Deinstitutionalization Process

1. Deinstitutionalization Process Photo: Carolyn Drake Regional Conference on Inclusive Education for Children with Disabilities Moscow, September 27-29, 2011 AnahitBakhshyan, Member of Parliament MeriPoghosyan, UNICEF Armenia

2. 605,000

3. 605,000 Is the number of children living in residential institutions in 27 CEECIS countries. Photo: www.thepromise.org.uk

4. 605,000 children in CEECIS face the risk of • Violence and abuse because of isolation and closed structure of most institutions • Discrimination/labeling from wider society • Insufficient provision of basic needs because of insufficient funds, corruption and lack of monitoring • Being institutionalized as adults as well

5. 605 000 children in CEECIS have higher probability of • impaired early brain development • poor physical and emotional health • poor self-confidence • lack of empathy and understanding of others • aggression towards others, cruelty to animals • autistic tendencies, self harming • problems with relationships • conflict with the law in adolescence and young adulthood

6. Is there an alternative for children? • Reunification with the natural/extended family • Substitute family • Short, medium and long term foster care • Emergency foster care • Specialized foster care • Respite care • Community-based small group homes • Adoption • Inclusion into mainstream schools (for education institutions)

7. Defining Deinstitutionalization • De-institutionalising and transforming children’s services is a collection of activities: it is not just the removal of children from institutions. Rather it is a systematic, policy driven change which results in considerably less reliance on residential care and an increase in services aimed at keeping children within their families and communities. Mulheir et al (2007) • Less costly in the long run • Best interests of the child

8. Constraints to deinstitutionalization Conceptual Level • Prevalence of medical vs. social model of disability • Unawareness about the harms of institutionalization • Lack of political will/vision/commitment • Stereotypes and prejudices Policy Making Level • Lack of appropriate legislation • Lack of intersectoral/interministerial cooperation • Allocations needed to cover transition costs

9. Constraints to deinstitutionalization Process Level • Financing mechanism • Sector – to –sector budget transfers • National level to community budget transfers • Management Capacity • Lack of capacity to manage de-institutionalization process (resource reallocation, re-profiling of staff, etc.) • Insufficiently developed social services • Case management • Monitoring of child rights in alternative care • Mainstream system not fitting the needs of every child

10. Constraints to deinstitutionalization Stakeholder level • Special schools and institutions • Professional convictions • Fear of loss of financing (per capita) • Fear of loss of jobs • Mainstream Schools • Lack of teacher capacity and resources • Discriminatory attitudes from teachers and parents and community in general • Families • Reluctance to raise their children in the families • Perceived fear of discrimination

11. FAILURE TO PLAN IS PLANNING TO FAIL

12. Failure to plan is planning to fail Strategic Plan Outline • Rationale for the choice of institution • Mission statement or statement of intent • Timescale • Projected costs • Available resources • Additional resources required • Partners • Methodology • Designated project management personnel • Strategies to address resistance

13. Failure to plan is planning to fail Strategic Plan Outline- Continued • System for evaluating and monitoring the quality of both process and outcomes for the children • Details of services to be developed (both prevention and placement services) • Building plans for the new services • Plans for use of the building currently housing the institution • Plans for the location of services • Plans for the phased preparation and movement of children • Plans for redeployment/selection and training of personnel Source: Mulheir et al (2007)

14. Levels of Intervention • Number level • System level • Paradigm/ mindset level SYSTEM LEVEL PROBLEMS NEED SYSTEM LEVEL SOLUTIONS

15. Deinstitutionalization in Armenia Facts and Figures • Over 1700 children with special needs in inclusive schools • 2800 children in special schools • 1050 children in orphanages • 800 in night-care institutions • 23 children in foster families

16. Deinstitutionalization in Armenia Number Level Intervention(education) • Increased number of inclusive schools from 0 to 81 in 10 years • Decreased number of special schools from 40 to 23 (only 10 were mainstreamed) • Increased per-capita financing for SEN students • Increased number of trained teachers Mindset/Paradigm Level Intervention • Introduction of Inclusive Pedagogy in Pedagogical University • Awareness-raising, non-discrimination campaigns

17. Deinstitutionalization in Armenia System Level Intervention • Legally stipulated right of parent to opt for mainstream school • De-I of orphanages officially declared as government priority • Creation of Integrated Social Services declared as government priority; pilot to be launched with UNICEF Assistance • Inter-ministerial Commission on Integrated Social Services and Working Group on De-I Master Plan (planned) • Amendments to the Law On Education • Creation of institute of Teacher Assistant in 1 region (pilot)

18. Amendments to the law on general education Main Amendments • Elimination of special standards of education (unified curriculum) • Transformation of 10 special schools into regional Psycho-pedagogical centers (PPCs) • PPCs serve as resource centers • PPCs evaluate special needs • PPCs retain right to educate children with severe mental retardation and multiple disability Will the amendments help?

19. Discussion

20. References and recommended readings • Garcia et al (2003) “Children in Institutions: The Beginning of the End? The Cases of Italy, Spain, Argentina, Chile and Uruguay. Innocenti Insight”, UNICEF Innocenti Research Centre • Mulheiret al (2007). “De-institutionalising and Transforming Children’s Services: A Guide to Good Practice”. • UN (2010) Guidelines to Alternative Care of Children, UN resolution 64/142 • UNICEF Social Monitor (2004) • WHO (2010) “Better health, better lives: children and young people with intellectual disabilities and their families”.