Trends in residential policies and services for people with intellectual disabilities in Taiwan.
Taiwan bucks the Western trend by growing both small group homes and large institutions at once.
01Research in Context
What this study did
The authors tracked Taiwan’s government-funded homes for people with intellectual disability from 1990 to 2005. They counted beds in small group homes (under 30 beds) and in large institutions. They used government records to see which way the country was moving.
What they found
Both small homes and big institutions grew at the same time. Western countries were closing large facilities, but Taiwan kept adding them. Government money only flows to licensed places, so more beds of every size appeared.
How this fits with other research
Wolfensberger (2011) predicted large institutions would soon vanish everywhere. Taiwan’s data show the opposite, creating an apparent contradiction. The difference is simple: Wolf used global theory while C et al. counted actual beds in one country that still funds big places.
J-Rutherford et al. (2003) already showed that people inside Taiwan’s institutions visit doctors twice as often as typical citizens. More beds mean more medical demand, so the growth trend has real health impact.
Harrington et al. (2009) found that complex client needs, age, and regional supply drive who ends up in California’s large centers. Taiwan’s dual growth pattern suggests the same forces—need plus available beds—are at work.
Why it matters
If you consult on international programs, do not assume deinstitutionalization is the default path. In Taiwan, advocacy may need to focus on quality control inside expanding large homes as well as fostering small community options. When you review placement decisions, check whether funding rules quietly reward size over individual fit.
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02At a glance
03Original abstract
BACKGROUND: In Taiwan, 92-95% of people with an intellectual disability (ID) live with their families, with the remaining residing in residential facilities. Instead of funding community-living alternatives, the Taiwanese Government funds only registered facilities as part of its residential policies and services. The purpose of this study was to evaluate current policies and services trends regarding people with an ID in Taiwan. METHODS: Both documentary research, such as an analysis of policies, services programmes, official statistics, surveys, reports and funding provision reports, and a mail survey, were conducted to examine current trends and characteristics of the 96 residential settings available for people with an ID in Taiwan. RESULTS: During the 1990s in Taiwan, residential programmes for people with an ID showed the biggest growth since 1952. Since the first 'Community Home' was launched in 1990, the number of smaller scale residential settings with a unit size of less than 30 has grown significantly, particularly since 2000. However, the rate of institutionalization of people with an ID and who live in the institutions has also risen. CONCLUSIONS: In Taiwan, unlike in Western societies, residential services for people with an ID provided by formal care systems are tending to grow in number, and these include both large and smaller residential settings.
Journal of intellectual disability research : JIDR, 2007 · doi:10.1111/j.1365-2788.2006.00850.x