This study contributes to the international debate on why deinstitutionalisation may not be achieving its intended outcomes, drawing on the experiences of practitioners who have acted as change agents in the Czech context over recent decades. Through a discursive stance analysis framed within an interpretive, critical approach, the research offers detailed insights into their accounts of experience. The findings indicate a discourse that swings between paternalistic and rights-based perspectives, leading to divergent understandings of deinstitutionalisation and complicating both shared comprehension and the effectiveness of practical interventions. By highlighting the persistent influence of the need for paternalistic care in a post-socialist setting, the study underscores the call for professional change management and curated discourse that would consider individual and interpersonal factors alongside legal, financial and organisational measures, and foster more critically-informed interaction among actors, both across disciplines and in practice.
Points of Interest
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Over the past decades, many people with disabilities in Europe have moved from large care institutions into local communities. Still, in Czechia alone, tens of thousands continue to live in conditions that do not fully respect their human rights.
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This study shows that the needed change is more complex than simply closing large care institutions. It needs a coordinated approach involving groups and individuals with both supportive and resistant attitudes.
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Professionals do not always agree on what moving to a more independent life in the local community means. Also, those moving out of large institutions may feel uncertain or afraid of the change, often due to habits and ideas rooted in the old care system which was more protective and controlling.
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Policy and practice need to pay attention to how people talk about people with disabilities moving out of large care institutions, because communication and language are not neutral – they shape how people think and act.
