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Creating a better future for communities through research

Deinstitutionalization and closing institutions in Canada

The Challenge

In the late 1970s and 1980s, governments in the Western world were being challenged by the disability rights movement to close institutions, large facilities, and psychiatric hospitals. This desire for social change was being fuelled by a human rights revolution and by a growing body of research that was showing that 'institutionalization' had negative impacts on both consumers and staff. At the time, there were limited efforts being made in Canada to 'deinstitutionalize,' although there was a lot of interest on the part of governments and advocates. The real challenge for governments and communities was how to close institutions in a humane manner, with genuine alternatives for people to live in the community. 

Participants

In the 1980s and 1990s, CCBR participated with a number of leading researchers, consumers, policy makers, and family members in presenting policy alternatives and in documenting the closure of a large institution. CCBR staff presented their knowledge at numerous community forums and conferences, and worked with three separate provinces consulting on institutional closures.

Innovative Solutions

Deinstitutionalization is a complex process that requires the involvement of a variety of stakeholders. CCBR's early work in this area sparked both the disability movement and governments to take coherent, value-based approaches to closing institutions. Some of the innovative solutions included:

1.  Developed a policy analysis paper on closing institutions

  • Included leading researchers, consumers, families, and policy makers in the development 

  • Distributed paper widely within the disability movement, community organizations, and governments

  • Initiated a "call for change" press release that was picked up by several media outlets.

2.  Responded to several requests for facilitated conversations about deinstitutionalization

  • Conducted numerous presentations to range of groups

  • Developed short summary statements that were reprinted in many newsletters of disability organizations

  • Made recommendations to governments

3.  Documented the closure of a major institution in British Columbia

  • Engaged several stakeholders in B.C. to help assess the closure

  • Published book, Return to the Community: The Process of Closing an Institution in 1987, the first such publication of its kind in Canada

  • Met with numerous groups across Canada who were interested in the book and consulted with governments in three provinces about the findings

4.   Developed a 'citizenship' framework on the values that need to drive community options for any vulnerable person

  • The citizenship framework that emerged from this deinstitutionalization work has influenced CCBR work with other vulnerable citizens

Discoveries

Closing institutions is an enormous process that requires the commitment, policy, and resources of government as well as the participation of consumers and communities. CCBR contributed to a body of knowledge that shows clearly how to close institutions effectively. We know now how to engage communities, how to use facilitators to assist individuals and families, and how to develop community resources that reflect the needs and aspiration of individuals and their families. The disability movement and governments have made use of this knowledge as institutions continue to close across Canada, although not all in a manner that reflects a citizenship framework.

-written by John Lord