Institutions and the history of care and support

In Week 1, we introduced institutionalisation as an example of the history of exclusion of disabled people. In this step, we explore institutionalisation in more detail and examine it in the context of care and support. This step has a particular focus on institutionalisation and deinstitutionalisation for people with intellectual disabilities.

Eric Emerson’s closing remarks in the above video capture an important perspective on care and support. He says that in all the countries he has visited, they are still trying to work out how to “provide support to enable people to do what they want to do with their lives rather than providing care, which is largely about providing support so that people do what we think they should be doing with their lives.”

Eric argues that deinstitutionalisation — the policy and practice of closing down large residential institutions so that people with disabilities can live in the community — has created a significant change in disability services and has overall improved the wellbeing of people with intellectual disability. But despite this, deinstitutionalisation has not achieved its overall goal — to undo the social exclusion of people with intellectual disabilities.

Talking points

• What were the goals of deinstitutionalisation?
• In what ways has deinstitutionalisation been successful? In what ways has it been unsuccessful? Why?
• What impact do you think deinstitutionalisation has had on the ability of people with disabilities to live good lives?

In this step, we focused on the late-20th century movements away from institutionalised care. In the next step, we look at what care and support look like today.