Presentation of DI experiences in Norway Background, policies and outcomes Jan Tøssebro NTNU Social Research Banská Bystrica,

2 Background  A pervasive trend in welfare services:  Child protection (1953)  Special education (beginning in 1959)  Care for elderly people (1980s)  Mental health services (beginning about 1970)  Services for disabled people  This talk:  Deinstitutionalisation for intellectually disabled people  Trend starting in the 1960s  Full transition to community care

3 Images of community care  1950s and 60s  A minor supplement to institutions  Ideology played no role  1970s and 80s  Community care the preferred alternative  Institutions the only realistic alternative for people with extensive service needs  Children should grow up at home  1990 and beyond  Institutions are unwanted and unnecessary  Community care the only option, level of services can be adapted to all levels of needs

4 Two waves of DI  1960s and 70s:  The ideology of normalisation  Children should grow up at home  Improving living conditions in institutions  1990s:  Full deinstitutionalisation  Transfer of responsibility from regional health authorities to local government (social services)

5 The birth and development of the idea  Professionals (inspiration developmental/child psych)  New optimism – new purpose, labelling theory  Normal stimuli is the better environment for development  Institutions are intellectually disabling  Parents and the public (inspiration welfare policies)  Unacceptable living conditions  The myth of the welfare state – groups left behind  Segregation means stigmatisation  Politicians (inspiration other sectors and countries)  Changing typical services in order to serve a more diversified group of people – e.g. schools

6 The first wave: children  The deinstitutionalisation:  Special schools from boarding to living with family (from 1960s)  State special schools closed ( )  Limited admission of children to institutions (from late 1960s)  Arguments and a new division of labour:  The normal family is a better environment for scaffolding/ supporting the development of the child  Living conditions in special schools are unacceptable  The role of public services are to provide services that should create opportunities for A normal family life A childhood as normal as possible

7 Current status: children  The majority grows up at home  Most go to regular day care but as they grow older, segregation in school is more common  What about consequences for the families?  Do they break down? No  What about siblings? Like other young people  What about mothers’ employment? Later return to employment and shorter working hours More difficult family-work-leisure/culture balance

8 The second wave: adults and full deinstitutionalisation  Decentralisation: From a regional health service to a local social service  Deinstitutionalisation: All people resettled from 1991 through 1996  Expansion: Local social service also responsible for adults living with their parents.  Slogans: Normalisation, integration, improved living conditions, participation

9 The rise and fall of institutions in Norway,

10 Implementation  Drivers of change: parents’ organisations and national policymakers  Implementation 1: Decision(s) in Parliament  Act on deinstitutionalisation  Amendments of act on social services  Different paths in Norway and Sweden The Swedish plus-legislation, stronger rights  Implementation 2: Practical planning and running of services:  Local government, mainly social services, but also public housing, employment authorities …  Little privatisation in NO, DK, more SE, FI

11 Outcomes  More people have services  Family: from opposition to support  Much improved housing conditions  More self-determination/ choice in everyday matters  Community presence and neighbourhood reactions  The revolution that disappeared (occupation, social networks, leisure …)  The loneliness issue  Few failures

12 Family attitudes Source. Lundeby and Tøssebro 2006

13 Questions of interest  Institution employees:  Guided by Labour legislation rules for business “takeover”.  Majority offered new jobs  Public education:  Media debates  Visible in streets, shops, swimming pools, TV, etc.  Costs:  Expansion did cost, improved housing did cost, otherwise unclear

14 Lessons  Little to be afraid of (if adequately planned and implemented)  Scepticism turned into support  Safeguarding future development  Norway left too much to local government without much regulations (only soft guidelines) and national monitoring/incentives  The anchoring at local political level was insufficient  Rules and regulations of community care is needed for groups that in themselves have a weak voice  Documentation of changes:  Example: social networks

Good luck!