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Characteristics of an institution

Characteristics of institutions
Social Role Valorisation (SRV)
Deinstitutionalisation
Disability services
Disability and community

Some Perspectives on Deinstitutionalization
Explanation of terms




Characteristics of an institution
Institutions are a part of the social construction of a community
Characteristics of an institution
Culture
Values
Hierarchy
Roles
Expectations
Behaviours
Institutions and institutional care
Formal institutions
Short term care
Long term care
Informal institutions
Outcomes
Negative outcomes (devalued)
Positive outcomes (valued)
Institutionalisation, deinstitutionalisation, what's the difference
The concept of Deinstitutionalisation and Social Role Valorisation



An institution could be describes as:
... any club, facility, organisation or activity that:
... has more than one member that actively participates in the club, facility, organisation or activity
... is organised within a defined set of formal and informal beliefs, values, roles, expectations and behaviours
... may be highly structured within these formal/informal beliefs, values, roles, expectations and behaviours
... shares a set of objectives
(What Are Institutions)

An institution therefore refers to:
... the setting of the activity: the design, location and anything that is removed from or added to, that may influence, aid or protect the members,
... the structure of the activity: the various restrictions that are added to, or removed from the activity, or the way the activity is organised,
... the formal/informal behaviours and attitudes of the members: the various policies, rules, roles, hierarchies of the members.

What are the characteristics associated with being instituionalized & does the institution have any relevance?

I think institutions operate within guidelines and from those guidlines people act in a certain manner. Its like customer service. People expect a certain level of treatment and rights to be respected especially when money is involved and to attract the consumers they need to hit targets and they have ways of doing that.

If disipline is needed in prison and compassion is needed as a nurse you can see how people will act differently.
All institutions operate within guidelines which also act like a belief system to get what they want from life and to keep the 'majority' of people happy.

The characteristics in (people) i think are:
Linear thinking, lack of emotion, not always open to new methods of doing things, convincing you their way is best and that you need to trust their methods.

hope that helped!

(http://uk.answers.yahoo.com/question/index?qid=20081231032008AAYZ2ef)


Institutions are a part of the social construction of a community:
Institutions define the way we interact with each other within a community. They are determined by the formal and informal cultures and values of that community, and provide order and stability within that community.

"Institutions are structures and mechanisms of social order and cooperation governing the behavior of a set of individuals. Institutions are identified with a social purpose and permanence, transcending individual human lives and intentions, and with the making and enforcing of rules governing cooperative human behavior. The term, institution, is commonly applied to customs and behavior patterns important to a society, as well as to particular formal organizations of government and public service. As structures and mechanisms of social order among humans, institutions are one of the principal objects of study in the social sciences, including sociology, political science and economics. Institutions are a central concern for law, the formal regime for political rule-making and enforcement. The creation and evolution of institutions is a primary topic for history." (Wikipedia: Institutions)

Without a form of order and stability ...
... the community can not fulfill its role,
... there are no boundaries that define the community,
... the members do not see themselves as a part of the community,
... communication brakes down, or is nonexistent
... the commnity looses its skills and reources,
... the community can not fulfill its needs,
... clubs, teams, groups etc are no longer are a part of the community,



Click on image to view details.



Characteristics of an institution:  (Top)
While the characteristics of different institutions may be similar, the value that is placed on the institution is mostly determined by the society or community in which it is used. The Institutions of one community may be acceptable in providing a valued outcome, but be unacceptable in another community because the outcomes may be seen to disadvantage the members (devalued outcome). Traditional Aborigional communities (for example) have a strict code of conduct that is seen as crule and barbaric by our standards. While their institutions are viewed as uncivilised, they managed to survive for thousands of years.


Characteristics of an institution.

Culture:  (Top)
"The set of shared attitudes, values, goals, and practices that characterizes an institution, organization or group"
The culture of the institution is the way the institution is organised. This is generally determined by its role in society. For example, while the institutions of a hospital, nursing home or prison are simular, the culture of each is quite different.

