Deinstitutionalization Of People Research Articles

The Limitations of Deinstitutionalization: The Case of the Israeli-Occupied Palestinian West Bank

This essay examines the concept and limitations of deinstitutionalization as a principle and practice derived from Western paradigms, and how it has been problematically implemented in non-Western settings, ­including the Israeli-occupied West Bank. It begins by reviewing the international literature on deinstitutionalization of people with mental health illnesses/disabilities. It then examines the Palestinian experience with deinstitutionalization in the West Bank with an eye to its many limitations, in order to propose alternatives to successfully relocate people with ­mental health disabilities from hospitals to their communities, and to ensure for them a dignified life. The essay ends with an emphasis on this need in the ­Israeli-occupied Palestinian territories given the ongoing daily reality of Israeli military occupation and apartheid, which have had dire effects on Palestinians’ mental health.

코로나19로 인한 청소년들의 간접외상이 우울에 미치는 영향과 자아탄력성의 매개효과

본 연구는 코로나19를 사회적 재난으로 정의하고, 이로 인한 청소년들의 간접외상과 우울의 관계에서 자아탄력성의 매개효과를 분석하였다. 이를 위해 2020년 8월~9월까지 약 4주간 경기도 소재 9개 고등학교 학생 1,927명을 대상으로 인터넷 설문조사를 실시하였다. 분석결과 코로나19로 인한 청소년들의 간접외상은 ‘사회에 대한 불신반응’, ‘개인의 인지·정서 변화’, ‘침습반응’ 순으로 높게 나타났으며 세 변수 모두 우울에 직접적인 영향을 미치는 것으로 나타났다. 또한 이들 변수와 우울의 관계에서 자아탄력성 매개효과는 모두 유의하였으나 매개효과의 성격은 다르게 나타났다.<BR> 이러한 결과는 코로나19가 장기화되고 있는 시점에서 청소년들의 간접외상에 대한 개입의 필요성 그리고 이에 대한 개입시 개인의 내적특성인 자아탄력성을 향상시킬 수 있어야 함을 시사한다. 이와 함께 본 연구결과의 함의와 한계점 그리고 후속연구를 위한 제언을 하였다.

Institutionalization / deinstitutionalization of people with disabilities a contemporary social problem

In contemporary society, although many adolescents with disabilities are making social integration efforts, many of them are unemployed. Unemployment officially and open refers to direct exclusion from the labor market, but there is also a phenomenon of exclusion inside the labor market. Some groups are involved in segments where jobs are uncertain, poorly paid and do not require special or specialized training. Labor market segmentation tends to be built around immediately identifiable groups (eg by age, ethnicity, gender), so that the exclusion of the "decency" is doubled, associated with other forms of social exclusion. It is necessary to improve social policies in the field of disabled people and the strengthening of strategies in the development process of institutionalization of disabled adults.

시설 거주 장애인의 탈시설 의향에 영향을 미치는 요인은 무엇인가?

본 연구의 목적은 시설 거주 장애인의 탈시설 의향에 영향을 미치는 요인이 무엇인지 분석하고 향후 장애인 자립생활 지원을 위한 정책 개선방안을 제안하고자 한다. 이를 위해 경기도내 146개 거주시설 401명의 장애인을 대상으로 설문조사를 실시하였으며 분석방법으로는 이항 로지스틱 회귀분석을 통해 시설 거주 장애인의 탈시설 의향 영향요인을 분석하였다. 연구결과 인구학적 요인으로는 연령이 낮고, 학력이 높으며, ADL 수준이 높을 때 탈시설 의향이 높은 것으로 나타났다. 시설요인으로는 입소기간이 길고, 시설만족도가 낮을 때, 자립요인으로는 자립생활지원정보를 알고 있거나, 자립지원서비스 정도가 높고, 다른 사람의 시선과 선입견이 낮을 때 탈시설 의향이 높은 것으로 나타났다. 이를 바탕으로 본 연구는 탈시설 및 자립 위한 정보제공, 지역사회 정착을 위한 주거지원, 탈시설 직후 활동지원서비스 시간 확대, 재시설화 예방 위한 주간활동 지원 그리고 일자리 등 경제활동 지원 등을 정책적 함의로 제시하였다.

