KATSUI Yoko

This study examined the provision of public social welfare—specifically, disability welfare services— for individuals with severe behavioral disorders and the outcomes of such welfare provision. This study identified an increase in the abuse of persons with disabilities—specifically those with severe behavioral disorders—in the context of welfare service provision. There is also a growing need for dignified support in which physical restraints are not used as a tool for management. Among individuals with severe behavioral disorders, needs have remained unmet because prior barriers embedded in public disability welfare provision have resulted in service delivery that diverges from the standard that allows the individual to lead the life they wish. These unmet needs, in turn, give rise to irreversible outcomes. The social welfare provision system must clearly define the responsibility for welfare provision and ensure its reliable implementation. Social welfare policies are required that ensure reliable service provision while enhancing responsiveness to the needs of the individual, their family members, and the entities responsible for social welfare provision.

The purpose of this paper was to study social exclusion as an effect of residential facility care in the provision of welfare services for persons with disabilities. This is based on an understanding of such welfare measures from the perspective of a system to provide social welfare that enables approximately 127,660 people with intellectual disabilities, autism spectrum disorders, etc. who are in institutions in Japan, to live in local society. The results showed the existence of not only the abuse of persons with disabilities as an outcome of the provision of welfare services to them, but also abuse in the background treatment premised on collective action, lack of staff to regulate these actions, lack of individual support, a shortage of staff to support regional transition, social isolation with 72.0% of residents staying for 10–40 years or longer, maintenance of the reproductive function of large-scale residential facilities, suppression of community life support services, policies that function to socially isolate and socially exclude as an effect of this, and a series of structural disadvantages at the micro, mezzo, and macro levels. These findings suggest the need for an improved system of social welfare provision. Keywords: Isolation, social exclusion, disability welfare measures, people with intellectual disabilities, Abuse of persons with disabilities

This study investigated abuse to people with disabilities, considered "abuse to people with disabilities by employees of welfare facilities for people with disabilities" as described in each "Report on the Investigation Results" for the fiscal years 2015-2019, and considered the current situation and problems of abuse to them suggested by these reports. As a result, it became clear that intellectually disabled people are intensively abused, and that people in higher disable support categories and people with behavioral disorders (the terms used in the reports) are being increasingly abused.