Values :  (Top)
Institutional values (or social values) are different to our personal values in that they allow the members to function within the institution.

Hierarchy:  (Top)
Institutions are all about a means of coordination and cooperation. The hierarchy defines the agenda and purpose, and the way things get done.

Roles:  (Top)
Leadership is probally the most important role, and provides the identity and purpose within the institution. Other roles are determined by the hierarchy and the members in fulfilling the agenda and purpose of the institution.

Expectations:  (Top)
The members are expected to fulfill their assigned role within the institution.

Behaviours:  (Top)
The way the members treat each other or interact with each other is determined by the culture, values, hierarchy, roles and expectations of the members within the institution.

Charmaine Spencer (Chapter 4 The Institutional Environment (Characteristics of Institutions)) describes 11 characteristics of institutional care as:
"... Group Living (the setting)
... Standardization of Services
... Treating Residents as a Homogeneous Population
... Formalized Standards of Care Quality
... Accountability
... Hierarchical Structure
... Power Structure
... Professional or Work Relationship
... Medical/Custodial Model
... Dual Nature of Facilities as Personal Residence and Care Facility
... Separateness from Community"


Other characteristics:
... A bureaucratic form of management
... Has a set of formal/informal beliefs, values, roles, cultures, expectations and behaviours
... Formal/informal induction, initiation or rite of passage
... Have ownership of their members
... Walls, barriers etc. that separate the members from the wider community (physical and/or psychological)
... Symbols of authority, keys and locks, badges, uniforms, restricted areas
... Division of the setting/facility into different areas
... Division of the members into different groups
... Members have particular functions or roles
... These roles describe the formal/informal behaviours and expectations of the members
... The routine of the members is organised
... The institution is organised around a particular agenda
... The setting and the activities are designed around the particular role/agenda of the institution
etc.

Think of the internet (WWW).
Think of the various communities that make up the internet
How do the above characteristics fit into these communities?


Institutions and institutional care:  (Top)
These 6 broad Characteristics can be further broken down to describe a particular insitution.
Institutions can be thought of within two main groups:
1) Institutional care (formal) : provides the mechanisms for providing a service or support for a group in society.
... Short term care
... Long term care
2) Social institutions (informal) : provides the mechanisms for social interaction and participation.

Any business, service or organisation that provides a service to a group of people is organised around a set of cultures, values, roles, hierarchies, behaviours and expectations. Whether the service is a day care for toddlers, a video hire, a school or hospital, nursing home or prison, they all have the same characteristics. Institutional care is about a specialised service that is provided within a community, where the community does not have the skills and resources to provide for the needs of it's members. While the characteristicts of the institutions of the community, business, service or organisation are the same, the outcomes of the community, business, service or organisation are different.


Shows the relationship between the skills and resources of the community,
 and the amount of support that can be provided within the community.
(See Community care Vs Institutional care)

Formal institutions:
Are defined by the agenda, mission statement, objectives, values and behaviours of the business, service or organisation. These are generally set out by a code of ethics and behaviours that can be used to measure the outcomes of the institution. These can be voluntary, where the service, organisation or busness sets its own standards, or mandatory, where they are built into government regulations that allows the service to function.

These institutions...
... provides the role of the business, service or organisation within society - what is its role?
... defines the way the business, service or organisation functions within society - how does it do it?
... sets the scope and boundaries of the business, service or organisation - when does it do it
... defines the roles of the members of the business, service or organisation - who does what?

Short term care:
Any service that happens in an acceptable period of time, and does not have much impact on our lives. I may get a plumber to fix the tap or go to the doctor for a checkup. I can get on with my normal lives without to much irritation. If for some reason the plumber has to replace all the pipes in the house, or I have to go the hospital for a few days, my normal routine is disrupted for an appreciable amount of time, and may create some stress for me and the others around me. I may enroll in a course at school or uni and have to change my whole lifestyle to accomodiate the different patterns and routines. I have books to buy, lectures to attend, exams to pass, and various other social functions associated with the school or uni. There are behavoiurs and expectations required of me and this can be a very stressful period. However I know that I am working toward a goal, and am prepared to adjust my normal way of living for the period required. Even changing a job or moving house can involve a stressful period until I adjust to the new situation. What ever happens, I know that I still have some control over my life and still have the choice to opt out of the system if I choose to.

