Croatia: Locked Up, Limited Lives

Thousands of people in Croatia with intellectual or mental disabilities are forced to live in institutions that strip them of their privacy, autonomy, and dignity, Human Rights Watch said in a report released today. The Croatian government has done little to provide alternatives to institutions, despite promises to the European Union and United Nations, and the number of people in institutions is growing, Human Rights Watch said.

The 74-page report, "'Once You Enter, You Never Leave': Deinstitutionalization of Persons with Intellectual or Mental Disabilities in Croatia," documents the plight of the more than 9,000 persons with intellectual or mental disabilities living in institutions and the lack of community-based programs for housing and support.

"Imagine always having to ask permission to leave the place where you live, having no privacy to take a shower, and no chance to decide what to eat or when to go to bed," said Amanda McRae, fellow with the Europe and Central Asia division at Human Rights Watch and the author of the report. "This is the reality for thousands of people living in institutions in Croatia."

Human Rights Watch research found that while more than 4,000 persons with mental disabilities are living in institutional settings in Croatia, the country has places for only sixteen people in supportive community living programs. The situation is not much better for people with intellectual disabilities: Croatia has facilities for only about 250 people in community living programs, while approximately 5,000 remain in institutions.

The experience with deinstitutionalization in other countries in Europe and North America has shown that individuals with mental or intellectual disabilities can live in the community with support and that those who live in the community enjoy a far better quality of life than those in institutions.

"In the community, I was free," Marija S., a current institution resident who once lived in a supportive community program, told Human Rights Watch. When she lived in the community, Marija could work, shop for her own food, and come and go as she pleased from her apartment, all parts of normal life that she is denied in an institution.

Croatia's failure to end institutionalization and provide community-based alternatives stands in sharp contrast to its promises to promote the rights of people with disabilities. Croatia was among the first countries to ratify the UN Convention on the Rights of Persons with Disabilities. Croatia has also pledged to deinstitutionalize people with mental and intellectual disabilities in an agreement with the European Union, linked to its preparations for EU membership. The contents of a recent government plan for deinstitutionalization have not yet been made public.

The report recommends that the Croatian government replace institutions with support programs that provide housing and assistance for life in the community and that give people with disabilities a meaningful choice of where and how to live. These steps are essential to ensuring the right of people with disabilities to live in the community, a basic right outlined in the convention.

"Croatia has positioned itself as a leader on disability rights," McRae said. "But when it comes to the right to live in the community, it has nothing to be proud of. Real leadership on this issue will require a serious and sustained commitment to provide community-based housing and support for people with disabilities."

About 70 percent of the 9,000 persons with intellectual or mental disabilities in institutions were placed there by guardians after a court stripped them of legal capacity -- the right to make decisions for themselves. That process, coupled with a lack of regular judicial review and other safeguards, puts them at risk of arbitrary detention.

Approximately 30 percent live in these institutions by choice, but that choice is not meaningful because there are so few other options, Human Rights Watch said.

The report is based on field research in Croatia in November and December 2009, including visits to nine institutions and interviews with current and former residents, staff, civil society organizations, and government officials.

Two Cases From the Human Rights Watch Report

• Marija S., a young woman with both mental and intellectual disabilities living in an institution in Karlovac, has been in and out of institutions for most of her life. In July 2009, after two years in a community living program, her disabilities became more severe. Because of the lack of government and community-based programs for people with mental disabilities, she was forced to move back into an institution. There she can no longer work, make any decisions for herself, or freely interact with the rest of the community. She told Human Rights Watch that she does not expect that she will ever be able to live in the community again.

• Senada H. agreed to move into an institution at the age of 23 because her family could no longer take care of her. She could not live on her own without help, and there was no support available to her outside of an institution. At the institution, individuality was discouraged and privacy was scarce - residents could not choose what to eat, where to go, or even when to go to bed. There was only one bathroom for 20 people, both women and men. Senada is one of the few lucky ones who was able to leave and live on her own, after seven-and-a-half years in the institution. She gets support from a program that works with 150 former institutions residents. Despite its success, this program has not received an extended government contract to serve additional people since 2006.