Prepared by Alixe Bonardi, July 2009
with funding from the sponsors of the Ian Axford (New Zealand) Fellowships in Public Policy
Alixe Bonardi is Assistant Director of the University of Massachusetts Medical School’s Center for Developmental Disabilities Evaluation and Research. She is a trained occupational therapist and has spent the past ten years working in disability policy research and development.
During Alixe’s Ian Axford Fellowship exchange to New Zealand she was based at the Ministry of Health in Wellington, where she researched approaches to risk management in New Zealand intellectual disability services.
Supports for people with intellectual disability in New Zealand have undergone great changes in the past 20 years, many of them positive and driven by a vision for real participation in the community for all New Zealanders. Movement of a service model from institutional care to a model that supports community participation, flexibility, and choice has been steady and in many cases has shown positive change in people’s lives. There is growing concern, however that the pace of progress has slowed, and that people with intellectual disabilities continue to experience barriers to living an “ordinary” life in New Zealand.
Studies completed in New Zealand, as well as international studies suggest that people with intellectual disability experience greater vulnerability to poor health outcomes, experience higher behavioural support needs, and are at greater risk of abuse or neglect, compared to the general population.
This report examines how risk management is approached in New Zealand, in particular in the context of services for people with intellectual disability. It reviews the development of the philosophy of service provision to provide necessary background, followed by an analysis of how risk management is perceived and applied by a number of stakeholders, including people with intellectual disability and their families. The tensions between flexibility (choice) and safety (control) are explored both at an individual and system’s level. The report concludes with considerations and recommendations applicable to the current New Zealand context.
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