Increasing emphasis on independent living and social inclusion is driving deinstitutionalisation - the shift away from a reliance on residential institutions towards family- and community-based settings for the provision of care and services. The aim is to ensure that people at risk of marginalisation have opportunities to participate fully in society and to exercise their personal rights and freedoms. An institutional culture that gives rise to social isolation and loss of autonomy can be present in any care setting, but it is commonplace in long-stay residential institutions such as children's homes and nursing homes. Although deinstitutionalisation strategies have been adopted across the EU, shortcomings are apparent. This report presents evidence on changes in the extent of institutional living in the EU over time, as well as information on national deinstitutionalisation strategies and practices. It includes two person-centred case studies that illustrate the benefits of deinstitutionalisation and greater social inclusion and the challenges encountered in efforts towards these goals.
Authors
Sanna Nivakoski, Marie Hyland, Nienke Boesveldt, Sophie Thunus, Héline Zabeau
- Catalogue no
- TJ-01-24-006-EN-N
- Cite this publication
- Eurofound (2024), Paths towards independent living and social inclusion in Europe , Publications Office of the European Union, Luxembourg.
- DOI
- https://doi.org/10.2806/4798019
- ISBN
- 978-92-897-2439-5
- Number of pages
- 82
- Pages
- 82
- Permalink
- eurofound.link/ef23018
- Published in
- Ireland
- Reference no
- EF23018
Files
Table of Contents
- Contents 5
- Executive summary 7
- Introduction 9
- Aims of the report 9
- Residential institutions 10
- Alternatives to residential institutions 11
- Quality of care, institutional culture and outcomes 12
- Chapter 1: Deinstitutionalisation 15
- Rights declarations 15
- Progress on deinstitutionalisation 16
- Potential for wider positive outcomes 16
- EU initiatives 17
- Chapter 2: Recent changes in institutional living in the EU 19
- Lack of a harmonised definition 19
- Existing estimates 20
- Latest estimates of changes over time 20
- Children in institutional care 20
- Adults with disabilities in institutional care 21
- Older adults in residential care 21
- Adults with mental health conditions in hospital care 22
- Use of emergency shelters by people experiencing homelessness 23
- Use of emergency shelters by victims of domestic abuse 23
- Chapter 3: Supporting independent living: Strategies and practices 25
- Strategies for deinstitutionalisation in the Member States 25
- Examples of initiatives to support independent living 25
- Children 26
- Adults with disabilities 27
- People with mental health problems 28
- Older people 29
- Victims of domestic violence 30
- Conclusion 31
- Chapter 4: Challenges with family- and community-based care and services 33
- Limited resources 33
- Suboptimal processes 35
- Challenges with achieving independent living 37
- Conclusion 37
- Chapter 5: Case study: Transitions from homelessness in the Netherlands 39
- Homelessness in the Netherlands: Trends, policies and evaluations 39
- Studies in two regions using ETHOS Light 42
- State of homeless shelters 42
- Case study evidence: Clients’ and professionals’ experiences 42
- Methods 42
- Preparation for transition to independent housing 43
- Actual transition to independent housing 46
- Independent housing in the long term 49
- Case study conclusion 50
- Chapter 6: Case study: Community-based mental health care in Belgium 51
- Mental health care in Belgium: Trends, policies and evaluations 51
- Brussels mental health policy 52
- Case study evidence: Members’ and professionals’ experiences 52
- Methods 52
- Creation of Alternative Spaces 52
- Members 53
- Alternative Spaces: A tentative definition 54
- Purposes 55
- Rules and values 56
- Workers 56
- Benefits of Alternative Spaces for members 57
- Key challenges 58
- Case study conclusion 58
- Chapter 7: Policy pointers 59
- References 61
- Annexes 65
- Annex 1: Institutionalised population 65
- Annex 2: National deinstitutionalisation strategies 71
- Annex 3: Network of Eurofound Correspondents 80
