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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Poverty Remains a Europe-wide Cause for Children’s Institutionalisation

Opening Doors, 01 Mar 2017

A review of the evidence on deinstitutionalisation (DI) and the status of care reforms across Europe in 2016 from the Opening Doors for Europe's Children campaign - a pan-European campaign advocating for strengthening families and ending institutional care.

Spain: Country Fact Sheet

Opening Doors for Europe's Children, 01 Mar 2017

This country fact sheet highlights the care reforms that Spain has instituted over the past few years. This sheet also provides short facts and the latest developments on children in alternative care in Spain.

Early life deprivation: is the damage already done?

Frank C Verhulst - The Lancet, 27 Feb 2017

In this comment piece that accompanies Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study, Frank C Verhulst discusses how that study "fills an important knowledge gap on the long-term mental health consequences of early severe childhood deprivation."

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Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study

Prof Edmund J S Sonuga-Barke, Mark Kennedy, Prof Robert Kumsta, Nicky Knights, Dennis Golm, Prof Michael Rutter, et al. - The Lancet, 22 Feb 2017

This study used data from the English and Romanian Adoptees study to assess whether deprivation-associated adverse neurodevelopmental and mental health outcomes persist into young adulthood.

Continuity of care in youth services: A systematic review

Jan Naert, Rudi Roose, Richard C. Rapp, Wouter Vanderplasschen - Children and Youth Services Review, 22 Feb 2017

This study provides a systematic review of the literature, focusing on the conceptualization and evaluation of continuity.

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Institutionalization and the commodification of children

Georgette Mulheir and Lynn Lina Gyllensten - The Routledge Handbook of Global Child Welfare, 16 Feb 2017

This chapter explores the drivers behind the continued, and in some parts of the world, growing, institutionalization of children.

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Country Care Review: Serbia

Better Care Network, 03 Feb 2017

The Committee's recommendations on the issues relevant to children's care are highlighted, as well as other care-related concluding observations, ratification dates, and links to the Universal Periodic Review and Hague Intercountry Adoption Country Profile.

“When Will I Get to Go Home?” Abuses and Discrimination against Children in Institutions and Lack of Access to Quality Inclusive Education in Armenia

Human Rights Watch, 01 Feb 2017

This report is based on Human Rights Watch visits to five state-run orphanages and ten state-run schools, including six special schools and four mainstream schools, and interviews with 173 people, in eight cities in Armenia.

Knowledge and attitudes towards disability in Moldova: A qualitative study of young people's views

Kenneth A. McLean, Samantha Hardie, Abigail Paul, Gary Paul, Iain Savage, Paul Shields, Rebecca Symes, Joanna Wilson, Catherine Winstanley, Jeni Harden — Disability and Health Journal, 25 Jan 2017

Three semi-structured focus group interviews were conducted with twelve schoolchildren, aged 13–15 years for the purpose of exploring the knowledge and attitudes towards disability of young people within Moldova.

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What does the future hold for Ukraine's children in care?

Maxim Tucker – ODR: Russia and Beyond, 18 Jan 2017

In this issue of ODR, Maxim Tucker details the deinstitutionalization challenges facing Ukraine