Dedicated Staff for Deinstitutionalisation

At its core, deinstitutionalisation is a temporary state. It is the transition between running a residential childcare institution and running a family-based alternative care system. While the transition can take up several years depending on the circumstances, it will end. The temporary nature of the deinstitutionalisation process can lead to people underestimating how important and how complicated it is. This, in turn, can lead to a reluctance to really invest in it. However, not mobilising the resources needed to make the process go smoothly is a big mistake and one that can come at both a high human and financial cost.

I have seen this happen repeatedly. The agreement is reached that deinstitutionalisation is to take place, but when the question of hiring a (full-time) transition manager comes up, this is waved away as unnecessary. The conviction exists that the manager of the institution can take care of that kind of thing after all he/she knows all the children and has lots of contacts. I do not disagree that the manager of the institution has a lot to contribute to the DI process and that at a later stage he/she would be a valuable acquisition for the new family-based alternative care team. However, at this moment the manager is already burdened with a more than full-time job and is struggling to stay on top of what needs to be done for the daily running of the place. There is definitely no spare time to take on an additional full-time job.

So, what tends to happen is that the organisation is adamant that this will do and I let it go initially. Several months pass and absolutely nothing happens regarding DI. Plans and promises are made, only to be postponed again and again and again, because there is just no lee-way for extra work. After a while, I enquire whether or not anyone is interested in pursuing deinstitutionalisation. I am assured that they are, and I am told that the delays are simply due to this or that coming up unexpectedly. Once more I explain that no, this is not because of an isolated incident, it is because of the impossibility of getting a full-time job done by someone who is already overburdened to start with.

They concede that it might be a little much, and they do want things to go ahead, so a compromise is made and an official transition manager is appointed. Only, it is not a new hire, but someone who already has a function within the organisation. Someone who is not quite as overburdened as the manager of the institution, but still quite busy. So now, at a snail’s pace, things start moving.

The new transition manager sets in motion the gathering of stock and flow data and the recruitment of a case worker. However, due to the other duties that still require frequent attention, there is maybe 10-15 hours a week to spare for work related to DI. And when a caseworker has been hired, she quits again after just a few weeks, because the transition manager does not have the time to train her and help her get settled into her job, so after a few weeks of literally waiting around to learn what she is supposed to do, she gives up and leaves.

After a few months, there are complaints from higher management that despite having appointed a transition manager, things are just not progressing. I explain again that this is what I have been saying. Being a transition manager is a full-time job, and someone who is not available full-time is going to really struggle to get things moving. A decision is made to free up the transition manager and to provide (limited) salaries for a case worker and a counsellor to join the transition team.

Three people is not a lot to gather all the data needed, put together an awareness-raising campaign, do dozens of individual assessments and home visits, write individual care plans, recruit, select, and train foster parents and caregivers for group homes and do a dozen other things at an equally large scale. However, the higher management generously says that the team is not on its own, the transition manager should feel free to call in the help of other people within the organisation, everyone can lend a hand, whenever they are not busy with other things.

This may sound like a good solution on the surface, but there are several problems with this. Firstly, most people working for the organisation are busy with their own duties much of the time. Secondly, the moments when they are able to offer their help, may not be the times when help is needed or can be accepted. Thirdly, when lots of people do small bits of a large job, it becomes very hard to keep the overview and to make sure that everything is done properly and nothing is forgotten. Plus, under these circumstances, the people needing certain knowledge or data, may not have it, because it was taken care of elsewhere. Fourthly, as explained in a previous blog (HERE), there are various parts of the process – pretty much everything to do with direct contact with children, parents and foster parents – that require one person to see things through, because the relationship that is built up over time, is at least as important as the knowledge and skills involved.

And so, the process is delayed further. Because over time it becomes clear that there are many things that can really only be done by the transition team, if it is to be done properly, and the transition team does not have the man power to get it all done. This leads to months passing before a template is finally put together, which is essential to being able to move to the next step, simply because there are so many other things that need to be taken care of every single day.

Again, higher management start to grumble, ‘why is it all taking so long?’ Well, mostly, because of the resistance to properly investing in the transition process. Something which initially seemed like a way to save money, but which is now starting to become quite costly. Because at a point in time when the original expectation had been that children would have moved out by now -which would have been perfectly possible with a proper team in place from early on -, the process has not even gotten to the stage of individual assessments yet. In the meantime, salaries for the transition team have to be paid, and this will continue for quite some time yet, unless investments are made.

For a properly organised transition of a single institution, which is not to take up to a decade, you need to invest in a transition team with the man power and the knowledge needed to keep things progressing.

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