期刊
JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY
卷 31, 期 2, 页码 65-76出版社
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/13668250600686726
关键词
deinstitutionalisation; community living; service quality; outcome
Background Deinstitutionalisation of services for people with intellectual disabilities has become a focus of disability policy in many countries. Research for the most part supports this strategy. However, outcomes are not uniformly better for everyone who moves to community living. This paper explores reasons for variability in service quality and highlights important lessons for countries starting to modemise services. Method The effects of demstitutionalisation are summarised and emerging problems identified. The changing context of different welfare-state models and paradigms in disability and public administration are outlined. Results The main changes which have impacted on the implementation of cleinstitutionalisation include: the rise of market-based approaches to service provision, arrangements for rationing services, the de-differentiation of intellectual disability services, and the rise of a rights-based model in disability policy. Conclusions The paper sets out priorities for the future development of community services. Success is likely to require a renewed focus on demonstrating improvement in the quality of life of people with intellectual disabilities and a change in the role of staff to provide more facilitative, enabling support of individuals, especially those with the most severe or complex disabilities.
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