Deinstitutionalization of support for people with disabilities in Poland: Genuine or superficial change?

Abstract

Deinstitutionalization (DI) is a key concept in disability policy in Poland. Despite its dominant role in long-term care, DI is controversial in terms of its effectiveness and implementation. This article assesses the DI implementation process in Poland from the perspective of neo-institutionalism and institutional change. The article is based on qualitative research, conducted as part of the DI diagnosis project in Poland. The article identifies types of operational organizational structures at different stages of DI in Poland: hybrid, alternative, and partial. Hybrid entities emerge by recombining existing elements. Alternative organizations are less hierarchical and bureaucratic, more responsive to PwD and community needs, and have the potential to become systemic solutions. Partial organizations are defined through a comparison to an ideal holistic model, incorporate only some structural elements, such a as: nonhierarchical relationships based on trust, reciprocity, and social capital, dialogue and collaboration. The DI process in Poland is hampered by the lack of a coherent vision for the new support system towards disability in Poland, resulting in chaos and spontaneous exploration. However, organizational enclaves are emerging that can become models for systemic solutions. The future of DI requires a better understanding of these mechanisms and a more coherent public policy.