Presentation of DI experiences in Norway Background, policies and outcomes

1. Presentation of DI experiences in Norway Background, policies andoutcomes Jan Tøssebro NTNU Social Research Banská Bystrica, 16.10.2013

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 1991-95

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 (1975-1992) • Limited admission of children to institutions (from late 1960s) • Argumentsand 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, 1945-1998

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 attitudesSource. 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

15. Good luck!