Do Not Rush Deinstitutionalisation

Even though we are all in a hurry to put an end to the institutionalisation of children, we cannot afford to rush the process of deinstitutionalisation. In a previous blog (HERE), I mentioned the dangers of time pressure on the deinstitutionalisation process at the national and international level. In today’s blog, I want to address the dangers of rushing the process at the level of the individual institution, and how hard it is to resist the temptation to give in to the push to go faster.

I am currently providing guidance for the deinstitutionalisation process of a large-scale institution in India. It is quite a roller-coaster ride, one that I have been on for close to three years now.

The first year was spent trying to convince the organisation – which I had been involved with for a number of years already — that it was a good idea to consider deinstitutionalisation. This idea was received positively from the first moment that I brought it up, but it took a long time to get the ball actually rolling to a certain extent. Once it started to roll, however, it very quickly got to a point where it almost spun out of control. Although no concrete preparatory steps had been taken yet, the enthusiasm was suddenly such that a couple of children were asked if they would like to go home and were sent back to their family the next day.

I immediately raised the alarm, and explained the need to do detailed assessments first, followed by a carefully thought out plan for each child, investigation whether the family was in need of support in order to be able to care for the child, setting up or coordinating those support services, preparing the child and the family for the transition and only then could it be possible to send the child home in a responsible manner. I also explained that if this process was not followed there were a number of big risks: 1) the child might be traumatised by the sudden move, 2) the family might find themselves unable to cope without support and end up sending the child back to the institution (which would be another abandonment for the child and also a traumatic experience), and 3) not doing things properly is almost certain to lead to failure of placements, which can be used by certain people to argue that the whole idea of deinstitutionalisation is irresponsible, putting an end to the process then and there.

This advice was taken, no further children were sent home for the time being. However, the cycle of patiently and diligently doing the groundwork to make sure things can be done right, followed by sudden impatience and a push to get things moving quickly, has continued and is ongoing. Every time, when I explain the risks of going too fast, there is nodding, understanding and patience for a time, until the patience runs out again.

I do understand the frustration. On the surface, while actual work has been ongoing for 16 months now, what you see is that not a single child has been placed back with their own family or in a foster family yet. However, that is just the outside. A lot of groundwork has been done. A lot of data has been gathered and analysed, a lot of templates have been made, a lot of recruitment and training has taken place. This is the stage where all the pieces are being put into place, so that when everything is prepared, things will in fact start moving quite quickly.

Plus, even though no child has been moved out through the deinstitutionalisation process yet, there are already far fewer children in the institution. Because of awareness raising and training, there is a shift in mentality. Instead of taking in any child that appears at the door, investigations are now being made to see whether it might be possible for the child to stay with their family, and often that turns out to be the case. Instead of seeking to fill ‘vacancies’ when children age out on their eighteenth birthday, only children who really have nowhere else to go are being admitted. So, while no child has been moved out yet, the number of children in the institution has gone down by 1/5 since the decision was made to move towards family-based care. That in itself is quite an achievement.

In the next blog, I will write about what these experiences and insights have inspired me to undertake.

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