The Parliamentary Assembly has already advocated the de-institutionalisation of children with disabilities (see Recommendations 1601 (2003) and 1698 (2005)). But all too often the most frequent response to disability in many countries in Europe is the virtually automatic decision – which cannot always be reviewed – to place children with disabilities in specialised institutions. Nonetheless, children with physical and mental disabilities have rights as individuals and today placement in institutions is no longer a generally acceptable solution; such decisions must be the exception, have certain guarantees attached and be regularly reviewed.
Children are not immune from institutionalisation syndrome which, coming on top of their disability, makes their situation worse. Nothing can repair the damage caused by social exclusion, segregation and isolation. Once children with disabilities are placed in institutions, there is a danger that they will spend the rest of their lives there. Without acquiring the necessary skills to live in society or enter employment, they will quite simply be transferred from children’s homes to institutions for adults with disabilities.
Even today, in Europe and particularly central and eastern Europe, living in institutions for children with physical and/or mental disabilities carries with it an inherent risk of violence, abuse (especially sexual) and neglect; the food is often inadequate, the material conditions in certain institutions for children with disabilities are still very poor, with use of restraints, such as cage beds, the lack of any privacy and of trained staff, overcrowding, no heating in winter, no rehabilitation and treatment programmes and over-medication.
The running of institutions cannot be left solely to the goodwill and abilities of the directors and their staff, even though in general their devotion and personal investment are to be commended. At national level, institutions and the living conditions provided to children with disabilities should be regularly monitored by the relevant authorities and any dysfunctions remedied and disciplinary action taken.
At national level children must be protected against any violations of their fundamental rights and against any abuse and ill-treatment by means of an accessible independent body having the authority to hear individual complaints from children and take appropriate action. At international level, the Council of Europe, the defender of human rights and fundamental freedoms, owes it to its member states not to ignore the rights of children, and in particular the rights of children with disabilities living in institutions.