Goffman also makes the distinction between long term and short term stay. When the stay is short time and the outcomes are positively valued, the person may be able to adjust to their normal living patterns quickly. Short term stay can also result in negative valued outcomes that last a persons lifetime.

Long term care:
It could be argued that the process of institutionalisation starts within our family, in the day care centre or kindergarten or with friends and peer groups. We learn the values and cultures from significant others in our lives. Whatever happens, there is a sense of control over our life. We can plan and work toward a future, and those institutions are a part of the backround, just as a canvas is the background that a picture is painted on. Its only when these institutions become more promonent in our life, that problems occur.

The longer the time in istitutional care, the more disruption occures in a person's life.
There is a period of adjustment, and maybe rebellion, to the new situation.
There is a learning curve involved in finding out how things work (learning the ropes).
The amount of loss of independence depends on
the reason for the long term care
the amount of skill and resources the person has
the amount of skills and resources the service has
the amount of control the person has over his/her own life

A person may have to give up a significant amount of his/her previous life
belongings
friends
lifestyle
may be realocated to another setting that is more able to provide for his/her needs.


Shows the relationship between the length of care and the amount of institutionalised care provided.

A person may spend a few years in a hospital or in a university. The amount of restrictions in the person's life depends on the institution, as well as the skills and resources of the service. The longer the person spends in institutional care, the more institutionalised the person becomes. For some, this can be a gradual process, and others, this process can be sudden and abrupt. For others, it is the only way of life that they have known. Goffman acknowledges that the concept of a "Total institution" is a concept only, that institutions can never be total, but can be positioned on a continuum from open to closed (Total Institutions: K. Joans & A.J. Fowles - In Understanding health and social care By Margaret Allott, Martin Robb, 1998, Open University P.70). Goffman uses the term "institution" to describe the building and the institution of the building (the social construction). An interesting observation about the concept of a "Total institution" is that there is an assumption is that the staff of the institution are just as institutionalised as the residents, This may be the case where the staff treat others outside the institution the same as the residents of the institution, however, the term "institutionalised" refers to the residents of the institution and not the staff, visitors or any outside contact that staff may have with the outside world, Therefore, any institution, where the residents have no contact with others, (staff, family, friends etc.) or the outside world, can be considered as a total institution in the truest sense of the word. Institutionalisation has been used to describe the negative experiences and outcomes associated with long term care.

It is also interesting that a person is not considered institutionalised, where,
the experiences and/or outcomes of the institutionalised care are positevely valued.


Informal institutions:
Informal institutions allow the members or groups to function within the servise, organisation or busness. These institutions may vary according to what the members do within the business, service or organisation. Different members or groups have different functions or roles that allow these groups to coordinate their activities within the organisation. These institutions are informal because they are more about the way these members and groups interact with each other, rather any formal policies, rules or regulations of the servise, organisation or busness. There can be any number of layers in the business, service or organisation, The bigger the business, service or organisation, the more layers there may be.


The relationship between the formal and informal institutions
 within the business,
service. organisation or community.

These Informal insitiutions could also be described as the social systems of a business, service, organisation or community.
Are all ways that the members of a business, service, organisation or community organise themselves.

While the community (business, service or organisation) or has a role in society, each group has another role within the community, and each member has a different role within the group, within the community. The institutions of each layer also determines the way the community functions within society. Disability services (for example) have different areas that support people. Homes have different cultures. One home may be supported along a medical model and another may be supported along a social model. While each home supports the formal institutions of the organisation, the informal institutions of each home are different.

