Hidden disabilities, hidden need

Clothing poverty persists in the UK despite widespread surplus. This article examines how access infrastructure can exclude people with unseen disabilities.

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Clothing poverty as an access problem, not a supply issue

When clothing poverty is discussed publicly, it is often framed as a problem of material availability: not enough coats, shoes or uniforms¹. Evidence from poverty and disability research indicates that this framing captures only part of the issue.

Across welfare, food aid and community support systems, researchers consistently identify situations in which people are eligible for support but do not access it². This non-take-up is not evenly distributed across the population.

For some people, barriers relate to cost, transport or time. For others, barriers are less visible. Accessing clothing support may involve asking for help in person, explaining personal circumstances, navigating uncertainty about eligibility or entering unfamiliar social environments. These processes are manageable for some people, but prohibitive for others³.

Evidence shows that groups facing greater barriers to accessing services, including people with mental health conditions, sensory challenges and neurodivergence, are more likely to under-engage with support systems that rely on informal negotiation or ambiguous language⁴. In such cases, help is not refused; it is never sought.

What “infrastructure” means in clothing poverty

In this context, infrastructure refers to the systems that determine whether clothing support can realistically be reached.

Evidence from disability and social policy research shows that access is shaped by how information about provision is communicated⁵, whether eligibility is explicit or implied⁶, whether access relies on verbal explanation or informal negotiation⁷, whether uncertainty is reduced or amplified⁸, and whether engagement requires social confidence, advocacy or disclosure⁹.

These conditions operate long before clothing is offered. Infrastructure is therefore not neutral: it advantages people who can ask clearly, tolerate ambiguity and navigate social processes, and disadvantages those whose disabilities affect communication, processing, sensory tolerance or trust¹⁰.

Hidden disabilities, infrastructure sensitivity and scale

Hidden disabilities are widely recognised in disability research as infrastructure-sensitive, meaning outcomes depend less on individual impairment and more on how systems are designed¹¹.

Autistic people report encountering significant systemic barriers in accessing health and community services, including environments that are not sensory-friendly and systems that do not reliably provide necessary adjustments¹². Autistic adults and families also describe long waits, confusion about service entitlements and environments that heighten distress rather than support access¹³.

Clothing support environments may share features associated with these barriers. Research by organisations representing visually impaired people shows that reliance on visual signage and informal layouts can prevent independent navigation and understanding of entitlement¹⁴.

Evidence from organisations representing people with hearing impairments indicates exclusion where access depends on verbal instruction or overheard information¹⁵. In clothing contexts, this can result in an inability to browse independently, lack of clarity about choice and difficulty understanding what is permitted.

Hidden disabilities are common. An estimated one quarter of the UK population reports a disability, the majority of which are not immediately visible¹⁶. Disabled people are also disproportionately likely to experience poverty¹⁷. The absence of people with hidden disabilities from clothing poverty statistics does not indicate lower need; it reflects systematic non-take-up.

Communication barriers as structural exclusion

Evidence from lived-experience research shows that disabled people, particularly those with non-visible conditions, often disengage from support when they fear disbelief, judgement or the need to justify their situation¹⁸. Negative societal attitudes and misunderstandings about disability are identified as barriers to confidence, independence and access¹⁹.

This challenge is compounded where language is conditional or tied to crisis thresholds, factors associated with reduced take-up of benefits and services among disabled people²⁰.

These dynamics apply directly to clothing poverty, where accessing clothing aid exposes need publicly. When infrastructure increases exposure or ambiguity, disengagement becomes a rational response.

Dignity and abundance

Clothing Collective’s first core belief is that people in need deserve their dignity as a human right. In clothing poverty provision, dignity is often framed as an outcome achieved through choice, quality or presentation²¹. This captures important elements of experience, but it focuses on dignity after access has been achieved.

Dignity can also function as a condition. If someone feels uncertain about whether they belong, unclear about what is available, or anxious about how they will be perceived, dignity has already been compromised regardless of intention.

As clothing poverty becomes more widely recognised, the challenge shifts from expanding clothing provision to ensuring that access does not depend on being articulate, assertive or socially confident.

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Reference list:

1.      Department for Work and Pensions, Households Below Average Income: Material Deprivation Indicators, official measurement of clothing and footwear deprivation, UK Government, 2023.

2.      Hernanz, V., et al., Take-Up of Welfare Benefits in OECD Countries, foundational analysis of non-take-up mechanisms, OECD, 2004.

3.      Cabinet Office, The Lived Experience of Disabled People in the UK: A Review of Evidence, synthesis of barriers including disclosure, uncertainty and social negotiation, UK Government, 2023.

4.      Equality and Human Rights Commission, Being Disabled in Britain, evidence of systemic access barriers for people with non-visible impairments, EHRC, 2017.

5.      Cabinet Office, The Lived Experience of Disabled People in the UK, evidence on communication barriers and informal systems, UK Government, 2023.

6.      Joseph Rowntree Foundation, Poverty, Stigma and Support, analysis of entitlement ambiguity and confidence in access, JRF, 2020.

7.      Mind, Barriers to Accessing Mental Health Support, evidence on anxiety, verbal negotiation and avoidance, Mind, 2021.

8.      National Autistic Society, Left Stranded, documentation of uncertainty and system navigation barriers for autistic adults, NAS, 2016.

9.      Scope, The Disability Perception Gap, evidence on disclosure, judgement and disengagement, Scope, 2019.

10.  Shakespeare, T., Disability: The Basics, social model and structural disadvantage, Routledge, 2018.

11.  World Health Organization, World Report on Disability, evidence that disability outcomes are system-dependent, WHO, 2011.

12.  National Autistic Society, Left Stranded, evidence on sensory environments and access failures, NAS, 2016.

13.  National Autistic Society, The Autism Act: A Decade On, evidence on service delays and entitlement confusion, NAS, 2019.

14.  RNIB, Access Denied: The Barriers to Independent Living, evidence on visual navigation barriers in services, RNIB, 2022.

15.  Action on Hearing Loss (RNID), Barriers to Accessing Services for Deaf People, evidence on verbal-only access exclusion, RNID, 2016.

16.  House of Commons Library, Disability Statistics: Prevalence and Life Experiences, official UK prevalence data, 2024.

17.  Joseph Rowntree Foundation, UK Poverty and Disability, analysis of poverty risk among disabled people, JRF, 2020.

18.  Scope, The Disability Perception Gap, lived-experience evidence of disengagement, Scope, 2019.

19.  Equality and Human Rights Commission, Being Disabled in Britain, evidence on stigma and social attitudes, EHRC, 2017.

20.  OECD, Barriers to Social Benefit Take-Up, evidence on conditionality and disengagement, OECD, 2018.

21.  Garthwaite, K., Hunger Pains, analysis of dignity framed as an outcome in charitable provision, Policy Press, 2016.