Page 15 - Social networks of people with mild intellectual disabilities: characteristics and interventions

General Introduction
Reinke, 2013) and in the United Kingdom, where people with disabilities are considered as citizens participating in all aspects of community and in control 1 of the decisions in their lives (Department of Health, 2009). Worldwide, over
recent decades, large institutions has been closed in favour of community-
based support; the so-called deinstitutionalization (Beadle-Brown, Mansell, &
Kozma, 2007; Lemay, 2009). In the Netherlands as well, an increasing number
of people with ID are living independently in the community with the aim of participating in society (Lub, Uyterlinde, & Schotanus, 2010). Physical presence
in the community, however, does not guarantee greater social inclusion, just as
taking part in an activity does not guarantee meaningful social contact (Ager,
Myers, Kerr, Myles, & Green, 2001).
At the present time in the Netherlands — but much earlier the Nordic countries (Tøssebro et al., 2012) — local government is becoming more and more the core provider of services, in a process of decentralization. In this context major changes were recently implemented in legislation regarding the care and support of people with ID. The Exceptional Medical Expenses Act (Algemene Wet Bijzondere Ziektenkosten, AWBZ) was until 2015 the insurance scheme for long-term care for people with ID. It has now been replaced by the Long-term Care Act (Wet langdurige zorg) for people who need the most intensive forms of care. Support provided in the home setting has been placed under the responsibility of local authorities, in accordance with the Social Support Act (Wet maatschappelijke ondersteuning, Wmo, 2015). This choice was based on the assumption that, compared to the national government, local authorities are more able to stimulate participation and are better attuned to specific local situations and citizens’ needs and, due to this, are able to provide services more efficiently (Dijkhoff, 2014). An important change is that the Wmo, in contrast to the AWBZ, does not prescribe entitlements to specific facilities for citizens, but instead places a general obligation on municipalities to provide social care and support, including general and tailor-made services (Dijkhoff, 2014). The Wmo expects independence from public services, self-reliance and ‘personal strengths’ and, if necessary, support from a person’s own informal networks (Grootegoed & van Dijk, 2012; Wet maatschappelijke ondersteuning, 2015). However, the aims of these policies are causing major challenges due to the vulnerability of people with ID and their networks. In the next section the characteristics of people with ID are outlined, followed by a description of their networks in section 1.5.
13