Child Abuse Raises Questions Over Effectiveness of Deinstitutionalisation Programme In Romania

Child Abuse Raises Questions Over Effectiveness of Deinstitutionalisation Programme In Romania

ENIL has on many occasions raised concerns about the process of deinstitutionalisation which consists of moving disabled people from institutions into group homes (also referred to as ‘family-type’ homes). This often results in replicating institutional culture in the community, rather than independent living. The case below, concerning young disabled people in Romania, demonstrates how deinstituionalisation can easily turn into reinstitutionalisation without adequate support and real opportunities for disabled people to live independently in the community.

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On 14 July, several online publications published disturbing footage showing a disabled child being tied up with a rope to a door handle in the courtyard of a social care home in Bucharest. According to statements by persons living in a nearby apartment building who witnessed his plight, the boy had been left tied up for hours in the blazing Bucharest midsummer heat, behind the wall surrounding the perimeter of the facility.

Several investigations were started following the ensuing public uproar. It surfaced that the incident took place in a “family-type home” that had been recently built as part of a national child deinstitutionalisation programme spearheaded by the NGO Hope and Homes for Children Romania (HHC Romania) in collaboration with state authorities. A major component of the programme, “family-type homes” are facilities based in the community that are supposed to accommodate 10-12 children, particularly disabled. The home where the incident took place was part of a larger complex of social services, at the heart of the community, which also included administrative offices where many people went to work daily.

In a public statement, HHC Romania maintained that it handed over the home to local authorities after having built it and declined to take any responsibility for the incident. In a different statement, HHC Romania, through its president, Mr. Ştefan Dărăbuș, expressed surprise at what had happened, mentioning that it monitored the home regularly, but had only noticed minor problems such as children being allowed to watch TV for a long time.

The Ombudsman, who visited the home in the aftermath of the incident and published a detailed report with his findings on 7 September 2015, found extensive irregularities at the home. The child who had been tied up was deaf and had a four-year old diagnosis of severe intellectual disability, autism and epilepsy. However, the Ombudsman expressed doubts about the accuracy of the diagnosis after all that time and noted that the child had never received any “behavioural support” or education. Staff did not appear to understand the nature of his medical condition and were not able to communicate with him. The Ombudsman found another child tied down at the time of his visit, based on an open-ended medical authorisation issued more than four years before. Staff stated that the child had been tied down regularly although the reason for that was not immediately apparent. In fact, the Ombudsman found major shortcomings with the manner in which incidents of restraint were being recorded, which was done irregularly on loose sheets of paper.

There were more general criticisms too. According to the report, there were two homes at the location in question, accommodating 11 children with “severe” disabilities and 10 children with “moderate” disabilities respectively. The Ombudsman remarked among others that medical supervision was sporadic, and access to treatment difficult, that children should not have been separated based on the seriousness of their diagnosis, and the absence of any therapeutic or occupational therapies, even though the facility was meant to develop independent living skills. Finally, the report mentioned that staff involved in the incident of restraint had been dismissed and that a criminal investigation had been started.

 

Written by Constantin Cojocariu

2 Comments

Michael Holden

October 18, 2015, 10:04 am

I’m glad to read that action is being taken, but it highlights the suffering of disabled people by those without compassion. If this treatment happens in the community, heavens knows what was happening in institutions.
The fact that these homes aren’t regularly inspected is frightening and should become an issue for the EU.
Too often the political class are obsessed with economic issues, whilst leaving social problems to the sidelines.
This has been highlighted recently with the migrant problem. No cohesive policies to deal with social problems affecting the entire union.
Disabled people have suffered at the hands of this inaction for decades and it hardly ever makes the news or political agenda.

Otto Sestak

October 27, 2015, 7:30 am

All of us at Hope and Homes for Children Romania have seen the shocking images of the young boy tied to the door, outside, in the yard of a Small Group Home administered by the General Directorate of Social Assistance and Child Protection and we were appalled at the time and continue to feel the same on the subject of poorly thought interventions and substandard services given to children an young people in care.

At the time, we offered our support to the public authorities responsible for the administration of care provided in the Small Group Homes in the form of training and support in developing and implementing person-centred care plans and behavior management plans that would eliminate the need for physical or chemical restraint. We have, since, proposed to the central government our support in developing a national programme for capacity building, so that staff working with children and people with special needs learn different approaches concerning direct work with their client.

Hope and Homes for Children Romania is an organization that develops services. Our mission, as organization is to ensure that all children have a chance to grow up in a family. We transform outdated childcare systems into ones based on family care by developing them. We cannot be service providers. For a sustainable national system, public authorities must be fully accountable for all services and ensure the service provision meets the quality standards.

However, we deeply believe that children should receive high quality services. This is the reason we continue monitoring services long after they were taken over by the authorities. This is the reason we insist on continuing with the provision of technical assistance and training for staff and management. This is the reason we provide various forms of support to all the services we helped developed.

We created IMPACT, an innovatively designed programme for working with children with special needs that proposes an efficient and humane approach to managing challenging behavior.

In spite of our efforts, the system is still not fully reformed. There are still major concerns deriving from decades of institutional care.

Staff is massively insufficient in services for children and young people with special needs. There are on average 2 staff per shift working with a group of 10-12 children and young people with special needs. No amount of training can supplement the actual people who should be there with the children at all times.

Unfortunately, the law is also in dire need of reform. The law on mental health allows restraint, if it is limited to 4 hours/day with regular check-ups of the person/circumstances every 30 minutes. The medical plans of the children in these family homes are carried over from the institution and cannot be challenged, under the current law, by an NGO.

These are serious and grave systemic irregularities, that significantly affect the form and quality of care provided in small residential units.

Hope and Homes for Children believes that the best form of care is in a family environment. However, at times, residential care is necessary, but it must be provided in a form that is as close as possible to the family environment. To get there, institutional care must be eradicated and a new structure of services needs to be built. We also believe that the central and local public authorities must become accountable for the services they provide. Such troubling and appalling instances of abuse against the most vulnerable of children further underlines the urgent need for a complete reform of the system, which Hope and Homes for Children has been advocating for in Romania since 1998.

Otto Sestak,
National Director, Hope and Homes for Children Romania

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