Residential institutions are becoming hotbeds of infection and abuse – governments need to act now

31 March 2020

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We are very concerned by the situation of persons with disabilities living in institutions. The estimated 1 million persons with disabilities that live segregated in residential institutions are now more vulnerable than ever, facing increased risk of infection by COVID-19, physical and psychological abuse due to isolation, neglect and even abandonment.

The dangers that persons in institutions face include:

  • Lack of personal protective equipment for persons with disabilities and staff of institutions leads to higher risk of infection- for both staff and residents. The risk is compounded due to the communal life typical of institutions;
  • Lack of care and residents left unattended due to staff shortage – staff cannot work as they are infected or under quarantine, or do not work because of fear of becoming infected;
  • Forced medication and forced restraint measures under the pretence of preventive measures;
  • Forced confinement leading to lack of contact with outside world – family, friends and others.

Reports show that this is already happening in several countries:

  • In Greece, psychiatric units are locking persons in their rooms and depriving them of access to mobile phones and the internet. Contact with family or friends is often prohibited or needs to be done through a single phone, which increases the chance of transmission of COVID-19. Psychiatric units are dealing with staff shortages due to many workers not showing up through fear of being contaminated; 
  • In Italy, 70 people became infected in an institution for persons with intellectual disabilities. Managers admitted that residents and staff lacked personal protective equipment;  
  • In Poland, 52 residents (out of 67) and 8 staff (out of 14) became infected in a residential institution in Poland; 
  • In Spain, the press reported several of these cases, including 43 deaths in a retirement home and at least 12 suspected cases in an institution in Granada. There are also reports of support services that are in dire need of masks, gloves and gowns – they are resorting to homemade solutions and are even microwaving equipment in the hope of sterilising them.
  • In Germany, residential institutions face a serious lack of personal protective equipment and of funding to support their preventive measures.

We are also extremely concerned with the discontinuation of community-based services in some countries.

We call on the authorities to:

  • Make every possible effort to close residential and psychiatric institutions and provide community-based living solutions;
  • Check and guarantee that residents are not being abused and neglected and that forced seclusion, forced restraint and forced medication are not being used or escalated during this crisis;
  • Guarantee that persons with disabilities can still contact their families and support network outside the facility and they can do so in privacy and through their own communication devices.
  • Introduce proactive, widespread testing and stricter preventive measures for groups of persons with disabilities who are more susceptible to infection – including those living in institutions. This measures should extend to their support network;
  • Ensure that persons with disabilities in residential institutions have equal access to treatment.
  • Designate providers of support services (including care, support workers and personal assistants) as ‘key workers’ who should continue to work and be provided with the personal protective equipment and instructions needed to minimise exposure and spread of infection, as well as being proactively tested for the virus. Workers should be allowed to travel to and from the workplace (both organisations or clients' homes). They should also be entitled to support granted to other keyworkers, such as childcare and school admission;
  • Urgently provide personal protection kits to staff and persons with disabilities living in residential institutions and to staff providing community-based support;
  • Ensure that institutions have hygiene supplies and that strict hygiene and prevention measures are undertaken. These supplies should also be available to residents and posted in accessible formats publicly in the institutions
  • Support agencies providing disability support in developing continuity plans, for situations in which the number of available staff may be reduced. This includes reducing bureaucratic recruitment barriers while still maintaining protection measures, such as background checks;
  • Invest in support services and ensure they can meet the increased costs associated with this crisis, including medicines, protective materials and overtime of staff, in a way that is inclusive of everyone in the affected population;
  • Conduct visits and carefully monitor the activities of institutional care facilities to ensure that residents are not left abandoned or put in danger by staff shortages and absence. Residents should have access to information on their rights and means to report violations.
  • The EU should provide countries with a lack of personal protection kits with the tools and materials they require to avoid infection. This equipment should be prioritised for frontline employees including staff supporting persons with disabilities.

 


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