20 March 2015
P
OLITICAL and media outrage is
strangely hard to direct and seem-
ingly impossible to sustain. There
was a lot of it about, though, when ‘Prime
Time’ did its exposé of áras Attracta
in Mayo and the inhumane treatment
of people with intellectual disabili-
ties there. The Taoiseach led the way
with: ‘This was frightening, sickening,
infuriating…people legitimately asked
question how could this happen in 2014
with trained nurses, healthcare work-
ers” and “...it was not an example of care;
it was an example of control over fragile,
vulnerable, voiceless people”.
The outrage had already waned when,
only a few days later, HIQA inspectors
found that residents in the Redwood
Extended Care Facility in Meath did not
have freedom to exercise choice and con-
trol in their daily lives. They reported a
high level of restrictive practice and
restraint used in the centre, including
locked doors and residents confined to
specific rooms, sometimes for signifi-
cant periods of time. Physical restraints
included the enforced removal of resi-
dents to designated areas of the centre,
and a number of staff physically holding
residents in a position, sometimes for
long periods.
No doubt there will be some resur-
gence of outrage when the numerous
investigations into these facilities finally
conclude. The outrage, however, was not
only temporary. It was also misdirected.
All the debate was about staff – the need
to punish them; about administrators
and the need for them to resign; about
getting surveillance and CCTV cameras
in all locations; putting in place advocacy
and independent confidential recipients.
No politicians or journalists, in their out-
rage, made reference to Article 19 of the
UN Convention on the Rights of all Per-
sons with Disabilities.
Article 19 is inconvenient. It com-
mits States to recognise the “equal right
of all persons with disabilities to live
in the community, with choices equal
to others”. It gets even more inconven-
ient: States are required to take steps to
ensure people with disabilities “have the
opportunity to choose their place of res-
idence and where and with whom they
live on an equal basis with others and are
not obliged to live in a particular living
arrangement” and to ensure they “have
access to a range of in‐home, residential
and other community support services,
including personal assistance necessary
to support living and inclusion in the
community, and to prevent isolation or
segregation from the community”.
It is not surprising that deinstitution-
alisation didn’t get a mention, given the
almost complete lack of progress on this.
The HSE currently has a target of moving
150 people with disabilities each year
from what are called congregated set-
tings. Even this minimal target is not
being met, with only some 100 people
with disabilities moved last year. This
lack of progress is despite a target set in
2011 to move all people with disabilities
from these congregated settings within
seven years. At that time there were
4,099 people living in such facilities.
Outrage didn’t allow for any analysis
of the root causes of what was happening
at áras Attracta or the Redwood facil-
ity. Nor are these isolated incidents.
The ‘Prime Time’ team analysed 420
HIQA inspection reports on disability
services and found that less than 2% of
them were compliant with the required
standards.
Institutionalisation strips people of
their human dignity. It enables abuse and
inhumane treatment. Dr Andrew Power
of the Centre for Disability Law and
Policy in NUIG notes that: “Residential
institutions worldwide have increasingly
been found to create high-risk environ-
ments for abuse and neglect”.
Useful indignation would have
d e m a n de d a n e nd t o i n s t i t u t i on a l s e t t in g s
for people with intellectual disabilities.
It would have explored the lack of dein-
stitutionalisation as well as the manner
in which the very limited deinstitution-
alisation is being implemented.
Deinstitutionalisation to date has
largely involved the transfer of people
with intellectual disabilities from insti-
tutions into community group homes.
Such community settings can merely
reproduce institutional cultures and
continue to deny choice to people with
disabilities.
Power’s research found that there is
“less personalisation and poorer out-
comes for persons in community group
homes compared to other family and
personalised arrangements”.
The failure to promote deinstitutional-
isation or to create personally supported
settings in communities where people
with disabilities are in control of their
lives and have choices merits sustained
outrage.
It is a gross abuse of human rights and
its remedy is not even on the agenda. •
áras Attracta drew indignation without reference to the UN Convention on the
Rights of Persons with Disabilities. By Niall Crowley
De-institutionalise!
NEWS áRAS ATTRACTA
Article 19
commits
States to
recognise
the “equal
right of all
persons with
disabilities
to live in the
community,
with choices
equal to
others”
“