Deinstitutionalisation of persons with intellectual disabilities: A review of Australian studies

Abstract

This paper provides a quantitative review of Australian studies on deinstitutionalisation and community living for persons with intellectual disabilities. Thirteen studies from eight separate projects were identified from a comprehensive literature search. Studies were included if they were conducted in Australia and focused on the effects of relocating per sons from institutions to community-based residences, involved a comparison of institutional versus community-based services, or investigated the community adjustment of people who had once lived in an institution. Each study was examined to ascertain details on the settings, participants, methodology, and results. Community-based placements were associated with increased adaptive behaviour, greater community participation, and improved contact with family and friends. There was little or no change in problem behaviour, health, or mortality The results are consistent with similar reviews from studies conducted in the USA and UK and support the development of community-based services for persons with intellectual disability. However, limitations in the Australian database are acknowledged and discussed.

Denied Inclusion for Prejudiced Women

“…Physical exposure creates adverse results such as the sense of alienation and otherness, when not followed by social inclusion. This result is clearly indicated in the research findings suggesting that it is social not physical integration that has a reliable positive influence on wellbeing and participation (Young et al, 1998;Hundert et al, 2002;Spreat & Conroy, 2002;Emerson & Mc Villy, 2004) …”

“…The openness of community towards people with disabilities is crucial for friendship establishment. This is highly recommended by previous literature suggesting that success of inclusion into community is determined by the characteristics of the environment that support improvement of personal characteristics for adaptation (Emerson, 1985;Young et al, 1998;Dangan et al, 1998;Felce, 2000;Whitehouse et al, 2001;Hundert at al., 2002;Baker, 2007). A third change targets policy, implying that social policy is more inclusive when provides opportunities for social relationship.…”

Desinstitucionalización y vida en la comunidad: Declaración del Grupo de Investigación sobre Política y Práctica Comparativas, de la Asociación Internacional para el Estudio Científico de las Discapacidades Intelectuales (IASSID)

“…En cinco de seis áreas (competencia y crecimiento personal, conductas problemáticas observadas, participación en la comunidad, tiempo dedicado a una actividad significativa y contacto del personal), la mayoría de los estudios informaban de efectos positivos; solamente en un área (la de conductas problemáticas observadas), la mayoría de los estudios no detectaron cambios significativos. Young et al, (1998) analizaron trece estudios australianos sobre desinstitucionalización publicados entre 1985 y 1995, que mostraron tendencias similares. En seis de las nueve áreas estudiadas (conducta adaptativa, satisfacción de las personas usuarias, participación en la comunidad, contacto con la familia o las amistades, interacciones con el personal y satisfacción de los padres), la mayoría de los estudios informaban de efectos positivos, y en las tres áreas restantes (conductas problemáticas, aceptación social y salud/mortalidad), la mayoría no encontraron cambios.…”

People with an intellectual disability in the discourse of chronic and complex conditions: an invisible group?

“…10 Positive outcomes included an improvement in adaptive behaviour, an increase in community participation and greater contact with family and friends. 9 The long-term goal was greater use of generic services and therefore a reduction in the number of special services. 11 The deinstitutionalisation movement resulted in 99% of families caring for their child with an intellectual disability in the family home.…”

“…7 In the 1970s there was a worldwide trend to deinstitutionalise people with disabilities. 8,9 Group homes were opened within the community, and unregistered (non-health professional) personnel were employed to provide care. In 1981, the "Year of the Disabled" further promoted this move from institutional to community living with the use of generic services and the goals of promoting attitude change, enhanced awareness of disability issues and increased mainstream integration.…”