發展智能障礙者社區居住與生活：美英兩國探討比較

Community Living for Adults with Intellectual Disabilities: Comparative Study in the US and UK

周月清(Yueh-Ching Chou)

《社會政策與社會工作學刊》 9卷2期 (2005/09) Pp. 139-196

https://doi.org/10.6785/SPSW.200509.0139

摘要

本文探討比較美、英兩國成年智障者從教養院搬到社區居住與生活改革源起、進程與配套措施，以文件研究方法從事文獻資料收集，含電腦檢索圖書館與網站期刊與書目及各國官方與非官方文件。研究發現：近代，美國發展智能或發展障礙者社區居住與生活重要改革事件為：1999年最高法院Olmstead決議障礙者有權利在社區生活；英國2001年學習障礙者白皮書，強調「對人支持」(supporting people)與「重視人的價值」(valuing people)，規定地方政府2004年4月前所有住在長期停留醫院之學習障礙者搬到社區生活。美英兩國比較發現其相同處為：智障者社區居住與生活改革自1960年代以來持續進行，近代因重要事件及改革政策，有更具體成果，以重度、極重度及有挑戰性行為成年智障者為對象。相關實證性研究一致發現住在社區小型一般住宅，即使針對有密集性支持需求之重度智障者，比住在傳統教養院或大型者，成本效益高。兩國不同處，美國屬於其醫療補助項下之改革措施，英國為其社區照顧一環；美國困境為其等候排隊住到社區一般住宅者眾多，英國則需致力於資源結合與配置適當性。

關鍵字

智能障礙者 ； 社區居住與生活 ； 社會融合 ； 獨立生活 ； 社區照顧

並列摘要

This study utilizes literature review to collect governmental documents and empirical studies regarding adults with intellectual disabilities living in the community in the United States and Britain in order to analyze the similarities and differences of their polices and services. Both the US and Britain initiated ”deinstitutionalization” in the 1960s. Currently in the US the Supreme Court decision in Olmstead v. L. C. in 1999 brought big effect on the policies revolution to support persons with mental retardation/developmental disabilities living in the community. In Britain, recent policy for supporting adults with learning disabilities to live in the community independently is the 2001 White Paper-Valuing people: A new strategy for learning disability for the 21St century. Adults with severe/profound intellectual disabilities and with challenging behaviors who stay in the institutions are the primary targets moving into the community in the US and Britain at the present. Based on the consistent findings of the empirical studies in the US and Britain, community-based ordinary housing is more cost-effective than the institution-based or large scale housing.

並列關鍵字

intellectual disabilities ； mental retardation ； learning disabilities ； community living ； independent living ； community care

參考文獻

U.S. Public Law 106-402: Developmental Disabilities Assistance and Bill of Rights Act of 2000

A Compendium of HHS Technical Assistance Activities Related to Administration's Community-Integration Initiative

President will Propose $1.75 Billion Program to Help Transition Americans with Disabilities from Institutions to Community Living

Fact Sheet: Assuring Access to Community Living for the Disabled

News Release: HHS Approves Nevada Plan to Help More Disabled Adults Live at Home