Socialinių paslaugų vystymas ir teikimas psichosocialinę negalią turintiems asmenims stacionarių globos institucijų pertvarkos perspektyvoje ; Development and provision of social services to persons with psychosocial disabilities in the perspective of social care reform

Abstract

Deinstitutionalization is a transition from institutional care or other segregating services to a system that enables independent living for people with disabilities in the community. The Ministry of Social Security and Labor of the Republic of Lithuania, municipalities, non-governmental organizations (NGOs) and social care institutions participate in this process. Changes in social care policy at the legal and practical levels depend on the interaction between these parties. The aim of the dissertation was to deconstruct the process of transformation of social care policy and its connection with human rights, as well as the interaction of participants of deinstitutionalization process in creating the content of community services. Combination of the agency and ecological systems theory and a comprehensive study on deinstitutionalisation identified key obstacles to transformation, including differing interests of participants of deinstitutionalization process, their opportunism, information asymmetry, lack of political leadership and cross-sectoral responsibility, and the exclusion of people with disabilities. People with disabilities are involved in the deinstitutionalization process only as objects (recipients of services), yet they lack opportunity to participate in the policy planning. Additionally, the results of the research revealed a threat of possible trans-institutionalization, which refers to maintaining the "old" institutional culture and structure, stigma, community resistance, and other aspects not directly related to the participants of deinstitutionalization process. This may leads to situation when people with disabilities are being simply 'placed' in the community instead of being given the opportunity for meaningfully engagement and participation within the community.