Institutionalization / Deinstitutionalization of People with Disabilities a Contemporary Social Problem

In contemporary society, although many adolescents with disabilities are making social integration efforts, many of them are unemployed. Unemployment officially and open refers to direct exclusion from the labor market, but there is also a phenomenon of exclusion inside the labor market. Some groups are involved in segments where jobs are uncertain, poorly paid and do not require special or specialized training. Labor market segmentation tends to be built around immediately identifiable groups (eg by age, ethnicity, gender), so that the exclusion of the decency is doubled, associated with other forms of social exclusion. It is necessary to improve social policies in the field of disabled people and the strengthening of strategies in the development process of institutionalization of disabled adults.

The Influence of Residence Type on Personal Outcomes.

Over the last 5 decades, the state institution census has decreased 85% in the United States. Despite these radical shifts away from institutionalization, people with intellectual and developmental disabilities (IDD) continue to struggle to be meaningfully included in the community. For these reasons, the aim of this study was to explore if and how residence type affects attainment of quality of life outcomes of people with IDD in the United States. To do so, we analyzed Personal Outcome Measures® interviews from approximately 1,350 people with IDD. Findings suggest much of what has historically been considered deinstitutionalization of people with IDD is transinstitutionalization, particularly with provider-owned or -operated settings. A systemic overhaul is needed to create an effective community infrastructure.

Preditores da qualidade de vida e de suporte social percebido em pessoas com doença mental crónica: Estudo preliminar

Objetivos: As políticas de Saúde Mental privilegiam as práticas que incentivem a desinstitucionalização; contudo muitas pessoas com doença mental crónica permanecem institucionalizadas, competindo às instituições de saúde contribuir para melhorar a sua Qualidade de Vida e a perceção de Suporte Social. Este estudo pretende caracterizar uma amostra de pessoas com doença mental crónica institucionalizadas e identificar as variáveis preditoras da Qualidade de Vida e de Suporte Social Percebido. Métodos: Neste estudo de design transversal e descritivo-correlacional, participaram 60 mulheres institucionalizadas, com diagnóstico de Esquizofrenia ou Perturbação Bipolar. Utilizou-se um Questionário Sociodemográfico, o Questionário Breve de Avaliação da Qualidade de Vida (Vaz Serra et al., 2006) e a Escala de Satisfação com Suporte Social (Pais-Ribeiro, 1999). Resultados: As análises de regressão múltipla efetuadas demonstraram que a Perceção de Felicidade é preditora da Qualidade de Vida e do Suporte Social Percebido; a Perceção do Estado de Saúde é preditora da Qualidade de Vida e a Satisfação com a Comunidade é preditora do Suporte Social Percebido. Conclusões: Ao nível das principais conclusões e como implicações para a prática clínica, destaca-se a importância que um maior sentimento de pertença e de satisfação com a comunidade têm na Qualidade de Vida e no Suporte Social Percebido.

知的障害者のある人の施設から地域への移行の実態と課題 : 長野県と長野県西駒郷における「地域生活移行」に即して(シンポジウム,学会フォーラム:地域移行支援の現状と課題)

知的障害者のある人の施設から地域への移行の実態と課題 : 長野県と長野県西駒郷における「地域生活移行」に即して(シンポジウム,学会フォーラム:地域移行支援の現状と課題)

Fighting the Enemy Within? Challenging Minor Principles of Professionalism in Care and Welfare

Wilensky’s seminal article on professionals mentions three identifying characteristics besides the familiar specialized knowledge, autonomy and professional ideology. These are the referral principle, which states that professionals should refer clients to a colleague with a different specialty if necessary, the principle of sloughing off, which dictates that professionals allocate less rewarding parts of their job to lesser paid assistants, and the principle of impersonal service delivery, which admonishes professionals to treat clients equally. A changing clientele in health care and social care warrants a reappraisal of these three principles. Population ageing necessitates a reappraisal in health care. The deinstitutionalization of people with psychiatric or mental disabilities necessitates a reappraisal in social care. Referral, sloughing off and impersonal service delivery are professional characteristics that concur with managerial or political objectives. Managers and politicians are partly responsible for their widespread application. Hence, professionals need their help to fight this “enemy within professionalism.”

