The impacts of deinstitutionalisation on the quality of life of a cohort of individuals with intellectual disabilities: A longitudinal mixed methods study

Literature review: The systematic review aimed to examine the impact that deinstitutionalisation had on the community integration of service users with intellectual disabilities. Six electronic databases (PsychINFO, Medline, Scopus, Web of Science, CINAHL, and ASSIA) were searched and 12 studies met the inclusion criteria. Findings indicated that access to community facilities increased but integration did not. Frequency and quality of social relationships with staff, family, and peers was generally high post move but relationships with individuals unrelated to services remained infrequent. It is concluded that the focus of policy should move towards developing close personal relationships rather than community integration. Research report: The empirical research project aimed to examine how deinstitutionalisation had impacted the quality of life of a cohort of 14 service users. The study formed the second half of a quantitative longitudinal study spanning eight years. A mixed methods approach was used. Eleven staff members who knew service users well completed outcome measures. Transcriptions of discussions alongside this were analysed using template analysis. Interviews were held with social workers who knew the remaining three. Six themes were created: Social relationships; community use; choice; emotional wellbeing; challenging behaviour; and adaptive behaviour. The move to the community was experienced very differently by each service user. While it appeared that a number of gains were made for some service users, others experienced poor quality care and received few benefits. Relationships with staff appeared to be very important for some service users and these relationships appeared to impact all areas of quality of life. It is concluded that for the move to the community to be successful, staff must be sensitive to the changing needs of service users throughout their lives. Critical appraisal: The research process is critically appraised and reflected upon. Key decisional points are considered, and extended theory is discussed.