 2005, p. 82-83). Situating people with disabilities within such pathologizing discourses can only make them "delegitimized" (p. 83). Such a priori constructions could potentially impact their immigration application experiences or shape their access to settlement services should they become admitted. Indeed, the scope of such constructions could go beyond immigration to affect service providers' perceptions about disability issues and how to deal with people with disabilities.

Put differently, the current state of social work and other helping professions dealing with immigrants and newcomers with disabilities reflects lack of appropriate knowledge about issues facing this social group. Added to this is an emphasis on medical model discourses, which leaves unchallenged pathologizing discourses and practices in social work (Meekosha & Dowse, 2007). The point I wish to emphasize here is not to deny these professions their agency and attempts to challenge oppression and marginalization in their capacities as service providers. Instead, I am building on the argument that suggests that social policies and practices are the "outcomes of discourse" (Ibrahim, 2005, p. 164).

Specifically, since social work and other helping professions are bound by and implicated in social policies, and since funding is mainly governed by bodies that control policies, there is little room to manoeuvre in order to fundamentally challenge oppressive policies embedded within immigration. Such policies continue to construct people with disabilities as inadmissible, which could play a role in lack of availability of services to address their needs in settlement settings. In fact, a recent study by two organizations serving immigrants found that newcomers with disabilities face additional barriers in their interactions with immigration officials and settlement services greatly "due to a lack of understanding of disability issues in general and a lack of capacity, and resources to service them" (Settlement at Work, 2012, General Findings section, para. 1).

Moreover, notions of reliance on health and social services, although not targeting people with disabilities directly, reinforce discourses of dependency and care that have long shaped the experiences of marginalization of people with disabilities within policies and broader social relationships (Barton, 2005; Fine & Glendinning, 2005; Poole et al., 2012). As Oliver (2005) argues, dependency discourses are central to the social construction of disability as a "social problem" (p. 9), which in the case of immigration is linked specifically to the assumption that people with disabilities will pose excessive demands on social and health services. In the contemporary Canadian context, there are many cases of inadmissibility or even deportations of immigrants with disabilities and their families that reflect the dominance of the excessive demands clause that continues to shape the immigration and settlement experiences of people with disabilities (please see El-Lahib & Wehbi, 2012 for a discussion of several such cases; also see more recent cases in Cronin, 2016; Pagtakhan, 2016). In fact, it is ironic to see that only when immigration applicants prove their dependency through arranging care that they become potentially admissible, as can be seen in the excerpt below. Indeed, the only allowance made in the documents to waive medical criteria is family sponsorship as noted in ENF2. The document states that applicants who can satisfy:

an officer that adequate arrangements for care and support (not involving social assistance) are in place, then they do not fall within this inadmissibility provision. (ENF2, p. 28)

It is beyond the scope of this paper to cite case evidence of how this exception to inadmissibility criteria has not been upheld. There are two points to raise here. On the one hand, we are reminded here of the idea that people with disabilities are assumed to be dependent, in this case on their families; and their admissibility is conditional on demands that reinforce this dependence. On the other hand, even when families of applicants commit to shouldering costs incurred in the care of disabled family members, there have been cases where people with disabilities have been denied entry or deported, as noted earlier (CCD, 2012; 2013; El-Lahib & Wehbi, 2012; El-Lahib, 2015; ERDCO, 2005).

In short, within the analysed documents, people with disabilities are constructed through discourses of "needs", "dependency" and "care" and remain assumed to pose "risk and danger" to Canadian society and impose "excessive demands" on social and health services. While these discourses may appear at first glance to be disconnected, I would argue that they form a set of related discourses that continue to reflect ableism contributing to the construction of people with disabilities as the "inadmissible Other." Moreover, taken together, these discourses point to the importance of an analysis using a governmentality lens because it offers a unique way to articulate the tools and technologies (e.g. dominant health and medical discourses, discourses of dependency and care, etc.) that govern immigration policies and make acceptable the construction of people with disabilities as "inadmissible Other."

Conclusion: Implications for social work & other helping professions

This article has reported on a critical discourse analysis study that explored the intersection of disability and immigration. Through an examination of Canadian immigration policy documents, findings demonstrated the preponderance of the connected discourses of risk, protection and dependency and how these shape constructions of inadmissibility through recourse to health and medical discourses. These findings hold implications for social work as well as other helping professions implicated in the immigration process.

Considering the importance of discourses in shaping the experiences of people with disabilities in general and in terms of immigration in particular, I would argue that we need to begin by challenging these discourses because they shape practice and policy. As Furman, Negi, and Ciserno-Howard (2008) note, social work's adoption of medical discourse needs to be challenged in favour of a social justice understanding of immigration issues. Social workers and other helping professionals are invited to begin by challenging dominant discourses and addressing the oppressive structures embedded within immigration policies and practices that shape the marginalization experiences of people with disabilities.

Moreover, there is a need for practitioner training and education to advance anti-colonial and anti-oppressive understandings of immigration and disability issues. Pacheco et al. (2003) note the need for anti-racism training for social workers engaged in practice on immigration issues as this is an important step in challenging racism in practice. I would also suggest that in addition to anti-racism training, helping professionals need to have the opportunity to be educated on, and made aware of issues facing immigrants with disabilities on the policy level. Social workers, settlement workers, community practitioners, among others, require training on issues related not only to settlement experiences, but also to the potential barriers that people with disabilities might face when attempting to immigrate (particularly during the application process). In fact, Harris and Roberts (2004) note in their study that social workers feel they are not adequately trained to serve clients with disabilities in terms of the immigration process. Hence, professional practice responses would be advanced by the provision of education and training opportunities on issues facing people with disabilities in both the application and settlement processes not only on the direct practice level but also at the level of policy.

Finally, while I believe that challenging and resisting ableism and other forms of oppression in immigration policies and practices is vital, I believe that this is a complex process that needs to be taken beyond policy change or adding "inclusive" discourses. After conducting this study, I am left with the impression that there is a thin line between fighting ableism within immigration policies and falling into the trap of reproducing it. Instead, needed policy change must be complemented by broader social change that is informed by and committed to an anti-colonial, anti-ableist and anti-racist values and understandings that foster social justice principles.

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