Reforma Psiquiátrica no Rio de Janeiro: situação atual e perspectivas futuras

This article analyzes the mental health network in the city of Rio de Janeiro. It provides a report on the current status of the implementation of psychiatric reform and identifies progress, limitations and challenges in this area. Documentary research was carried out by examining official documents, ordinances, SUS databases, information that was available at the Superintendency of Mental Health of the city of Rio de Janeiro, and a literature review of Brazilian and international scientific articles. The results point to important advances in the de-institutionalization of care, with a substantial reduction in the numbers of psychiatric beds, and increased community facilities. However, the following significant challenges remain: the need for increased coverage by psychosocial care centers; the implementation of psychiatric beds in general hospitals; the integration of mental health with primary health care; the de-institutionalization of people who remain in hospitals for long periods; the expansion of the number of residential facilities; and an increase in the provision of specific services for people using alcohol and other drugs.

REABILITAÇÃO PSICOSSOCIAL EM MORADIAS ASSISTIDAS NO BRASIL E EM PORTUGAL

O objetivo desta pesquisa é discutir como as Moradias Terapêuticas para usuários com transtorno mental, nos municípios de Miranda do Corvo-Portugal e de Volta Redonda-Brasil contribuem com o processo de reabilitação psicossocial das pessoas com sofrimento psíquico. Estudo de perspectiva histórica, cujas fontes foram leis, resoluções e relatórios oficiais e depoimentos de enfermeiros, psicólogos e assistentes sociais. Constatou-se que, embora em ambos os municípios a intenção seja a desinstitucionalização das pessoas com sofrimento psíquico, em Miranda do Corvo-Portugal a gestão financeira e administrativa é de responsabilidade de uma Fundação e, em Volta Redonda-Brasil, essa gestão fica sob os auspícios do poder executivo municipal, além de se observar em Miranda do Corvo a adoção de normas disciplinares em função no excesso de usuários. Conclui-se que a crise econômica em Portugal interferiu na política de expansão de Moradias Terapêuticas para uma quantidade de usuários que não permite intervenção mais individualizada.

Desinstitucionalização de seniores com doença mental: A implementação de um modelo de transição e integração na comunidade

On the deinstitutionalization of people with mental illness from psychiatric institutions to the community, we !nd relevant con tributions from the beginning of the twentieth century, but it continues to generate interest and a contemporary challenge, considering the complexity and multidimensionality of integration in a community context. In this paper, we describe the process of transition to the community of 24 seniors with mental illness, with an average age of 71 years, 13 men and 11 women in the original group and with an average 40 years of psychiatric institutionalization. is initiative enabled the closure of the Hospital Miguel Bombard, and describes the various stages and activities of the transition process: a) in the hospital b) the transition c) phasing in new housing and community context. To document the journey a formative model has been built with independent variables (demographics / economic status and legal / hospital / mental health / co morbidity) and dependent variables (daily functioning, social supports, community participation and perceived health status). e data were structured from the qual itative and descriptive analysis of individual and group travel in T0 (transition), T1 (1 year) and T2 (2 years) of deinstitutionalization, emphasizing the perspective of the participants, their families and professionals and systematic consultation of the records of daily operation of community residence. e results show a gradual, continuous and meaningful involvement with personal care, participation in activities within housing and sporadic or regular activities in the community.

Deinstitutionalization of People with Mental Illness: Causes and Consequences

Movements to deinstitutionalize people with mental illness and to make institutionalization more legally difficult have resulted in a lack of space and resources for the care of those with severe mental illness, and many have ended up in jails and prisons.