While the home may promote the cultures, values and institutions of the organisation, the cultures, values and institutions of the home are dependent on ...
the staff
the residents
The skills and resources of the staff and the residents

Two homes that are supported by an organisation may share the cultures, values and institutions of the organisation, however the cultures, values and institutions of the organisation of each home become more important. Each home has its own identity. The needs of the residents are different, the staff are different and are organised along different routines that suit the needs within the home. Even within each home the informal institutions change according to the staff that are on duty. One shift may be highly organised and structured along a medical model. Another shift bay be relaxed and casual along a social model. The shift may have strong leadership and is run along along organisational policies and proceedures


Outcomes:  (Top)
Institutional care, then, is an ordered and specalised intervention that requires an appropriate setting, skills and resources that are not available within the wider community. The way the care is provided and the outomes of this care are directly related to the service that provides the support. A prision, for example, has the same institutions as a hospital, however it is immediately obvious that the outcomes of the prision and the hospital are different. Even within different prisions and hospitals we see different outcomes.

From the above, it can be seen that the institutions of the buildings and communities that disadvantaged people were placed in, are the same as the institutions of the different buildings and communities that we all participate in, but have different outcomes. At he bank, we have to suffer all sorts of indignities to get a loan or see a teller. There is no compensation when something happens to our money because it is not their fault. Even when it is there fault, there is no one that takes responsibility.

When referring to an institution, there needs to be a new perspective in the way we approch service delivery. Institutions are neither open or closed, they just are. The way we use these institutions within the service determines the outcomes of the service.

Within the banking institution ...
... There is a sense of loss of self within the systen.
... A small staff/client ratio
... Are treated as objects (numbers, interns, defectives ect)
... Settings and activities are structured around staff --> clients
... Strict separation of staff and clients
While there are these negative outcomes, the value of the institution is positively valued by society. The institution may also be negatively valued by different communities within society.

Negative outcomes (devalued):
Collins 1993 (from Mental health care for elderly people By Ian J. Norman, Sally J. Redfern, P 501) describes institutional characteristics that are negatively valued as:
"... denial of humanity and individuality
... no personal space
... no privacy
... little choice
... little comfort
... little personal safety
... few possessions
... no dignity
... pauperized
... dependent
... no control, participation or decision making
... cannot function as ordinary human beings"


Other negative outcomes:
... A small staff/client ratio
... Low value (Sick Person, Subhuman, Organism, Menace, Object of Pity, Burden of Charity, Holy Innocent, Deviant etc. The Origin and Nature of Our Institutional Models)
... Low expectations
... Are treated as objects (numbers, interns, defectives ect)
... Settings and activities are structured around staff --> residents
... Strict separation of staff and residents
... Separation of residents into groups
... All residents are all treated and dressed the same
... All residents follow the same daily patterns of communal living
... There is no variety in the routine
... Activities are confined to the facility and separated from the community
etc.

Positive outcomes (valued):
Ramon, 1991 (from Mental health care for elderly people By Ian J. Norman, Sally J. Redfern, P 503) describes institutional characteristics that are positively valued as:
"... people first
... respect for the person's
... right to self-determination
... right to be independent
... empowerment"

Other positive outcomes:
... A large staff/client ratio
... High value
... High expectations
... Settings and activities are structured around residents --> staff
... Residents are treated as individuals
... Less structured daily patterns of communal living
... Variety of activities and different patterns in the routine to suite the residents
... Mixed activities where residents are included in the normal activities of the community (living, recreational, education and employment)
etc.

Goffman describes four main characteristics of institutional care as:
Batch living
Binary management
The inmate role
The institutional perspective

Rather than describing a characteristic of institutional (the building and the "social construction") life, Goffman is actually describing a set of outcomes that are characterised by the "social construction"of the institution. These outcomes are described as negatively valued outcomes. When used in the context of the corrective services or similar institutions, or in another culture, these outcomes may be seen as positive outcomes.

