Policies for a good life in the community: sustaining and improving community services for people with intellectual disabilities in difficult times
Abstract
Having substantially replaced institutions in many countries, a number of issues are evident: 1)The excellent results in terms of improved quality of life achieved in early demonstration projects in deinstitutionalization have often not been achieved in services set up afterwards; many community services achieve mediocre results 2) The rate and scope of advance in the process of continuous improvement in community services seems to have slowed dramatically, 3) ideology of inclusion and quality of life has been placed by pragmatism 4) Opportunities to broaden deinstitutionalisation and community living to less affluent countries have had limited success and 5)There are early signs of retrenchment in community services, with larger settings being provided, in the UK, Norway and Australia and in some areas new institutions are being built. There appears to be a tendency in some countries for those who are ageing and develop complex health needs to move back into more institutional settings.
In addition, strong national and local leadership is giving way to priority setting and resource management and innovation is more difficult in this context. The symposium took the form of a panel discussion focusing on the issue of how to overcome some of the issues outline above to sustain and develop good quality community based services.
The panel comprised experts from around the world including the Nordic countries, central and Eastern Europe, UK, North America and Australia.