Although there are local differences, in countries across Europe and Central Asia, there are five primary drivers of institutionalisation. Many people imagine that children are in institutions because they have no parents, ie they are orphans, or 'bad' parents, ie they have been abused or neglected. In fact, research from a number of sources, including Lumos' own research, has found that the five key drivers of institutionalisation are poverty, disability, ethnicity, behavioural issues and child abuse and neglect.
A significant proportion of children in institutions are there because their families are poor. Some research suggests that this accounts for the majority of children in institutions. This is a contravention of the UN Convention on the Rights of the Child, according to which children should never be separted from their parents simply because of poverty. Countries that rely heavily on institutions to look after vulnerable children tend to have few support services in the community. If a family is in financial crisis and does not have enough money to meet their child's basic material needs, instead of being provided social support, they will be given no option but to place their child in an institution.
Due to a lack of specialised healthcare and inclusive education in the community, parents of children with disabilities are made to feel they have no choice but to place their children in an institution. Many are advised by healthcare professionals that the institution is the best pace for their child and that the State knows better than parents how to care for children. In many communities, there is no inclusive education and, if parents want their child to go to school, the only choice is an institutional placement. Local school buildings are not adapted to the needs of children with disabilities. Stigma attached to disabilities means that parents fear for their children's futures - they worry how their children will cope when they grow up. There is a powerful causal relationship between disability and poverty, and it works both ways. If you are poor, you are more likely to have a disabled child. If you have a disabled child, their additional needs mean that you are more likely to live in poverty. Across Europe there is a significant over-representation of children with disabilities in institutions and they are more likely to stay for longer periods of time than their peers. In some countries, children with disabilities never leave institutions: at age 18 they are transferred to adult institutions where they remain until their death.
Across Europe and Central Asia, children from ethnic minority communities are signficantaly over-represented in institutions. In many Central and Eastern European countries, Roma children are particularly vulnerable. Due to discrimination, Roma children are routinely misdiagnosed as having learning disabililties. This is often simply an educational delay because the child did not have the opportunity to attend kindergarten. As a result they are arbitrarily separated from their parents and placed in residential special schools. This situation is compounded by the pressure from communities, where parents of children in mainstream schools are reluctant to have their children educated together with Roma children. This has resulted in generations of children in the same family being routinely separated from their parents. Due to discrimination and this generational exclusion from access to formal education, Roma people are much more likely to live in poverty than the majority community. This makes their children doubly vulnerable to institutionalisation.
Some countries register significant numbers of children who are institutionalised because of behavioural problems. Yet Lumos' resaerch shows that many of these behaviours would not be considered extremely serious in other countries; certainly they would not warrant separating children from their families and placing them in institutions. These behaviours include: truanting from school, running away from home and committing minor offences, such as petty theft. Our research shows that these children often come from some situation of family breakdown and it appears that little attention is paid to the reasons for these children's behaviour. Placing them in institutions is meant to be a measure to protect them, or rehabilitate them, yet these children are often placed in institutions together with other children who have committed serious offences, including violent offences. This can place often vulnerable children at serious risk of abuse. Research shows that institutionalisation causes behavioural problems, so it is unlikely to provide genuine rehabilitation. Lumos' research in a number of such institutions has found that psychiatric drugs are commonly used to control behaviour, even when children have no psychiatric diagnosis.
CHILD ABUSE AND NEGLECT
In a minority of cases, children are admitted to institutions because they are being abused and neglected. But Lumos' research shows that in many instances, children had previously been referred to social services, when the family was vulnerable, and the lack of intervention allowed the situation to develop into a crisis. In many countries, social workers lack assessment tools to ascertain the cause of the neglect - and there is a world of difference between a parent who has resources but wilfully neglects their child and one who cannot care properly for their child due to grinding poverty. Admitting children who have been abused to institutions compounds the trauma they have suffered and leaves them vulnerable to further abuse. Therefore institutionalising such children is a wholly inappropriate response to child abuse.
Thus an analysis of the key drivers of institutionalisation demonstrates that, in fact, a lack of support services in the community to respond to the needs of poor children and those with disabilities or from an ethnic minority, can result in abuse, neglect or behavioural problems, forcing families apart and driving children into institutions.
Across Europe and Central Asia, children from ethnic minority communities are significantly over-represented in institutions.
Safeguarding Children by Monitoring and Improving Standards of Social Care
'I was told by the doctor to leave my child...'
Drivers of Institutionalisation
Supporting Vulnerable Families
Lumos in Greece in 2017
Better Health, Better Lives
Families in emergency situations