Batch living, for example, describes the conditions of living, the activities and the attitudes of the management and staff towards the residents.
"Batch living – where people are treated as a homogeneous group without the opportunity for personal choice. Activity is undertaken en masse. Rules and regulations dominate and residents are watched over by staff." (Lennox Castle Hospital: a twentieth century institution)

Batch living is used to describe negatively valued outcomes:
The members are separated into groups - authoritarian - subservient
The members of the subservient groups are all treated the same - as a group (group living, group activities etc.), rather than as individuals (no personal choice, no variety etc.) by the authoritarian group. "It is characterised by a bureaucratic form of management .... 24 hours a day without variety or respite." (Goffman, 1961 : 5-6, in, K. Joans & A.J. Fowles : P.71)

Within the wider community, we see these same outcomes, and although they may be less extreme, they are still there in all forms. Sometimes these outcomes, described as batch living, are a necessary part of the activity and the setting and are positively valued in providing positive outcomes for its members. A package tour, for example, the members are all living together and participating in the same activities. They are restricted in what they can and can't do, they have a set timetable that has to be followed, the service provider is responsible for their welfare etc. The value that is placed on the packaged tour is determined by the experiences of the members of the tour. I'm sure you have read or heard about a tour where the members were poorly treated, were placed in lousy accommodation, left on a ship or in a hotel for the whole time (these things have happened) etc. Boarding schools, the army, a prison are other examples of batch living.

We also see these outcomes (in varying degrees) in living, recreation, employment and education services that support disadvantaged people in the community. Does this mean that we need to remove all organisations, community groups or services that support disadvantaged people?

NO! There will always be a need for institutions and institutionalised care in the community.


Goffman states that no institution is all open or all closed. That they all share similar characteristics.
An institution is either positively or negatively valued, according to the values
of  the community or society that the institution is a part of.

It is the total value of the outcomes of the institution that determine whether the institution is
positively or negatively valued, rather than the characteristics of the institution.
The value of these outcomes are determined by the values of the community and it's members.

At school, for example, the students may negatively value school; they have to study, do homework, are not allowed to do what they want, are expected to be at a certain place at a certain time, are put on report if they don't do what they are told, can not go out at night during the week, have to wear a uniform, respect the teachers, have to participate in activities that they don't like (they may also be bullied and victimised) etc. etc. etc., while the parents and the wider community positively values the school in that the students develop knowledge, learn life skills, social skills etc. towards being productive members of the community.

In a religious convent, for example, the institutions may be positively valued and provide positive outcomes in one community, while the same institutions may be negatively valued and have negative outcomes in another community. Prisons may have a positive outcome for some, and have a negative outcome for others. Nursing homes can also have a positive outcome where the institutions of the nursing home provide positive outcomes for the residents (SRV).

From the above it can be seen that the values (high order, middle order or low order) of the community and the person determine whether the values of the institution are positive or negative. Do we, as a community, value liberty or security as a high order value? Do we value order and structure, or freedom and individuality, as a high order value? Do we value the sanctity of human life as a high order or a low order value? Do we value a physical life, or a spiritual life as a high order value? Do we value individual wealth, or shared wealth, as a high order value? Do we believe that all people should be treated equally, but some more than others?

Institutions and institutionalisation can then be seen to have two definitions within society.
1) the community definition is concerned with normal community activities such as education, religion, the legal system, or any body of knowledge or behavior that is a part of the community and is organised within a set of formal and informal settings, beliefs, values, roles, expectations and behaviours. They can be positive, where the members benefit from these institutions (positively valued outcomes), or negative, where the members are disadvantaged by these institutions (negatively valued outcomes).
2) within the human services (social definition), the terms institutions and institutionalisation have been used to describe the conditions that people with an intellectual disability lived in, in society. These are usually negatively valued outcomes.


While the term Institutionalisation can be seen to have
two definitions, they are describing the same things.
Community definition: the model of care is positively valued.
Social definition: the model of care is negatively valued.


"The term institutionalisation is widely used in social theory to denote the process of making something (for example a concept, a social role, particular values and norms, or modes of behavior) become embedded within an organization, social system, or society as an established custom or norm within that system. See the entries on structure and agency and social construction  for theoretical perspectives on the process of institutionalisation and the associated construction of institutions.

