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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Children Need Families Not Orphanages

Lumos, 04 Sep 2015

This animated video from Lumos, narrated by Lumos founder J.K. Rowling, illustrates the “tragic consequences of orphanage care,” and argues that more can and should be done to support families to care for their children, eliminating the use of institutional care.

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The Visionaries: “No One Left Behind”

The Visionaries, 26 Aug 2015

Visionaries, a documentary series on public television in the United States, aired two episodes featuring the work of Disability Rights International (DRI) in uncovering the egregious abuses suffered by children and adults with disabilities living in institutions around the world.

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Beyond Orphanages: Family and Community-Based Orphan Care Webinar

Child Family Health International (CFHI), 19 Aug 2015

In August 2015, Child Family Health International (CFHI) held a webinar reviewing the situation of children living in residential care facilities around the world.

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Aging Out of Care in Ethiopia: Challenges and Implications Facing Orphans and Vulnerable Youth

Julia M. Pryce, Sarah Lyn Jones, Anne Wildman, Anita Thomas, Kristen Okrzesik, and Katherine Kaufka-Walts - Emerging Adulthood, 09 Aug 2015

This interpretive study examines the experiences of 54 Ethiopian emerging adults who had aged out of institutional care facilities.

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No Justice: Torture, Trafficking and Segregation in Mexico

Disability Rights International, 22 Jul 2015

This report from Disability Rights International (DRI) outlines the findings from a two-year investigation into the treatment of children and adults with mental disabilities in Mexico City, particularly those in the care of state-funded and private residential facilities.

The Relationship over Time between International Adoption and Institutional Care in Romania and Lithuania

Shihning Chou, Kevin D. Browne - Child Abuse Review, 14 Jul 2015

This study investigates the correlation over time between international adoption and institutional care.

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Cuidado de niños pequeños: Modelo para la prevención del abandono y la institucionalización

RELAF y UNICEF, 01 Jul 2015

Orphanages in Haiti

Lumos, 01 Jul 2015

This video reveals the adverse conditions in the many unregistered orphanages in Haiti

Orphanages In Haiti

Effects of institutional rearing and foster care on psychopathology at age 12 years in Romania: follow-up of an open, randomised controlled trial

Kathryn L Humphreys, Mary Margaret Gleason, Stacy S Drury, Devi Miron, Charles A Nelson 3rd, Nathan A Fox, Charles H Zeanah - The Lancet, 23 Jun 2015

This study examined psychopathology at age 12 years in a cohort of Romanian children who had been abandoned at birth and placed into institutional care, then assigned either to be placed in foster care or to care as usual.

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A World Without Orphans: A Documentary Dialogue to Engage the Church the Pursuit of a World Without Orphans

Dianne Becker - Missions Dilemma, 23 Jun 2015

This post on the Missions Dilemma website features an article and 30 minute documentary film on the harmful impact of institutionalization on children.

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