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, Orphanages, and Families: a Summary of Research to Help Guide Faith-based Action

Kelley Bunkers, Amanda Cox, Sarah Gesiriech, and Kerry Olson, Faith to Action Initiative, 12 Jun 2014

This Summary of Research provides a concise overview of a range of studies and findings that can inform approaches to caring for children who, through orphanhood, abandonment, or other causes, have been separated from parental care.

Niños, Orfanatos y Familias

Kelley Bunkers, Amanda Cox, Sarah Gesiriech, and Kerry Olson, Faith to Action Initiative, 12 Jun 2014

El presente resumen de investigaciones se ofrece a iglesias, organizaciones religiosas y personas de fe que buscan información basada en pruebas sobre la mejor manera de cuidar a huérfanos y niños separados del cuidado parental.

Without Dreams: Children in Alternative Care in Japan

Human Rights Watch, 08 May 2014

This report by Human Rights Watch examines Japan’s alternative care system for children. It describes its organization and processes, presents current data on the use of different forms of alternative care and highlights the problems found in the institutionalization of most children (including infants), as well as abuses that take place in the system.

Deinstitutionalization in Croatia: A Summary of Open Society Support

Open Society Foundations, 01 May 2014

This paper examines the work Open Society Foundations have done in Croatia as part of its Mental Health Initiative (MHI), with the goal of helping people with disabilities return to their communities where they are support

Consensus Statement on Group Care for Children and Adolescents: A Statement of Policy of the American Orthopsychiatric Association

Mary Dozier, Roger Kobak, Abraham Sagi-Schwartz, Carole Shauffer, Marinus H. van IJzendoorn, Joan Kaufman, Thomas G. O’Connor, Stephen Scott, Judith Smetana, Charles H. Zeanah, 01 May 2014

This statement of policy of by American Orthopsychiatric Association reviews the evidence on the use of congregate or group care for children and adolescents and concludes that institutional care is nonoptimal for children of all ages, including teenagers, and that even smaller group care settings can be detrimental to the growth and well-being of youth.

Understanding Vulnerability: a Study on Situations that Affect Family Separation and the Lives of Children in and out of Family Care

Irwanto & Santi Kusumaningrum, Center on Child Protection University of Indonesia PUSKAPA UI , 01 May 2014

This report presents analysis and key findings from a study aimed at fully understanding the situations of children in Indonesia that may lead to family separation.

Policy Brief: Child Care Institutions – A Last Resort

Save the Children, 01 Apr 2014

Save the Children has released a policy brief outlining its position on the institutional care of children.

Orphanage Tourism Video

LearningService.info , 25 Mar 2014

This video from Learningservice.info discusses issues around orphanage volunteering and tourism. The video is accompanied by a number of prompts for further discussion.

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Adolescents' reports of physical violence by peers in residential care settings: an ecological examination

Mona Khoury-Kassabri, Shalhevet Attar-Schwartz, 14 Mar 2014

Physical victimization by peers was examined among 1,324 Jewish and Arab adolescents, aged 11 to 19, residing in 32 residential care settings (RCS) for children at-risk in Israel.

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Understanding Care Leavers in Russia: Young People's Experiences of Institutionalisation

Evgenia Stepanova & Simon Hackett , 13 Mar 2014

This paper presents the findings of a survey of Russian care leavers. The emphasis is on care leavers' experiences of the Russian institutional care system, and the issues that impacted on their postcare transition to adulthood.

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