Self-Determination and Community Inclusion: Exploring Policy Reform in Day Services for Adults With Intellectual and Developmental Disabilities in the Republic of Ireland

IF 2.5 4区 医学 Q2 HEALTH POLICY & SERVICES Journal of Policy and Practice in Intellectual Disabilities Pub Date : 2025-02-14 DOI:10.1111/jppi.70003
Nicola Maxwell
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Abstract

Adult day services are central to service provision for people with intellectual and developmental disabilities (IDD) in Ireland. Policy reform, in the guise of New Directions, has sought to address the segregated and institutionalized nature of these specialist services. New Directions aims to reorient services toward providing supports to enable users to make self-directed choices and decisions and to be included in their communities, reflecting the values of the Convention on the Rights of Persons with Disabilities (CRPD). Yet, segregated day service provision is increasing and people with IDD continue to be structurally excluded from other opportunities and to have their choices circumscribed. This paper focuses on the interview narratives of staff employed in a day service in Ireland. It explores the disjuncture between, on the one hand, New Directions policy descriptions of day services as supports for self-determination and community inclusion and, on the other, the actualities of day service provision. The findings show that New Directions is understood as a means of providing individualized supports to make choices in inclusive mainstream settings but is not perceived as a clearly articulated policy. The research illustrates that the conditions and opportunities to support self-determination and community inclusion are lacking within day services and several challenges inhibit the aspirations of New Directions. The study recommends that the Irish state meets its human rights obligations to ensure that rights to self-determination and community inclusion for people with IDD are upheld. This requires critical excavation of current service provision and targeted policy resources to ensure that the fundamental rights of people with IDD are upheld.

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