Health and Social Services for People with Intellectual and Developmental Disabilities in Taiwan

Abstract

The provision of health and social services for people with intellectual and developmental disabilities has historically followed a different path in Asian countries than in Western countries. The most important of these paths is that there was no institutionalization in the history of Taiwan in the last 150 years. However, residential services for people with intellectual and developmental disabilities in Taiwan are available, but not on a large scale. One reason is that families are concerned about stigmatization if they have a family member with intellectual disabilities. Such families are not likely to seek outside services, choosing instead to have the immediate family or relatives provide the care. The other reason has to do with the fact that during the past 200–300 years, Chinese society has not been influenced by social Darwinism, which contributed to social separation and the isolation of people with intellectual disabilities from the rest of the society. This unique history has not been recognized by most Western researchers. Because Asian culture is both rich and highly diversified, it is nearly impossible to discuss in a single chapter the health and social services available for people with intellectual disability. Asia has not been a mainstream focus for Western researchers and most of the published Western research work on intellectual disability services in Asian countries has assumed a Western perspective and has ignored the characteristics of these services that are unique to Asia. In the last two to three decades, there has been little published research about the situation of people with intellectual or developmental disabilities in Asian countries, and only recently a few reports have appeared in Western journals. In this chapter, I use the case of Taiwan to open a window for understanding the status of health and social services for people with intellectual disability in Asia. Taiwan stands out partly because in the last 15 years many articles about intellectual and developmental disabilities have been published in Western journals, which provides material for comparison. The other reason is that Taiwan has the most advanced democratic system of any country influenced by Chinese culture, and disability-rights advocacy groups in Taiwan have actively participated in various policy-making initiatives; this has not been true in China or Hong Kong. From a disability-rights viewpoint, the accumulating research results from Taiwan offer Western countries an opportunity to learn about the health and social services available to people with intellectual disability in Taiwan and to see how they compare to the services available in the West.