The Negative Effects of Institutional Care

“I constantly experienced a sense of profound loneliness and a deep sense of uncertainty. I felt lost. You have to understand that my exposure to the outside world was limited… What did I have? Where would I go for Easter or Christmas?”

- - Stephen Ucembe (grew up in an institution, speaking about trying to fit into University life after the institution)

Reading this post it is easy to come to the conclusion that we believe all institutions are bad. However we believe there are such things as good institutions. We define a good institution as one that…

1. 1. Understands they are not a long term solution for a child and seeks to re-unify or adopt their children out as soon as possible.

2. 2. Ethically seeks out alternatives for their children and seeks re-unification with family members before turning to adoption.

3. 3. Does their best to meet the children’s emotional and physical needs

4. 4. Meets a need in the community rather than creating one. This means they set up in an area that is not already overrun with orphanages and they only take in children that are truly in need of their care.

The goal of this post is not to attack every institution out there- it is to show that institutions should be a last resort for children and never a long term solution.

We will approach this by addressing myths some people hold when it comes to institutional care.

Myth: An institution that is well run and well funded can provide all a child needs to develop into a healthy and functioning adult.

“For the last half century, child development specialists have recognized that residential institutions consistently fail to meet children’s developmental needs for attachment, acculturation and social integration.”

The best institution in the world cannot give a child everything a loving and committed family can. Children in institutions may be given food and clothes and an education but their emotional needs cannot be met in an institutional setting. In the best institutions children are well loved by the workers and volunteers who care for them. However these volunteers come and go and the workers shifts’ end and new groups come in. One consistent caregiver is not provided and as a result children develop attachment issues that can lead to developmental delays, self esteem problems, trust issues, behavioral problems, and future relationship issues. Children’s unique needs and differences aren’t accommodated when there are other children to be cared for and this can also lead to increased emotional, psychological, or physical problems. Research shows children raised in institutions have lower IQ’s, higher rates of suicide, homelessness, brain damage, and psychological disorders and medical problems.

Myth: But the kids seemed so happy and loving. They came running up to us and held our hands and jumped into our laps. They must be well-loved if they know how to show it.

“Although such behaviour may initially seem to be an expression of spontaneous affection, it is actually a symptom of a significant attachment problem. A young child with a secure sense of attachment is more likely to be cautious, even fearful, of strangers, rather than seeking to touch them.”

Think of the children you know back home. If they were in a room without their parents and a whole group of people who didn’t look like them walked in, how would they react? Most children would be scared. They’d either cry and run away or at least act shy. It isn’t normal, safe, or healthy for kids to run up to strangers and jump into their arms immediately after meeting them. This behavior is a sign of attachment issues these children face as a result of their years spent in an institution. These children were never given one caregiver who consistently met their needs so they never learned how to attach to another person and develop that relationship of trust and love. They can get their cuddles and special attention from the new visitors or anyone else that shows up- it makes no difference to them.

Usually this can be changed if and when the child is placed in a family. A consistent amount of time having their needs met by their mom and dad eventually teaches them how to form relationships and place their trust and love in others. Some children however develop a disorder called Reactive Attachment Disorder. This is often a result of severe neglect and/or abuse and is often found in children who have grown up in institutions. This disorder can be hard to treat and makes family life difficult for these children.

Myth: Okay so kids in orphanages may be a little behind developmentally but they can easily catch up as soon as they get into a family.

“Every three months that a young child resides in an institution, they lose one month of development.”

Kids are little sponges that are great at bouncing back and catching up in their development when given the right environment, but for a child who spends years in an institution permanent damage can be done. For someone who has never been consistently loved it’s hard to believe you are worthy of love. For someone who has lived in an incredibly structured and strict daily routine it is hard to adapt to any new environment. For someone who has never known family life it’s hard to adjust. Some research even supports that institutional life can actually damage a child’s brain and affect their ability to emotionally process their environment.

*Now if I was not a Christian I might believe there are children who are beyond saving, but thanks to our all powerful God I can say that no child is beyond saving - that miracles are possible, that healing is within these kid’s reach. However that does not mean we cannot ignore the long term affects children face from institutional life.

Myth: There’s nothing wrong with someone moving to a country to open an orphanage. There are still kids out there that need help.

“In communities under severe economic stress, increasing the number of places in residential care results in children being pushed out of poor households to fill those places.”

In some cultures, such as African cultures, a significant amount of value is placed on family ties. In countries where there are very few institutions available children are often cared for within the extended family or community if their parents are unable to care for them. However when institutions start to open families who are uneducated in the possible developmental harm of these institutions make the decision to send their children there instead of finding alternative solutions. The orphanage can actually create the need.

A survey of orphanages in Uganda in 1992 found that 95% of the children in institutional care had living relatives. Now it would be naïve to assume all of those children could return home to their families but a large majority of them could and did thanks to efforts by Save the Children (86% were re-united). This is why it is so important that institutions are careful about what children they allow to be admitted and why just starting an orphanage without the research and knowledge of the area can be more harmful than helpful. Some orphanages are what we would call good institutions (see opening) and these can meet a real need for orphaned and abandoned children, but we don’t need hundreds of orphanages in the same area. We really only need a few good ones so to that person wanting to move to a country they know little about and open an orphanage- please think about the impact you’re really making and whether it is going to be a beneficial one.

Myth: We’re a Christian run orphanage and we’re raising up our children to be strong Christian leaders in their own country.

With the developmental delays, possible brain damage, attachment issues, and psychological and medical problem your children are at risk for chances are they’re not going to make really good leaders. Every child deserves a family (God places the lonely in FAMILIES-Psalm 68:6).

I hope this discussion of the harmful effects of long-term institutional care shows why it is Abide’s goal to prevent as many children as possible from being separated from their families and entering into this form of care.

Sources/other resources:

*All quotes (unless mentioned otherwise) are from the document Families Not Orphanages found here

Blog of a wonderful couple living in Uganda and working with alternative orphan care initiatives- http://rileysinuganda.blogspot.com/p/important-links.html

One of our favorites in the blog world- Kristen is an adoptive mother and advocate for creative orphan care solutions: http://www.rageagainsttheminivan.com/2010/02/et-tu-anderson-cooper.html

http://www.rageagainsttheminivan.com/2011/03/psychological-impacts-of-abandonment.html

Some great resources for studies and documents on alternative care options for vulnerable children:

Better Care Network- http://www.crin.org/BCN/

The Way Forward Project: www.thewayforwardporject.org

Orphans and Other Vulnerable Children (OVC): http://www.mglsd.go.ug/ovc/

Book:

Federici, Ronald. Help for the Hopeless Child. 1998.

(Megan would like to add a personal note about Dr. Federici. She has had some experience with him and while she loves his research and insight into institutionalized kids she does NOT support his therapy practices. So please do not take away from this article that we endorsing his therapy in any way, shape, or form)