What Does Deinstitutionalisation Mean?

A very long word, often shortened to DI to save ourselves the trouble, that is thrown around more and more, in various different places. A word of some importance, and therefore important to understand. What exactly do people mean when they talk about deinstitutionalisation and what is involved in the process.

In this blog I will give a brief overview and in the following blogs I will pick out some elements that are mentioned today and look at them more closely, to allow a more thorough understanding to develop.

At its most basic, deinstitutionalisation links the different subjects that have been mentioned in blogs over the past six months. We have looked at the drawbacks and the dangers of children living in institutions, we have looked at what can be done to prevent children getting separated from their parents – and ending up in institutions – as much as possible and we have looked at the family-based alternatives that allow children who really cannot stay with their parents safely to still grow up in a family environment.

All of that is wonderful, and important. However, there is a link missing: how do we get the children who currently live in institutions into family-based care (whether with their own family, or in foster families, adoptive families or small group homes)? The short answer is: through deinstitutionalisation.

Of course, if you have the best interest of the children at heart, it quickly becomes apparent that deinstitutionalisation cannot be as simple as just moving all the children out of in institutions, waving them off at the door. A lot more is needed to make sure that the children are going to be well cared for and will not be traumatised by the transition.

To start with the government of a country needs to play a role. Legislation needs to be in place to make it possible to even consider starting to make a move towards family-strengthening and family-based care. If under the current laws some of the things involved in placing children in alternative families are illegal, obviously the new system has no hope of succeeding. It is also very useful if the government can play a role in the setting up and monitoring of a foster care system and in helping to develop community services that allow children to be cared for in their own community.

Then, whether together with the government or with NGOs with experience in the field, a system for the family-based alternatives, such as foster care and small group homes, needs to be set up. Making sure that all the future ‘parents’ are very carefully selected and trained.

At the level of the institutions themselves, all children and their situations need to be individually assessed, so that a plan can be made, relevant to that child, as to what the best options are to help him. Some children will be able to go home to their own families – with or without financial, material or other support – some may be eligible for adoption, some may be best off going into a foster family and some are best placed in a small group home. These decisions and those about the kind of care and support needed from here on, need to be very carefully and thoughtfully made. And experts, caregivers, family members and the child should all be involved in this process.

Finally, before the child is sent away to start life outside the institution, a careful preparation process should be followed. This helps the child understand what is going on and why it is happening. It will help make the child familiar with his new situation before he makes the move, which in turn will greatly reduce the fear and anxiety involved and makes the transition less traumatic.

This is an extremely brief overview of the various things involved in deinstitutionalisation. But the basic meaning is clear: getting the child out of an institution, into the family-based situation that is best suited to him. In the next few blogs we will look closer some of the things involved.

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