Effects of Institutional Care

Institutionalising children has been shown to cause a wide range of problems for their development, well-being and longer-term outcomes. Institutional care does not adequately provide the level of positive individual attention from consistent caregivers which is essential for the successful emotional, physical, mental, and social development of children. This is profoundly relevant for children under 3 years of age for whom institutional care has been shown to be especially damaging.

Common issues for children in institutional care are a significantly increased risk of sexual and physical abuse, a lack of stimulation, and harsh discipline. Children in institutions are less likely to attend school, and are frequently isolated from their traditional communities. Long periods in an institution make it harder for a child to assimilate back into a family and community, and deny them access to the life-long attachments and community support systems that family relationships and communities can provide. For funders and implementing bodies, care in the community is a significantly more effective and sustainable use of resources since it avoids the high maintenance costs of institutions, and prevents many of the problems posed by institutional care.

It is widely accepted that institutions should be used as a last resort only. Countries which have traditionally relied on institutional care are now transforming their institutions into small family style group homes and actively pursuing preferences for community-based care options based around small family style units. This policy shift is urgently required in HIV/AIDS affected countries which are taking a backward step in resorting to the use of institutions to care for children orphaned or affected by the disease.

The body of literature contained in this section provides in-depth explanations of the damaging effects of institutionalisation on children and provides recommendations for alterative community care options.

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ABC Head First - Orphanage Tourism

Keke Marc Robertson - ABC, 08 Sep 2014

This animated video, made for an Australian audience, illustrates the orphanage industry in Cambodia, particularly how Australian “voluntourists” unwittingly contribute to the exploitation and traumatization of children in orphanages.

Hidden in Plain Sight : A Statistical Analysis of Violence Against Children

UNICEF, 01 Sep 2014

This report highlights the prevalence of different forms of violence against children. It is based on global figures and data from 190 countries.

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Orphanage Voluntourism in Nepal and its Links to the Displacement and Unnecessary Institutionalisation of Children

Martin Punaks and Katie Feit - Institutionalised Children Explorations and Beyond Volume 1, Number 2, 01 Sep 2014

This article argues that orphanage voluntourism fuels the displacement and trafficking of children from their families in Nepal and their unnecessary institutionalisation.

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Going Home: Children’s Reintegration in Mexico, Moldova, and Nepal

Dr Gillian Mann - Family for Every Child , 01 Sep 2014

This report from Family for Every Child and partners summarises research on children’s reintegration that took place in Mexico, Moldova and Nepal from 2011 to 2014.

My Home, My Choice in Hungary: The right to community living for people with mental disabilities in 2014

Mental Disability Advocacy Center , 01 Sep 2014

Despite Hungary signing on to the UN Convention on the Rights of Persons with Disabilities (CRPD), there has been no significant change in the number of people with disabilities in Hungary who are placed in institutions. Mass institutionalisation continues to be the predominant form of care for people--including many children--with mental health issues and intellectual disabilities.

Stability and Change in Institutional Alternative Care for Children in Israel and Japan

Michael Maher King, University of Oxford, 25 Aug 2014

This Masters thesis paper, by Michael Maher King of the University of Oxford, reviews the situations of children in institutional alternative care in Israel and Japan.

What neuroscience and social science tell us about the effect of care environments on children

Dr. Kathryn Whetten & Dr. Charles Nelson, Christian Alliance for Orphans, 24 Aug 2014

This video features a segment of a talk on the effects of care environments on children, hosted by the Christian Alliance for Orphans. The key speakers featured include Dr. Kathryn Whetten & Dr. Charles Nelson, who discuss the Positive Outcomes for Orphans study (POFO) and the Bucharest Early Intervention Project (BEIP), respectively.

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Call to Action to end the placement of children under the age of three in residential care endorsed at 35th CARICOM Heads of Government conference

UNICEF, 07 Jul 2014

The Heads of State of the Caribbean region endorsed the Call to Action to end the placement of children under three years of age in residential care institutions at the 35th CARICOM conference.

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Does Family Matter? The Well-Being of Children Growing Up in Institutions, Foster Care and Adoption

Christie Schoenmaker, Femmie Juffer, Marinus H. van IJzendoorn, and Marian J. Bakermans-Kranenburg - In A. Ben-Arieh et al. (eds.), Handbook of Child Well-Being, Springer Science+Business Media Dordrecht, 03 Jul 2014

In this chapter of the Handbook of Child Well-Being, the authors review the findings from research on the cognitive and social-emotional development of children growing up in institutions, foster care and adoption.

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Deinstitutionalization in Croatia: A Summary of Open Society Support

– Judith E. Klein – Open Society Foundation, 01 Jul 2014

This paper examines the benefits and challenges of de-institutionalizing disability residential services in Croatia through Open Society Foundation’s Mental Health Initiative (MHI).