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Áras Attracta lesson: rights-based model

Most service-providers for people with disabilities exert control over them

On 4 January 2016 I found myself in a court-residents. The review group recommended a move to a room in Castlebar, Co. Mayo. One man and ve women were on trial, charged with assault alleged to have occurred in Áras Attracta. Sitting in the courtroom my hope was to use this experience as part of my own catharsis, having lived through physical abuse in Áras Attracta which is the HSE-run residential centre in Swinford, County Mayo where 96 men and women with intellectual disabilities live. It featured of course in a recent exposé by RTÉ’s Prime Time programme.

Bodily integrity, in the context of receiving support for personal care, brings an unspoken vulnerability. Fear is ever-present. Dignity and respect should be basic imperatives. Those of us involved in the rhetoric of human rights and the independent-living movement must remember that our sisters and brothers with learning disabilities are uniquely susceptible to abuse.

The material captured on the hidden camera placed by Prime Time’s undercover reporter showed staff shouting, pushing, force-feeding and dragging residents across the floor. The footage was used in evidence in the case by the State prosecutor. The five staff, including nurses and care workers, were found guilty of assault. All but one avoided jail terms. Four were sentenced to community service orders in lieu of prison terms. The fifth was given a prison term of four months which is currently under appeal.

The protracted saga of Áras Attracta is a reminder of the slow pace of the State’s apparatus. Two years on from Prime Time’s exposure of what was happening in Áras Attracta an independent review group published the ‘What Matters Most’ report in August with thirteen recommendations and an action plan for all congregated settings.

The most pertinent of these was to “accelerate the process of supporting people to move into community living, avoiding transitional arrangements”. The HSE has committed to implementing this and claims that “individual needs assessments have been completed for all residents to identify their future support requirements to live a successful life in the community”.

The independent report stated there was “widespread institutional conditioning and control” of people living in Áras Attracta. It found that this was generally imposed for the convenience of staff and management and the model of service was structured to suit staffing constraints rather than the needs and aspirations of residents. The review group recommended a move to a rights-based social model of service delivery in one of its overarching recommendations for Áras Attracta.

Most service-providers for people with disabilities are state-funded. They remain institutions where power and control exerted over us and people’s right to independence and choice is denied. The report tells those of us who have to have relationships with service providers nothing new. It con rms unspoken realities. There have been a series of HIQA reports on these services that back up this analysis. The inertia in implementing recommendations from these reports coupled with the lack of rights-based legislation further demonstrates state inertia when it comes to people with disabilities.

The Áras Attracta situation merely highlighted the insidious practices that take place in residential institutions. Often there is an inference that somehow people who are abused brought it on ourselves. In the context of Áras Attracta, what was considered, or diagnosed as challenging behaviour could better be described as very challenging circumstances for the residents. There are still over 2,700 people living in congregated settings throughout the country. Residential settings echo a discredited previous era. We suspect, we fear and we know. However, still they continue.

Twenty-seven people currently living in Áras Attracta are now waiting to move into new supported accommodation. The Minister for people with disabilities, Finian McGrath, has announced that the Government has provided a dedicated €100m capital fund to facilitate de-congregation over the period 2016-2021. €20m has been provided for 2016 and Áras Attracta has been prioritised to receive funding in this first phase. Action is now needed, not just another report or political promise that will become redundant as time passes and nothing changes.

The kernel of the ‘What Matters Most’ report is in the overaching recommendation for Áras Attracta that “The voices of the residents need to be facilitated, listened to and promoted”.

Why would you need to make such a recommendation? What has gone so badly wrong that this has to be one of only three overarching recommendations. Fostering the independent voice of the people accessing services, attending to their preferences, and ensuring people know their rights and have access to advocacy services should have been a given. These are the voices that must now determine the future.

Rosaleen McDonagh