HOW THEY DO IT ABROAD: MOST WEALTHY western countries have been closing down institutions for people with disabilities for the past 40 years. The UK finally closed its last institution in 2009, while Norway and Sweden phased out institutional care many years ago. In the US at least two-thirds of old-style care homes are closed, while programmes are afoot to replace the remainder. Most people with intellectual disabilities in Europe who are still in institutions are concentrated in central and eastern European countries such as Poland, Hungary and Romania, a legacy of the Soviet era.
Experts agree that community-based living is the way forward. It allows people with intellectual disabilities to use the same range of accommodation and living patterns that are available to the rest of the population. “It’s about ensuring they have a good quality of life and participate as full citizens in social, cultural and economic activities to the extent and in the ways the individual chooses,” says Prof Jim Mansell, an UK-based expert on disability. This can involve independent living or supported accommodation in homes that typically have no more than five or six residents. Larger care homes built in the community are already considered outmoded. While there is no formal programme of de-institutionalisation here, we may need to act sooner rather than later. The Government has signed – but not ratified – the UN Convention on the Rights of People with Disabilities. A key provision – Article 19 – gives rise to the right of independent living.
It provides for “a range of in-home, residential and other community support services, including personal assistance necessary to support living and inclusion in the community, and to prevent isolation or segregation from the community.” Prof Gerard Quinn, an expert in disability law who played a key role in the drafting of the convention, says it will have major implications for Ireland. “My interpretation is that all institutions and mini-institutions would have to be phased out in favour of wrapping housing and services around individual needs and preferences. “The key is how do we modernise service delivery to ensure that can happen. There’s a lot of learning to be done on how this can be done successfully.”