Effects of Institutional Care

Institutionalising children has been shown to cause a wide range of problems for their development, well-being and longer-term outcomes. Institutional care does not adequately provide the level of positive individual attention from consistent caregivers which is essential for the successful emotional, physical, mental, and social development of children. This is profoundly relevant for children under 3 years of age for whom institutional care has been shown to be especially damaging.

Common issues for children in institutional care are a significantly increased risk of sexual and physical abuse, a lack of stimulation, and harsh discipline. Children in institutions are less likely to attend school, and are frequently isolated from their traditional communities. Long periods in an institution make it harder for a child to assimilate back into a family and community, and deny them access to the life-long attachments and community support systems that family relationships and communities can provide. For funders and implementing bodies, care in the community is a significantly more effective and sustainable use of resources since it avoids the high maintenance costs of institutions, and prevents many of the problems posed by institutional care.

It is widely accepted that institutions should be used as a last resort only. Countries which have traditionally relied on institutional care are now transforming their institutions into small family style group homes and actively pursuing preferences for community-based care options based around small family style units. This policy shift is urgently required in HIV/AIDS affected countries which are taking a backward step in resorting to the use of institutions to care for children orphaned or affected by the disease.

The body of literature contained in this section provides in-depth explanations of the damaging effects of institutionalisation on children and provides recommendations for alterative community care options.

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Behavioral adjustment of Chinese adoptees: The role of pre-adoption experiences

Chloë Finet, Harriet J. Vermeer, Femmie Juffer, Guy Bosmans - Children and Youth Services Review, 31 Jan 2018

In the current study the authors examined associations between children's pre-adoption experiences (type of pre-adoption care and early deprivation) and their adaptive and maladaptive behavioral adjustment.

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The Transition from Institutional Care to Adulthood and Independence: A Social Services Professional and Institutional Caregiver Perspective in Harare, Zimbabwe

Getrude Dadirai Gwenzi - Child Care in Practice , 29 Jan 2018

This paper discusses findings from a small-scale qualitative study conducted in Harare, Zimbabwe. Findings show that young people aging out from Harare’s care institutions face challenges making their transition from care into adulthood.

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Research review: Aging out of residential care in South Africa

Adrian D. van Breda - Child & Family Social Work, 24 Jan 2018

This article reports on a systematic review of research on residential care-leaving in South Africa, from 2003 to 2016.

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The prevalence of mental disorders among children and youth staying in residential institutions, children’s homes – a review of epidemiological studies

Witold Pawliczuk, Anna Kaźmierczak-Mytkowska, Tomasz Srebnicki, Tomasz Wolańczyk - Psychiatria Polska, 2018

This article presents an overview of the few studies carried out so far in the European residential institutions, including children’s homes, over the years 1940–2011 in the UK, Germany, Romania, and Poland.

Formation and disruption of bonds between caregivers and institutionalized children

Ruth Irmgard Bärtschi Gabatz, Eda Schwartz, Viviane Marten Milbrath, Hudson Cristiano Wander de CarvalhoI, Celmira Lange, Marilu Correa Soares - Revista Brasileira de Enfermagem, 2018

The purpose of this study was to understand the perspective of caregivers about the formation and disruption of bonds with institutionalized children in Brazil.

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Adult outcomes of youths who have spent time in a judicial treatment institution in the Netherlands

Janna Verbruggen, Victor van der Geest, Catrien Bijleveld - Longitudinal and Life Course Studies: International Journal, 2018

This study examines adult outcomes of youths (N=251) who spent time in a Dutch judicial treatment institution.

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The orphanage industry: Flourishing when it should be dying

Nigel Cantwell and Emmanuelle Werner Gillioz - Scottish Journal of Residential Child Care, 2018

This article looks at how the orphanage industry serves to tear families apart in order to ‘create orphans’, and argues that convincing foreign contributors to withdraw their support will be key to stopping the ‘orphanage industry’ from flourishing.

Violence and Trauma in the Romanian Residential Child Protection

Maria Roth, Imola Antal, Ágnes Dávid-Kacsó, Éva László-Bodrogi, Anca Mureșan - Revista de Asistenţă Socială, 2018

Exploring the testimonials collected during a focus group and 45 individual interviews with adult alumni of such institutions the Romanian research team enrolled in the SASCA Project revealed a wide range of forms of violence and traumatic consequences.

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Malnutrition and psychosocial dysfunction among the orphan and vulnerable children in Kaski district, Nepal

Dipendra Malla, Bishwas Acharya, Lil Bahadur Nepali, Anup KC, Pratik Gurung, Nanda Lal Gupta, Hoshiar Singh Chauhan - Progress in Medical Sciences, 23 Dec 2017

The objective of this study was to assess malnutrition and psychosocial dysfunction among vulnerable children as well as to determine the association between malnutrition and psychosocial dysfunction among orphan and vulnerable children in Kaski district, Nepal.

Emotional health and coping mechanisms among adolescents in Malaysian residential foster care homes: A comparative study with adolescents living with families

Marjan Mohammadzadeh, Esra Tajik, Hamidin Awang, Latiffah Abdul Latiff - Asian Journal of Psychiatry, 18 Dec 2017

This article presents the findings of a study that examined the emotional health status and coping mechanisms of adolescents living in residential care facilities in Malaysia, in comparison with that of adolescents living in families.

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