1. Deinstitutionalization strategy and implications for south asia
Dr. Nilima Mehta

2. Concept & Process: Deinstitutionalization
Reforming Child Care Systems where community and family based care is the first priority and an institutional care is the last option
Release of institutionalized children into the care of family and community
Reunification with the family & Reintegration into the community
Transitioning out of Institutional Care to family based alternative care needs family support, adequate preparation of the child & life skills education
Goal- Reunification with the child’s family or an alternative family

3. Institutional Care
Poverty- It shouldn’t be the only reason for institutional care
Gate Keeping- An important component for prevention
Community Based family oriented Alternative Care programmes for family support & strengthening as a preventive strategy in institutions
Institutional Care may be necessary for some children due to compelling circumstances
Minimum standards of Care moving to quality standards of Care
Prevention: Primary, Secondary & Tertiary

4. Mental Health Concerns
Importance of Relationships & Attachments in a Child’s Life
Negative Impact of Long term institutional Care:
Self- Esteem, Sense of Self & Identity Issues
Multiple Caregiving
Failure to Trust
Sense of Security
Emotional Resilience
Externalizing or Internalizing of Negative Experiences

5. Emotional Deprivation Separation Anxiety Maternal Deprivation
Low Self Esteem
Anonymity & Lack of personal attention
Failure to Trust
SOME OF THE NEGATIVE IMPACTS OF LONG TERM INSTITUTIONALIZATION OF THE CHILD
Interpersonal Relationship Problems
Developmental Delays
Excessive Routinisation and Regimentation
Difficulty in mainstreaming & adjusting in society
Segregation & Isolation from Society
Physical Abuse and Trauma

6. Process of Deinstitutionalization
Family Assessment/ Home Investigation Report
Case Management
Individual Care Plans- Unique to each child
Ongoing Review of the Care Plans
Preparation for the reunification & reintegration with the family
Child Participation in Decisions which impact her/his life

7. Alternative Care Options
Reunification with the birth family
Adoption for the child who is legally free for adoption
Kinship Care with the extended family
Foster Care
Sponsorship
Community Outreach Programmes
Day Care/ Night Shelters
Group Homes
Institutionalization as a last option

8. Community Based Rehabilitation Strategies
Empowerment Programmes for the community
Mental Health Interventions
Education
Health Awareness
Family Strengthening, Support & Counselling
Coordination & Collaboration from Policy to Practice

9. Way Forward
Advocacy for Alternative Care from the macro to micro level
Policy Development on Alternative Care
Intervention Programmes at the practice level
Facilitating access to community services and resources
Training, Orientation, Sensitization to bring about a mindset change/ paradigm shift in child protection
Monitoring, Supervision & Follow Up after Deinstitutionalization
“Institutional Mindset Change”
Mapping of Vulnerable Groups and Resources