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Non-take-up of sociomedical institutions and services in the disability sector: Indicator of a mismatch between supply and demand

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2021. Ressources en ligne : Abrégé : Why do people with disabilities who have been referred to a specialized institution or service not apply for admission? We held 103 interviews in 4 départments in mainland France to shed light on individual situations and answer this question, in a context where the supply appears to be not only insufficient, but also too focused on specialized institutions.Who are these individuals not taking up the offer? They often appear to have a physical disability or a mental illness. Less than half of them have never been to a sociomedical institution (ESMS) for disabled people. Non-take-up is uncommon in children referred to specialized home care services and, conversely, it is more often observed in adults referred to a residential facility for adults with light disability. Half of our respondents did not contact the ESMS to which they were referred by their local public support institution (MDPH). However, a third said that they would eventually use an ESMS, sooner or later.Respondents’ families had set up alternative solutions to ESMSs. They usually relied on one or two independent professionals, mainly speech therapists, physiotherapists and psychologists.The main cause of non-take-up seems to be the mismatch between the existing offer and the needs or wishes of beneficiaries or their families. The second cause we identified is ESMSs rejecting applications. The third reason pertains to strategies respondents set up to secure their trajectory. Part of non-take-up is due to a unilateral decision by the Commission on disabled people’s rights and autonomy (CDAPH).The wishes expressed throughout the interviews show respondents’ interest in living “at home”, and make the case for a better organization of at-home support, with a different approach from that of current sociomedical services.
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Why do people with disabilities who have been referred to a specialized institution or service not apply for admission? We held 103 interviews in 4 départments in mainland France to shed light on individual situations and answer this question, in a context where the supply appears to be not only insufficient, but also too focused on specialized institutions.Who are these individuals not taking up the offer? They often appear to have a physical disability or a mental illness. Less than half of them have never been to a sociomedical institution (ESMS) for disabled people. Non-take-up is uncommon in children referred to specialized home care services and, conversely, it is more often observed in adults referred to a residential facility for adults with light disability. Half of our respondents did not contact the ESMS to which they were referred by their local public support institution (MDPH). However, a third said that they would eventually use an ESMS, sooner or later.Respondents’ families had set up alternative solutions to ESMSs. They usually relied on one or two independent professionals, mainly speech therapists, physiotherapists and psychologists.The main cause of non-take-up seems to be the mismatch between the existing offer and the needs or wishes of beneficiaries or their families. The second cause we identified is ESMSs rejecting applications. The third reason pertains to strategies respondents set up to secure their trajectory. Part of non-take-up is due to a unilateral decision by the Commission on disabled people’s rights and autonomy (CDAPH).The wishes expressed throughout the interviews show respondents’ interest in living “at home”, and make the case for a better organization of at-home support, with a different approach from that of current sociomedical services.

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