Bhargavi Davar & Aleisha Carroll
2024
This ‘Disability Equity and Rights: Challenges, opportunities, and ways forward for inclusive development’ publication was prepared under the DFAT – CBM Inclusion Advisory Group Disability Inclusion Technical Partnership, an Australian aid initiative implemented by CBM Inclusion Advisory Group and the Nossal Institute for Global Health at the University of Melbourne.
This publication has been funded by the Australian Government through the Department of Foreign Affairs and Trade. The views expressed in this publication are the author’s alone and are not necessarily the views of the Australian Government.
Background:
Central to the disability rights movement, culminating in the development of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), was protesting ‘against the service systems, medical professionals and social institutions that keep people with disabilities “captives of care”’. Progress towards universal deinstitutionalisation has been slow. Many people with disabilities are continually denied the right to live independently in the community. They are segregated in health or social care institutions or held captive in homes where they are deprived of basic liberties such as being able to make decisions about their lives and participate in the community on an equal basis with others.
The UN Committee on the Rights of Persons with Disabilities’ Guidelines on Deinstitutionalisation calls on Member States to ‘recognise institutionalisation as a form of violence’. The Guidelines, together with the Committee’s General Comment No. 5 on living independently and being included in the community, emphasise that institutionalisation is a discriminatory practice, involves de facto denial of legal capacity, constitutes detention and deprivation of liberty, and exposes people with disabilities to the administration of drugs and other interventions without free and informed consent. As such, all disability-based institutionalisation is prohibited under the CRPD.
People with mental health issues and psychosocial disabilities, people with intellectual disabilities, and those with complex support needs make up the largest institutionalised groups. In the European Union alone there are an estimated 1.4 million people living in institutions. The UN estimates that of 8 million children who live in institutions, 1 in 3 are children with disabilities. People in institutions, particularly women and girls, experience greater rates of sexual and physical violence, forced sterilisation, neglect, substance abuse, suicide, human trafficking, and other forms of torture and violence. The COVID-19 pandemic brought institutionalisation back into the public eye with higher rates of infection and morbidity than the wider population. Representative organisations of people with psychosocial and intellectual disabilities indicate that disability-based institutionalisation is one of the gravest issues affecting their constituents in Asia and the Pacific.
