Institutional Care and Family Reintegration: The Transition Process in the Voices of Young Brazilians

This article aims to present reflections on the transition from being institutionalised to autonomous life, from the perspective of deinstitutionalised young Brazilians. Five young adults participated in the pilot study. The Piagetian clinical method was used. Through semi-structured interviews, the following were investigated: causes of institutionalisation, preparation for transition, deinstitutionalisation and perspectives of present and future life. The results indicate that there was no effective preparation for transition from the institution to the family and/or independent life. Biological families have difficulties in achieving (re) integration and overcoming conflicts between parents and children. In conclusion, when leaving institutions, some young people manage to build their own arrangements for a new life trajectory, while others return to contexts of risk and life on the street. Public policies to assist these young people should be prioritised.

Environmental Barriers and Functional Outcomes in Patients with Schizophrenia in Taiwan: The Capacity-Performance Discrepancy

Environmental factors are crucial determinants of disability in schizophrenic patients. Using data from the 2014–2018 Certification of Disability and Care Needs dataset, we identified 3882 adult patients (46.78% females; age, 51.01 ± 13.9 years) with schizophrenia. We found that patients with severe schizophrenia had lower capacity and performance than those with moderate schizophrenia. The chances of having an access barrier to environmental chapter 1 (e1) products and technology in moderate schizophrenic patients and in severe schizophrenic patients were 29.5% and 37.8%, respectively. Logistic regression analyses demonstrated that the performance score was related to accessibility barriers in the categories described in e1, with adequate fitness of models in category e110 for personal consumption, e115 for personal usage in daily living activities, and e120 for personal outdoor and indoor mobility and transportation. Furthermore, the capacity-performance discrepancy was higher in moderate schizophrenic patients with accessibility barriers in the e110, e115, and e120 categories than that in moderate schizophrenic patients without accessibility barriers. However, severe schizophrenic patients with category e120 accessibility barriers were prone to a lower discrepancy, with institutional care a potentially decreasing factor. In conclusion, providing an e1 barrier-free environment is necessary for patients with schizophrenia to decrease their disability.

The Influence of Pension Mode on the Mental Health of Older Adults—Evidence from Older Adults in China

Successful aging is achieved throughout the life course, and successful aging groups tend to have good psychosocial and physical conditions and are active in social activities. With increasing age, the mental health problems of older adults have become increasingly prominent, and the choice of pension mode is closely related to the mental health of older adults. Starting from the psychological level of the older adult, this paper used data from the 2018 Chinese Longitudinal Healthy Longevity Survey to study the impact of three pension methods on the mental health of older adults. The study found that, at present, there are three types of pension modes in China: living alone, family pension, and institutional care, and family pensions are still the mainstream pension mode. Older adults with deeper negative feelings are more inclined to family pensions than to live alone, but the spiritual comfort provided by family members does not improve the negative feelings of older adults. Institutional care deepens the negative feeling and reduces the positive feeling of older adults. In addition, retirement or pension and medical insurance, as life security in old age, can effectively reduce the negative feelings of old age and promote positive feelings. In view of the present situation of China’s pension mode and the psychological characteristics of the older adults, we should further build a perfect family pension security system, promote the personalized service construction of older adult care institutions, promote applicable aging renovation of existing residential areas, and encourage older adults to engage in healthy exercise.

Deinstitutionalization in Macro Practice

The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as trans-institutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, expanding admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase and model programs illustrating what can be done; yet, it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. It has been documented, from political, economic, legal, and social perspectives, how this policy has affected the care and control of populations such as older adults, children, people with mental illness or developmental disabilities, people under correctional-system supervision, and, more recently, individuals without a home. Suggestions for a truer implementation of deinstitutionalization’s initial aspirations are available.

Prevention of Violence against Children: Challenges and Opportunities

This book is a compilation of papers authored by academicians, practitioners, researchers who are the witnesses to increasing challenges in mitigating violence against children. Children are considered to be the backbone of human development. Violence against children is a multi-dimensional phenomenon which consists of all forms of physical, mental torture, injury, abuse, neglect, maltreatment and sexual abuse perpetrated on them. It is very evident that children experience certain forms of violence at their various stages of life. Global evidence suggests that girls and boys in certain contexts are more vulnerable to violence (UNICEF, 2017). For instance, vulnerability may be heightened for children living with disabilities, in institutional care and deprived of liberty; those living in extreme poverty, unaccompanied or separated from family; children on the move (migrants, refugees, asylum seekers and internally displaced children); and children living with HIV, facing discrimination for their sexual orientation or gender identity, belonging to marginalized social or ethnic groups, and those living with other social and economic disadvantages. While individual factors that increase the risk of violence are clearly important, there is broad consensus in the field that violence prevention and response must not focus too narrowly on individual characteristics of victims and perpetrators rather the focus should be enlarged to give more attention to broader social, economic, normative and institutional environments in which children and adolescents live.

THE ESSENCE AND FEATURES OF SOCIAL COMMISSIONING IMPLEMENTATION IN UKRAINE

Relevance of the research problematics is proved by the social demand for acceleration of social commissioning implementation in Ukraine so as to respond to the ongoing pandemic COVID-19, armed conflict in Ukraine, long lasting tradition of institutional care for vulnerable people. The purpose of the article is to reveal the core of social commissioning linked to social work with families with children, to characterize dynamics of its implementation and development in Ukraine. Methods of research: the theoretical analysis of actual scientific sources, rated to the topic, is applied in the research together with desk review of a new international and national legislation. The methods of generalization and systematization were applied for definition of actual interpretation of “social commissioning” and its characteristics. The results of the research are as follows: The social commissioning is determined as an instrument for public regulation in the system of social service provision by means of contracting social service providers for satisfaction of social service needs identified within social service need assessment by entities of local self-government. Research attention is paid to the structure and key elements of social commissioning. Participants (сustomers, recipients and providers of social services), constituents (social character; contracting core and innovation value), and principles of social commissioning (result orientation; awareness; planning; priority to prevention and early intervention; partnership) are covered in the article. The procedural stages of social commissioning are also unpacked in the article (designing; implementation; monitoring and evaluation). Prospects for further research are the studies of barriers to the implementation of social commissioning and ways to overcome them, development and implementation of optimal algorithms for its implementation in a decentralized environment.

Care Centers and Professional Caregivers: from the Project to a Sustainable Social Child Care Policy

In Lithuania the deinstitutionalisation of children left without parental care is being implemented since 2014. The term of transformation is more recognizable in the political context of the country. Various alternative services to institutional care are being developed during the transformation process, but some have become massive and overly institutional in nature (e.g., community children living homes), while the institute of professional caregivers has not gained popular attention when comparing child care rates across different alternatives. This article presents and discusses the activities of care centers that train permanent guardians (caregivers) and professional guardians. The article presents a research during which the staff of the care center evaluated the effectiveness of the activities of the care center and the guardians on duty. The results of the study revealed that care centers face the risk of projectivity at both micro and macro levels. Cooperation and support between the Ministry of Social security and labout and municipalities and other institutions is also very important for the effectiveness of care centers.