Polish and Swedish context of social care for the adolescent and adult mentally handicapped people

In order to understand the different models of organising living accommodation for intellectually handicapped people in Sweden and in Poland a short historical background of social care for handicapped in each country has to be presented. It should be underlined that in both countries the changes especially in the second half of the 20^th century played a crucial role in changing social attitudes towards handicapped, thus triggering changes in their lives.

1.1. The Swedish disability reform

In Sweden, like in the rest of the western world, lots of big institutions were built for people with disabilities during the first decades of the twentieth century. The institutions were mostly placed in the suburbs, far from towns and even villages and the inhabitants’ had no possibilities to get in contact with people in the local community. The institutions were total to their character, which means that the inhabitants spent all their time in the institutional area and were supposed to live there their whole life (Goffman, 1987).

Some of them were really big accomodating 100–200 inhabitants, and some were a bit smaller. In the end of the sixties there was some criticism towards the institutions. In Sweden the most well-known fighter against the total institutions was Bengt Nirje and he was the one who formulated the normalisation principle in the end of the sixties. This led to a modest close- down process of the big institutions which escalated in the middle of the eighties. Since then there have been a lots of disability reforms in Sweden which have implied a paradigm shift according to the organisation of living accommodation for people with intellectual disabilities.

The main values can be described as normalisation, integration and social membership for people with disabilities. The last Swedish disability reform is dated in the early 90’s, LSS (Act Concerning Support and Service for Persons with Certain Functional Impairments). The aim is to make living conditions for people with disabilities and for the rest of the population more equitable (SOU, 2004). With different forms of rights, the act intended to guarantee

the people with severe and permanent disabilities to obtain help when support under other legislation is insufficient. The commonest LSS measure is daily activity, in which just over 21,000 people took part, followed by adult accommodation for 17,500 people, and contact persons for 14,000 people. More men than women at all ages, except for old-age pensioners, were covered by measures. One explanation may be that more men than women have impairments.

The reform may be viewed as a new trend in many different ways. Ideals such as fairness, equality of efforts, equity and collective organisation have had to relinquish to expressions like market, individualism and the individual’s freedom of choice (Barron, Michailikis & Sšder, 2000). Another trait that is typical for the reform is also the focus on strengthening the individual’s rights and self-determination rather than to regulate the obligations of society. Assistance is to be requested by the individual or by his or her representatives. The shift of responsibilities from the national to the local government also meant that the municipalities have been given more opportunities to shape the welfare services in a way that appears feasible and reasonable in the local context.

The consequences have resulted in large differences between municipalities, regarding the kind of support they were to offer.

Studies show that neither the size nor the type of the municipality is a factor that can explain the differences (SOU, 2004). The local variation may be caused by differing priorities, but for the individuals it has meant that the support from the public sector looks different depending on where he/she lives and how he/she can formulate his/

her needs for support and demands for assistance.

1.2. Transformations of Polish Social Welfare System The social welfare system for handicapped and poor people in Poland, after several centuries of immense activities of different charity organisations, especially these led by different Convents of the Catholic Church, was formally established after 1918, the most important of the state acts being the Social Welfare Act from 16.08.

1923. It recognised the state as a provider of social services for these citizens who are in need. After the WWII, in the Communist time, social problems in Poland were made political issues. On the one hand

social services were monopolised by the state and the right to perform it was withdrawn from convents and other than state institutions, on the other hand official government propaganda denied the existence of the poverty or disability problems in a state of ‘blooming prosperity’:

the statistics were artificially lowered or the problems of handicapped people were not taken into account. Different forms of help were incidental, non-consistent, insufficient (Sierpowska, 2006).

In the Polish society family as such was traditionally highly valued and a moral duty of looking after its handicapped members, from birth till death, was traditionally assigned to parents and siblings of the disabled person. However, the totalitarian system was permanently destroying family bonds, affirming other than traditional values (religiosity and traditional model of family were ridiculed) and parents of the handicapped children often felt official pressure (e.g. from doctors or other professionals) to abandon their child and place him or her in one of state institutions. If the family decided to look after the child, it got minimal financial help from the state and almost no professional or social support, so it was common that after some years, especially when the parents became older, the child was finally placed in a state institution.

Social Welfare Homes were at this time the only available institutions where those in need were provided with permanent accommodation. They were total institutions: it was quite common that 100 or 200 people lived there, they were of all ages (sometimes even severely handicapped children at a very early age were placed there), inhabitants have different disorders (people with sensory, mental or physical disability, the elderly, the poor, the alcoholic clients, homeless people). The homes were usually located in rural areas, far from towns or even villages (to avoid making ‘the problem’ visible), that is why the inhabitants had no possibilities to socialize with local community and because of the lack of contacts they were usually ostracised. Communication difficulties (lack of public transportation services in a country where having a car was a privilege of not many) made it difficult for the families to contact their disabled members, so the family bonds were usually disappearing.

It was not until the political and social transformation of the 1989 that some changes started. The state policy towards social problems

became different and a big social movement started. Handicapped people began to get out of their homes and institutions and demand their rights, like many other social groups in Poland those days. Then, their parents and volunteers began to gather in foundations and non-governmental organisations (that was finally legal to establish them) and undertook a lot of activities, realising the integration and normalisation principles. Mainly, as an effect of this social movement some important acts were established, the first of them being Social Welfare Act of 1990 (with amendments in 2004). Its main principles are to support each handicapped person and their families in their efforts to fulfil their basic needs and make it possible for them to live in conditions protecting their human dignity (par. 3). The aim of these activities is to support the clients in reaching personal independence and integration with the society. According to the subsidiary principle, the state performs a supportive role towards the handicapped people and their families’ activities, respecting the principle of partnership co-operation with social organisations, NGO’s, Catholic Church and other Churches, and individuals (par.2)

Other important formal act is A programme of activities for the handicapped and their integration with the society, accepted by the Polish Government 5.10.1993 that promotes normalisation (comp. Pańczyk, 2005) of the handicapped people’s life in the spheres of education, employment, physical and social environment organisation, participation in culture, sport, recreation and tourism.

In 1997 an Occupational and Social Rehabilitation and Employment of the Handicapped Act was signed to promote equal rights of the disabled to get education and occupational training which enables them to live independently in a society and creates possibilities for vocational training and employment in regular institutions and establish special institutions to prepare the severely handicapped for regular work (Occupational Therapy Workshops, Occupational Activation Centres)

The possibility to perform scientific research freely, the ability to use foreign literature and establish international contacts brought about some important changes in Polish special pedagogy that has opened towards the ideas of individualism, integration and normalisation. Medical model of social care for handicapped people

has been gradually abandoned and more humanistic, personalistic model has been taking its place. It underlines individual needs of each handicapped person and stresses the role of a family whose significant role in the process of social integration and rehabilitation has been recognised (see: Dykcik, 2005; Kornas-Biela, 2006).

2. Living accommodation for mentally handicapped