Deinstitutionalization of People With Mental Illness: A Failed Policy That Could Have Succeeded

Deinstitutionalization of People With Mental Illness: A Failed Policy That Could Have Succeeded

Deinstitutionalisation of people with intellectual disabilities in Finland: a political perspective

A gap between the basic principles of deinstitutionalisation programmes and reality is evident in many countries. In this article, we approach this gap, using the deinstitutionalisation process in Finland as an example, as an incongruity between progressive disability policy and neoliberal economic policies. Drawing on earlier research and reports on both the neoliberal turn in economic policy and thinking and the current state of services for people with intellectual disabilities, we explore the ways in which the neoliberal turn has shaped the deinstitutionalisation process in Finland. We argue that it has at the same time accelerated the closure of long-stay institutions and hampered the development of alternative services. We identify which neoliberal economic policies are among the most crucial with respect to the development of the system of services for people with intellectual disabilities, and then analyse their effects. We offer also a theoretical interpretation of neoliberalism, arguing that at heart it is a political project.

A Place to Call Home: Intellectual Disabilities and Residential Services in Nova Scotia

Despite broader trends toward the deinstitutionalization of people with intellectual disabilities, evidence that they have a higher quality of life in the community, and recognition of community living as a human right, many in Nova Scotia remain segregated in institutional settings. This article provides insight on the reasons why people with intellectual disabilities continue to be institutionalized in the province. It is based on participant observation, document analysis, and qualitative interview research. It finds that implicated community members— including policymakers, residential service providers and workers, and advocates— hold conflicting beliefs about the purpose and necessity of large institutions, as well as the extent to which community-based group homes reflect institutional models. This paper argues that these conflicting beliefs have practical implications for disability advocates, community service providers, and policymakers in Nova Scotia and in other provinces as they attempt to improve residential services.

Jail Inmates with Co-Occurring Mental Health and Substance Use Problems: Correlates and Service Needs

The confluence of the deinstitutionalization of people with mental illness and the massive incarceration of drug offenders has dramatically raised the number of substance abusers with mental illness in American jails. This study sought to identify correlates of comorbidity and service gaps among jail inmates using data from the 2002 Survey of Inmates in Local Jails. Results suggest that offenders with comorbidity can be satisfactorily identified according to their past exposure to certain risk factors. One third of the jail population met the comorbidity criteria and 64% of them did not receive any treatment or counseling service while incarcerated. Policy implications are discussed.

Deinstitutionalization of People With Developmental Disabilities: A Review of the Literature

Ontario has recently closed its last 3 institutions for persons with developmental disabilities. Very little research has been conducted on Canadian deinstitutionalization projects, and the impacts and bona fides of such endeavours have not been well documented in Canada. However, the closing of institutions has occurred in most Western jurisdictions and has been the subject of much research in Australia, the United Kingdom, and the United States. Although community services are of variable quality, this literature review suggests that the Ontario plan to close institutional facilities in favour of community-based residential services will be of general benefit to former institutional residents.

Book Review: Deinstitutionalization of People with Intellectual Disabilities: In and Out of Institutions

Book Review: Deinstitutionalization of People with Intellectual Disabilities: In and Out of Institutions

Met and unmet needs of schizophrenia patients in a Spanish sample.

Deinstitutionalization of people with schizophrenia increases the importance of evaluating their needs. This study set out to identify the most common needs of people with schizophrenia who live in the community, analyze how those needs differ when evaluated by staff or by patients, describe the kind of help patients receive, and find out the variables that correlate with having unmet needs. A random sample of 231 outpatients with schizophrenia were evaluated with the Camberwell Assessment of Need and other predictor and outcome variables. Staff detected more needs than patients did. Mean number of needs as rated by patients was 5.36 and staff 6.6 (p < 0.001). Mean number of unmet needs was also greater when assessed by staff than by patients: 1.38 versus 1.82 (p < 0.001). The most frequently detected needs by patients involved psychotic symptoms, house upkeep, food, and information. Staff most often detected needs involving psychotic symptoms, company, daytime activities, house upkeep, food, and information. In a multiple regression model, needs were weakly associated with the clinical variables and quality of life. Needs assessment is complementary to clinical evaluation in schizophrenia.