The Development, Conceptualisation and Implementation of Quality in Disabili... (Ukázka, strana 99)

in Vienna alone ⎯ the federal state known for having the most progressive approach (Berger 2003). Evidence of ongoing hospitalisation to the present day ⎯ although with a strong pedagogical rather than medical focus ⎯ can be found in the Social Medical Centre Ybbs (while this institution is located in another federal state entirely, it nevertheless belongs to the City of Vienna), where six group homes for people with learning difficulties are available in a psychiatric hospital (see https://www.wienkav.at/kav/szy/.) Additionally, large pedagogical institutions founded in the 1960s by parent led-organisations (see above) with (sometimes many) more than 100 inhabitants still exist, as their structures are not considered to be “hospital-like”, and therefore are not subject to the new law. According to Flieger (2011), it can be said that de-institutionalisation ⎯ or more appropriately, “de-psychiatrisation” ⎯ was implemented only partially in Austria, as many people with learning difficulties were moved from psychiatric clinics to homes for the elderly or other large institutions whose suitability has never been questioned.

THE CURRENT STATUS QUO: CHALLENGES IN IMPLEMENTING ARTICLE 19 OF THE UN-CRPD The above sections have already pointed towards the massive challenges that Austria will have to tackle when the UN-CRPD and its implications are finally taken into account. Looking at the full content of the CRPD and Article 19 in particular, the Austrian Monitoring Body (“Monitoringausschuss”, responsible for monitoring the implementation of the UN-CRPD) has identified some implications, as has a 2018 report by civil organisations (ÖBR, “Österreichischer Behindertenrat”, the umbrella organisation of organisations for people with disabilities). The third state report on the implementation of the CRPD is due later this year.

Data on people with disabilities accessing the “new” services are poor and focus on people with learning difficulties is lacking completely (Schädler 2007; Stockner 2011; ÖBR 2018). Nevertheless, it can at least be said that in 2010 12,798 people with disabilities (without particular focus on people with learning difficulties) were living in accommodation services or care units. Among them, 12.552 people ⎯ the vast majority ⎯ resided in units with more than 7 inhabitants, with up to eighteen institutions accommodating more than 100 inhabitants (Stockner 2011). In addition, Flieger, Schönwiese and Wegscheider (2014) state that in 2011 an estimated 13,000 people with disabilities (again, in general) were living in the “new” services, of which: � 1,800 people were living in institutions with more than 100 inhabitants; � 3,800 people were living in institutions with more than 30 places; � 5,700 people lived together with 11 to 30 co-habitants; � 2,000 people resided in units with a maximum of 10 people.

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But while these numbers could be seen as standing for themselves in stark contradiction of Article 19, the problem gets worse: The Austrian Monitoring Body states that the numbers of inhabitants living together can be easily fudged, and furthermore usually are, since large institutions split up their residential care into smaller units, leading to e.g. four or more group homes in one large building. Even though the external statistical image is massively altered using this strategy, the actual institutional structures stay the same.

This is mirrored in the fact that huge amounts of state money are spent on the renovation of large institutions (Monitoringausschuss 2016). Additionally, a focus on the number of people living together does not help us identify the institutional structures in which, on a higher level, a small(er) unit might be embedded in terms of its administrative or legal aspects (Kremsner 2017).

Institutional structures also mirror the fact that individual needs still have to adapt to the given system and not vice versa (Monitoringausschuss 2016).

This can be illustrated by the fact that decisions on (the number of) co-habitants and employees do not truly lie in the hands of the “clients” living in these settings, even though attempts to involve them are often made (e.g. in “group home parliaments” or suchlike). The opinions of “clients” rarely form the basis for decisions, which usually are driven by administrative considerations. Such forms of decision-making can therefore be framed as examples of tokenism and “new paternalism” (Goodley and Runswick-Cole 2012: 54): participation is limited to an absolute minimum and only takes place within institutional structures ⎯ and all too often just sells well as an abstract idea.

Massive challenges in implementing Art. 19 also follow from the fact that community-based services are defined therein by full inclusion in all areas of life and are not limited to accommodation only. Therefore, community-based services offer both specialised and general services (which can be used by everyone). But at the core of this concept lies the fact that users ⎯ whether they describe themselves as disabled or not ⎯ have choice, but also control over which kind of support they want and need (Monitoringausschuss 2016: 5f.). Taking this definition into consideration, the vast majority of people with disabilities (in general) still live in institutions instead of in community-based services.

CONCLUSION (AND LIMITATIONS) As shown above, institutions for people with learning difficulties have a long history that is deeply rooted in societal discourses in Austria. This is mirrored in the fact that twelve years after the ratification of the UN-CRPD and its Article 19, “regimes of institutional care with more than 100 persons living and working in the same institution still exist in 5 out of 9 Austrian provinces” (Kremsner, Koenig and Buchner 2019, 46) ⎯ and at least some people with learning difficulties still live in psychiatric hospitals (Kremsner 2017). StrateFrom hospitalisation to (de-?) institutionalisation – 99 –

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gies for finally tackling de-institutionalisation are still lacking (Kremsner Koenig and Buchner 2019; Monitoringausschuss 2016; ÖBR 2018). Though most accommodation services in Austria now portray themselves as “community based”, critical analysis shows that they are all too often institutional in form and therefore can’t be fully considered “de-institutionalised”. We see this in particular when we consider that alternatives to a life in such institutions ⎯ besides living with the family ⎯ do not exist: concepts such as Personal Assistance or a Personal Budget are simply not available to people with learning difficulties in Austria33 (Monitoringausschuss 2016; ÖBR 2018). Further steps to finally reaching full de-institutionalisation and thus conforming with the UN-CRPD need to consider that transitions ⎯ from school to work/accommodation or from institutions to “true” community-based services, personal assistance, or other forms of deliberately chosen self-determined accommodation ⎯ have to be carefully planned and realized with the highest level of participation possible with the person concerned, in order to avoid tokenistic or paternalistic approaches (Monitoringausschuss 2016).

But the problem goes even deeper: The debate around Article 19 is ⎯ as in this paper ⎯ mostly concerned with de-institutionalisation with a focus on adults. However, boarding schools specifically for students with learning difficulties and/or large institutions for children with integrated special schools can be found in most Austrian federal states; statistics on the numbers of children living in such institutions are again lacking. Due to the fact that surrounding schools don’t offer integrative settings34 or are not accessible, parents are often forced to send their children to such institutions. This is in clear contradiction not only to Article 19 or the CRPD in general, but also to the Convention on the Rights of the Child (Monitoringausschuss 2016). Furthermore, transitions from special or integrative schools to ⎯ mainly ⎯ segregated work or institution-like accommodation services (as detailed above) have to be considered problematic. Therefore, further steps should consider not only obvious challenges and target groups; serious attempts to fully implement Article 19 have to take on a much broader approach.

REFERENCES Berger, E. 1996. “Die psychiatrische Betreuung (geistig) behinderter Menschen.” In Beiträge zur Theorie und Praxis sozialer Dienste, edited by Michaela Moritz and Elisabeth Neck-Schaukowitsch, 85–91. Vienna: Festschrift Wr. Sozialdienste.

33 Very small pilot programmes have started recently in Tyrol and Salzburg.

34 The Austrian school system follows a double approach: parents have the right to send their children to either special or integrative schools (even though some pilot schools call themselves “inclusive”). Hence, the school system cannot be considered inclusive at all (Biewer and Proyer 2018).

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