Harm Caused by Institutionalisation- Short Version

When I was helping to put the written material together for the Immersive Simulation Lab: Family-Based Care Conference last month, writing parts for the conference pack, for press releases and so on, I was asked to give a very short version of how institutional care is harmful to children. This was followed with the reassurance that I could just copy something from my website or blogs. It sounded like good advice, except that when I started to look for a few paragraphs to borrow, I discovered that I have not written a blog-size version of the general overview yet. So I guess it is high time to change that. Here is my attempt:

Things like food, hygiene, shelter, and sleep are generally recognised as basic needs. These are universally acknowledged to be things children require to be able to survive and thrive. It is much rarer for people–anywhere in the world–to realise that attachment, attention, physical contact, and stimulation are needs that are just as basic and essential. Few people realise that a child’s survival can depend on these things. Researchers have found that in Europe and the USA, before 1920 when the standard practice was to only feed children, keep them clean, and provide them with a roof over their heads but not to take care of the other essential basic needs, between 70 to 100% of children in orphanages did not survive.

Receiving attention, stimulation, physical contact and opportunities to form secure attachments are part of our essential basic needs, from birth onward. Especially in institutions, these needs are often forgotten or pushed way down the priority list as a luxury. They are not a luxury. Children, who for a long time do not receive physical contact, stimulation, attention, and the opportunity to form secure attachments aside from having their practical needs met, become emotionally scarred and in some cases even intellectually handicapped–if they survive.

Children in institutions experience at the very least psychosocial deprivation, which has serious consequences. It affects the way their brain develops, it affects their physical growth and health, it affects the way they interact with the world around them, and it affects their behaviour, not just while in the institution, but also in their later life. Children who have spent time in an institution, particularly if it was at a very young age, have a very high risk of developing attachment disorders, physical and mental health problems, challenging behaviours, developmental delays, problems with social interaction, and problems coping with living in the community when they become adults. Institutionalisation also causes growth stunting, reduced brain size, and a weakened immune system, due to over activating the stress response of children. All of this is the result of the impossibility of meeting all of a child’s need in an institutional setting, while those needs are met in almost all families without giving it any thought.

Something that is easily overlooked, but that has a big impact on children growing up in institutions, is that they grow up isolated from the community, cut off from ‘the real world’. Children who grow up in an institution do not have a gradual opportunity to learn and develop skills and networks in the community as children in families do. They live cut off from society. Meaning that when they do leave the institution, they are really on their own. It is this fact of growing up isolated from the community, as much as not having had the opportunity for proper brain development that leads to an enormous shock when the young adult finds herself in the outside world, suddenly having to rely entirely on herself. She very quickly discovers that she is not equipped to handle the situations she finds herself in.

Various studies have shown that young adults who grew in institutions have a higher chance of long-term (or permanent) unemployment, of ending up living in the street, of being unable to care for their own children, of ending up with a criminal record, and of committing suicide.

So, that is the postage stamp size version of the argument against institutionalisation of children. Having gotten that out of the way, we can continue to look at what is available as alternatives and what is needed to set them up.

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