Services, disability and community
Institutionalisation and deinstitutionalisation are used to
describe the situation that people with high support needs live in, and
process of enabling these people to live more normal lives in society.
Institutionalisation could be described as a loss of
identity within society.
Deinstitutionalisation could be described as a gaining of
identity within society.
(1), Goffman (2, 3), Narje (4), Wolfsnsberger (5) and others have
the plight of people with intellectual disabilities. Social Role
was intended as a vehicle for social change (6). We are shown that
have the same feelings and needs as ourselves, and therefore have the
rights in participating in valued relationships and activities i.e.:
are just like you and I (7, 8, 9, 10, 11).
There is a growing amount of literature available
internet that suggests that deinstitutionaslisation is not working as
it was intended. The trend in some countries is the
people with intellectual disability or mental illness because of a lack
skills and resources. (12, 13, 15, 16,
17, 18, 19, 20, 21, 22, 23)
“There is overwhelming evidence
that people in the criminal justice system
have considerably increased mental health needs and that these needs are
extensively neglected in terms of developed and unified mental health
service strategies. Comparisons with the general community reveal that a
disproportionately small amount of our existing mental health resources,
already inadequate to meet community needs, are directed at meeting the
needs of offenders and those placed on remand in the jail system.” (22)
How can a community become empowered in providing
the needs of people with high support needs?
The project is designed to explore the various ways a community
more actively engaged (empowered) in providing for people that have
support needs in their community
(providing valued roles for
(24, 25, 26, 27, 28).
The traditional methods of service delivery of social work and
services seem to be opposed to each other:
… Social work looks at
community and the social barriers that people have in participating in
… On the other hand, disability services looks at the personal barriers
people have in participating in the community (27).
The concept of de-institutionalisation and
inclusion has achieved very little
in regard to people with high support needs becoming valued as a part
own community. Yes, some of these people
do live and work in
and have valued roles within the community,
but are they a part
community, and more importantly … Do they
feel that they are a
their community and are they valued as a part of their community?
Does the community have the skills and
resources to fulfil
The growing economy. Growing population, getting
technology means people are living longer (29).
Lack of community
A smaller work force to draw on
Higher cost for goods and services
Increasing population pressures on existing services
The existing resources are being
stretched to the max
Participates in the activities of
Becomes dependent on the organisation in providing for the needs of
have a severe physical or intellectual disability.
Learned helplessness etc
When providing the most appropriate care for people with high support
1) The community is not where the
person is living, but where the
person participates, shares experiences and has valued relationships
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
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,
profession or service define the way the person is supported within
7) Facilities that support people with high support needs do not
need to be the nursing homes or prisons in the
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.
The research has been done in information
available on the
internet, as well as my own experiences. There is also an assumption
attitudes are determined by the type and severity of the disability of
person, and the impact of the person in the lives of the individuals
(17). There is also
the assumption that there
studies available that support or contradict this view.
Any dialogue in the discourse of people with high support needs and the
community, needs to be positioned in the context of the person and the
community. What are the needs of the person ? What are the needs of the
? How can the
needs of the person be balanced with the needs
of the community
By looking at disability as needs based, rather
located in the person or society, we can find strategies to fulfil
within each community that the person participates in.
“The rise of the social model of
disability has de-emphasised intervention to help
people gain skills and independence. Staff training emphasises
practice and the promotion of choice and opportunity for people who can
clear intentions – not the skilled professional support required to
enable people with
significant intellectual disabilities to continue to grow and develop
The implications of these broad changes in context are important.
Deinstitutionalisation and community living has very largely been
sustained, in the
policy arena, through the promotion of a particular philosophy. Great
been carried through on the assumption that community-based services
than the institutions. This is unlikely to be enough in a harsher, more
climate. The pursuit of more staff, smaller services, tenancy status
rather than group
homes, in the absence of unequivocal evidence that these things make a
unlikely to carry sway. If community services continue to provide very
and overall if they are seen to be not much better than sanitised
institutions, then they
will lose out in the policy marketplace.” (26, P.13)