Public Care for People with Intellectual Disability in Denmark – Ideals, Policy and Practice

Mie Engen,Anthon Jørgensen,Mette Rømer

doi:10.16993/sjdr.582

Abstract

Denmark, internationally known for its high level of welfare and solidarity with vulnerable groups, has been in the forefront promoting the ‘normalisation principle’ regarding people with intellectual disability (ID). Formulated in the 1950s by Niels Erik Bank-Mikkelsen to ensure people with ID have equal rights to live and participate in the community, social policy has since shifted toward individual rights, self-determination and active citizenship. However, these ideals and social policy goals have proved difficult to realise in practice. Drawing on two empirical studies of professional practice in Danish accommodation units for people with ID, this article investigates how care is practised vis-a-vis people with ID, who – for different reasons – depend on daily interaction with professionals for care, support or treatment. Finally, the article discusses current conditions for providing individualised care and support and how autonomy and active citizenship can be in opposition to empowerment through individual care and support.

Highlights

De-institutionalisation—the move from large residential institutions to small-scale services that enable people with intellectual disability (ID) to live in the local community—has probably been the most important development in social services for people with ID since the 1950s (Mansell and Ericsson 1996; Mansell et al 2010)
The professionals in the accommodation units must manage several dilemmas, which are embedded in the social organisation of public care: in principle, people with ID have the right to privacy and self-determination as all other citizens, but in practice, they are obliged to live and receive care and support in institutional settings regardless of their ability to use their right to self-determination or to respect that of others
Caring practices build on the relationship between the caregiver and the care-receiver, but these relationships can be difficult to establish and maintain, and as we have demonstrated, residents with higher support needs can resist cooperating around daily tasks

Summary

Introduction

De-institutionalisation—the move from large residential institutions to small-scale services that enable people with intellectual disability (ID) to live in the local community—has probably been the most important development in social services for people with ID since the 1950s (Mansell and Ericsson 1996; Mansell et al 2010). According to Mansell et al (2010: 104), the process of de-institutionalisation is well advanced in Scandinavia, as well as in the United States of America, Canada, the United Kingdom, and Australia. In Scandinavia, important reforms involving further de-institutionalisation in public services for people with ID—a process that started in the 1960s—were introduced during the 1990s. In Norway and Sweden all institutions for people with ID were closed and replaced by supported accommodation in the community (Tøssebro 2012). In Denmark all institutions were not closed. The intention was to break with the institutionalised care of the past that attributed power to the staff and to support the resident’s individual rights and dignity

Objectives

Methods

Discussion

Conclusion