The term 'institutionalisation' may also be used to refer to the committing by a society of an individual to a particular institution such as a mental institution. The term institutionalisation is therefore sometimes used as a term to describe both the treatment of, and damage caused to, vulnerable human beings by the oppressive or corrupt application of inflexible systems of social, medical, or legal controls by publicly owned, private or not-for-profit organisations or to describe the process of becoming accustomed to life in an institution so that it is difficult to resume normal life after leaving." (Wikipedia: Institutionalisation)

The above shows that the term "institutionalisation" both describes the 1) process, and 2) the outcomes of the process that are negatevily valued by a person.

Types of institutions:
... Political
... Community
... Cultural
... Religious
... Health
... Educational
... Recreational
... Professional

The local museum (The Museum's Community Role) is an example of an institution in the community, and how the institution relates to the community.
While museum's are not disability service providers, they share some characteristics:
... Provide a service to the community
... Rely on government and community support
etc.:


Institutionalisation, deinstitutionalisation, what's the difference:  (Top)
Deinstitutionalisation has been describe as ... "the process of re-establishing people with disability in a community through community based services, where they have greater control over their lives and have positively valued relationships within society".
Another way to describe the process is ... "the relocation of people that are supported by an organisation or service into another setting, where they have a greater opportunity to experience the same activities and relationships as others within that setting".

In the above descriptions, the person still uses the support systems that are provided by an organisation or service, or within the disability arena. Issues of funding, responsibility, accountability, staffing and personal care, transport and medical are the responsibility of the organisation or service. The values, behaviours and expectations (institutions) of the organisation or service provide the institutions of the support used in supporting the person. The goal is to facilitate the develpoment of valued relationships and networks within a community, where a person is valued as a part of that community.

When moving to another setting, the particular institutions of the setting may become more inportant than the institutions of the organisation or service that provides the service.
Any setting where people live, work or play has its own particular institutions. They can't be avoided.
Think of any activity you are involved with.
Think of the various institutions that may be involved with the activity.
What are the various outcomes that may be associated with the activity? 

To deinstitutionalise can then be then thought of as a process of consciously or unconsciously adapting or modifying a person or people, their values, behaviours, the social structure, and the environment in which they participate. What is actually happening is a process of reinstitutionalisation, where, the outcomes change from negatively valued to potisively valued. While institutionalisation is often referred to the situation of people with disability (especially people with a mental condition), it is certainly not limited to this group.

Any person or group of people become institutionalised to a greater or lesser degree by the community,
organisation, culture or ethnic group of which they are a part of.

When moving from one community to another, we take on the values, behaviours, responsibilities and expectations (institutions) according to our particular role within the new community. A father in one community may be a teacher, or a student in another.


The concept of Deinstitutionalisation and Social Role Valorisation:  (Top)

Social roles are how we see ourselves and others in society. They are often about a particular characteristic (age, gender, race, ethnicity, culture, occupation, disability or even ability) rather than the person. A Muslim, for example, is often treated different because of his/her religion and culture. If the Muslim also had a particular disability or disadvantage, that person would have less chance of becoming a valued member in society. The same can be said for an aboriginal, a bikie or drugie, or possibily even a bank manager or used car salesman.

Social Role Valorisation (SRV) uses the concept of roles in the Implicit sense in that roles are used to generalise the values, behaviours and expectations (the institutions) that define the person or people, within a particular group, activity and setting, as a normal part of society. While this generalisation is true in the most part, I think that it is unwise to assume that the institutions of all activities and settings share the same roles.

For example, Wolfensberger describes in his paper "The Origin and Nature of Our Institutional Models" the buildings that devalued people were institutionalised in. They are characterised by the values, behaviours and expectations within the building. Rather than being institutionalised in these buildings, they were placed in these buildings because there was nowhere else. Because of a lack of skills and resources in the community they were assigned a devalued status. Once this transition happened, it became a normal part of community life (normalised in the community) in a sense that "these people are devalued lets lock them up". The outcome was that people who can not look after themselves, and need a structured life, were placed in large buildings that could provide their basic needs i.e.: they were institutionalised.

