About 4,200 people with intellectual disabilities are living in outdated institutions or group homes which need to be closed down or replaced, a report commissioned for the Health Service Executive (HSE) is expected to conclude.
Officials familiar with the draft findings of a report on “congregated settings” say the process of providing proper community-based care facilities could take years and require substantial resources.
Of the people with intellectual disabilities living in institutional care, some 300 are residing inappropriately in psychiatric hospitals, even though they may not have a mental illness. A further 350 disabled people live in “de-designated” units, parts of psychiatric hospitals that were reclassified as community units about 20 years ago.
Latest international research indicates that the best outcomes for people with disabilities in residential care are for those living independently. However, the quality of support is considered crucial to avoid creating “mini institutions”.
Experts say the numbers still living in institutions in Ireland are out of step with most western European countries which have been shutting institutions for the past 30 years.
Prof Jim Mansell, the author of a major report on the future of residential care commissioned by the UK government, said institutions by their very nature deny people with disabilities their basic rights.
“In the US and Britain at the end of the 1960s and 1970s there was scandal after scandal associated with institutional care, such as concerns on overcrowding, ill-treatment and abuse and neglect ... But if you provide the right kind of care in the community, you can transform the quality of people’s lives,” he said.
In a statement last night, the HSE said it was committed to increasing the provision of community-based care for people with disabilities and has been moving in that direction for several years. It said about 4,000 people are already in such settings.
Following the publication of the report on congregated settings, it says it plans to work closely with the Department of Health to finalise plans to increase the numbers of people with disabilities cared for in a community setting.”
Disability experts also say a major change in the culture of residential care is needed where residents are given the opportunity to be involved in the community and in decisions affecting them. Dr Fintan Sheerin, a lecturer in intellectual disability nursing at Trinity College Dublin, said many services need to move on from the “medical model”, which operates on the basis that there is something wrong with disabled people that requires treatment.
