A transformative framework for deinstitutionalisation

Closure of the remaining institutions where some people with intellectual disabilities live is increasingly urgent following the Australian Government commitment to the United Nations Convention on the Rights of Persons with Disabilities, the National Disability Strategy, and the full National Disability Insurance Scheme. How can the transformative opportunities that this new policy context opens for people leaving institutional care be realised? This article analyses the rights of people leaving institutions by drawing on the data from an evaluation of the closure of three New South Wales institutions and the related development of four new facilities. The closures aimed to achieve a better quality of life but results were mixed. While participation, growing and learning, health and wellbeing, social relationships, and autonomy improved for some people, results were not consistent between sites and in some cases people were actually worse off than before. Community inclusion was not the focus of the closures and social isolation negatively affected the quality of life of people who were relocated. The implications are that remaining closures must apply a rights-based framework rather than building new facilities to meet legislative rights obligations. This includes: taking a person-centred approach to housing support; using closure as a transformative opportunity for community living; identifying people's choices through informed supported decision-making; applying sophisticated change management with families, staff and unions; and using the resources, expertise and successful closure experiences from the disability community to inform the process and opportunities for housing support. Applying the framework could draw on Australian and international evidence and experience.