If I showed you a photo of a building, chances are that you would not know what its role was unless you knew what happened inside the building. In our community, we see all sorts of activities that are carried out in buildings of a similar design that have similar institutions (universities, hospitals, hotels, office buildings, factories etc). We also see examples of people being assigned a devalued status outside these buildings in communities.

Wolfensberger uses imagery (Semiotics- Signs and Symbols, Image Juxtaposition, Image Transference etc) with great effect so that the reader has an idea of what it may have been like to live in one of those facilities as well as society in general, and how he/she can avoid the same thing in the future. Maybe he has done his work to well, in as much as the points that he is trying to make and concepts he is trying to explain have been absorbed into almost every corner of our culture with gay abandon.

Just because a person has a valued role and is living in a home by himself or with others does not mean that his life is any less institutionalised (in the context of SRV) than he would be when living with 20 or even 200 others.

Whether the person with a disability is institutionalised (in the context of SRV) would depend on the:
... the model of care
... the amount of support the person has
... amount of restrictions the person has
... the setting of activities
... the structure of activities
... the person's relationships with others
... the formal/informal cultures, values, policies, practices and, the behaviours and expectations (institutions) of the administration and staff of the service provider.

When moving from one community (living, recreation, employment or education) to another, for example, we take on the policies and practices, cultures, behaviours, rules and regulations - the normal rhythms - of the community. We have to fit into the particular institutions of the community that we are joining.
Sometimes when the goal is the de-institutionalise a person, all we end up doing is re-institutionalising the person.

By changing the cultures, values, policies, practices and, the behaviours and expectations of the community, where people with high support needs have a better quality of life, we change the institutions of the community.

To Re-institutionalise then, is to bring about, or normalise, a behaviour, activity or policy that supports disadvantaged people within a setting, where that behaviour, activity or policy becomes a part of the setting (institutionalised).





"The authors discuss what can be learned from our experience with deinstitutionalization. The deinstitutionalization of mentally ill persons has three components: the release of these individuals from hospitals into the community, their diversion from hospital admission, and the development of alternative community services. The greatest problems have been in creating adequate and accessible community resources. Where community services have been available and comprehensive, most persons with severe mental illness have significantly benefited. On the other hand, there have been unintended consequences of deinstitutionalization—a new generation of uninstitutionalized persons who have severe mental illness, who are homeless, or who have been criminalized and who present significant challenges to service systems. Among the lessons learned from deinstitutionalization are that successful deinstitutionalization involves more than simply changing the locus of care; that service planning must be tailored to the needs of each individual; that hospital care must be available for those who need it; that services must be culturally relevant; that severely mentally ill persons must be involved in their service planning; that service systems must not be restricted by preconceived ideology; and that continuity of care must be achieved."
Some Perspectives on Deinstitutionalization




When providing the most appropriate care for people with high support needs ...
1) The community is not where the person is living, but where the person participates, shares experiences and has valued relationships with others.
2) People with high support needs (severe disability, aged etc.) will always need support structures as a part of their lives.
3) The amount of participation in a community (living, education, employment or recreation) is directly related to the skills and resources of the person, and, the skills and resources of the community that the person wishes to participate in.
4) Institutions are going to be around in one form or another whether we like it or not, It is the way that they are used that is the problem.
5) The institutions of a society towards a particular group determine the way the group participates in society.
6) The institutions of a particular government department, organisation, profession or service define the way the person is supported within that society.
7) Facilities that support people with high support needs do not need to be the nursing homes or prisons in the sense that they are today, but can become warm inviting community places that offer a range of services to the community, as well as be a part of the wider community within that society.
8) People with high support needs are a minority group in our society, and will have the same problems as other minority groups in being a part of society.


01/10/2010
Peter Anderson
http://www.psawa.com