Anna Kittelsaa

Tjenestene til personer med utviklingshemming er fantasiløst like

Tjenestene til mennesker med utviklingshemming er standardiserte, bærer preg av institusjonstenkning, bidrar til segregering og viser at det er små forventninger til at personer med utviklingshemming, i følge professor Anna Kittelsaa.

Tjenestene til mennesker med utviklingshemming er alt for ofte alt for dårlige, noe som er veldokumentert gjennom tilsyn på feltet og gjennom sporadiske mediaoppslag. Få har bedre kjennskap til feltet enn professor Anna Kittelsaa som gjennom et langt liv har jobbet på nær sagt alle deler av feltet. Som ung sosionomstudent på slutten av 1960-tallet, jobbet Anna Kittelsaa på sentralinstitusjonen Nærlandsheimen. Siden den gang har hun holdt seg til sektoren, i et mangfold av roller. Anna Kittelsaa har jobbet direkte med personer med utviklingshemming, hun har hatt jobbet i kommuneledelsen med ansvaret for tjenester til innbyggere med utviklingshemming, før hun begynte på NTNU Samfunnsforskning og som professor II på Universitetet i Tromsø, avdeling Harstad. Det er nærliggende å høre med Anna Kittelsaa om hva gjøres og hva bør gjøres for å sikre mennesker med utviklingshemming gode liv?

 

- Jeg kan nevne at Tor-Inge Romøren i år 2000 viste til at tjenestene til personer med utviklingshemming er fantasiløst like fra sted til sted. Det er jo bare å reise gjennom kommune Norge så ser vi det. Dette bekreftes også av Tøssebros undersøkelser av levekår for personer med utviklingshemming hvor det framgår at rundt 80 prosent bor i ulike former for bofellesskap. De nyeste levekårsundersøkelsene viser dessuten at bofellesskapene stadig øker i størrelse slik at en bor og mottar tjenester i en større gruppe av såkalte medbeboere. Disse medbeboerne er stort sett personer en ikke selv har valgt, og ikke nødvendigvis har et nært eller personlig forhold til. I tillegg kommer at en selv (eller pårørende) ikke har valgt hvor en skal bo, men blir tildelt bolig hvor det måtte finnes en «ledig plass». Det betyr at en ikke har noen innflytelse på hvor en skal bo eller hvem en skal bo sammen med. De aller fleste bofellesskapene bygges dessuten med fellesareal hvor en kan samle beboere til felles måltider eller aktiviteter, eller hvor de kan oppholde seg og slik være «passet på» (en billig driftsform, j fr. nedenfor).

 

- Det som i sin tid kjennetegnet institusjonsomsorgen var at en mottok alle typer tjenester på samme sted. For å bryte med institusjonsomsorgen ble det nedfelt i dokumentene fra avvikling av institusjonene at det skulle være skille mellom bolig og tjenester. Dette er et prinsipp som ser ut til å være fullstendig forlatt. Dette gjelder ikke minst kombinasjonen av bolig og tjenester hvor ansatte som yter tjenester, er knyttet til boligen og ikke til beboeres enkeltvedtak. I enkelte kommuner er dessuten vedtakene såkalt tjenestebeskrivende; det vil si at de ikke egentlig beskriver konkret hva s lags bistand den enkelte skal motta, men bare sier noe om type tjenester. I praksis kan dette føre til at personer som trenger lite hjelp, kan får for mye og dermed komme inn i en tilstand av «lært hjelpesløshet» mens andre kan få for lite. Det siste gjelder blant annet personer som er relativt selvstendige når de bor sammen med andre som trenger omfattende tjenester og som derfor «prioriterer seg selv».

 

- Den britiske professoren Jim Mansell studerte over mange år tjenester til personer med utviklingshemming. Han vurderte blant annet tjenestekvalitet i gruppeboliger av ulik størrelse. Hans konklusjon var at store boliger ikke var billigere enn små, men at det var lettere å gjøre dem billigere. Med dette mente han at det var lettere å senke kravene til kvalitet i større omgivelser hvor det ikke var så lett å holde oversikt og hvor det var enkelt å samle beboere i grupper i stedet for å yte individuelle tjenester. I norske bofellesskap kan en for eksempel yte mange tjenester i fellesskap ved å legge aktivitet til fellesarealet i bofellesskapet i stedet for å yte tjenester i de individuelle leilighetene. En kan også spare ved å kutte ned på individuelle tjenester i fritid og legge til rette for gruppeaktivitet både i bofellesskapet og utenfor. Det betyr i praksis at alle må delta i de samme aktivitetene og i liten grad kan følge opp egne interesser.

 

- Utviklingen viser også at mange mangler sysselsetting eller meningsfylt aktivitet i hverdagen. Her kan jeg vise til studiene til Olsen og til Reinertsen. Levekårsundersøkelser viser at 53 % er utenfor arbeid og aktivitet og at rundt 80 % får uførepensjon når de fyller 18 år. Når vi føyer til at de fleste går i spesielt tilrettelagte skolegrupper i videregående skole og at de fleste mangler dokumentasjon på hva slags utdanning de har fullført, blir det tydelig at det er små forventninger til at personer med utviklingshemming er tiltenkt en plass i produktivt arbeid.

 

Er situasjonen helsvart eller ser vi lyspunkter?

 

- Spørsmålet er om utviklingen bare går i negativ retning. I en kommune, Namsos, flytter beboere ut av det store bofellesskapet midt i byen og til mindre enheter. Dessuten viser Nordlandsforskning i en studie for et par år siden at de som er unge med utviklingshemming i dag, ikke vil bo i bofellesskap, men leve et liv på linje med andre unge. Dette er interessante innspill som bør følges nøye.

 

-J eg skulle ønske at noen kommuner tok initiativ til å støtte personer med utviklingshemming som ønsker å bo på andre måter, at det for eksempel kunne vært bevilget midler til forsøk på alternative bo- og praksisformer. Samtidig er det behov for alvorlige løft i videregående skole slik at de med utviklingshemming som er i stand til å lære mer enn de får anledning til i dag, blir sett på som ordinære elever som faktisk skal ha en framtid som yrkesaktive i en eller annen form. Og når jeg først ønsker, kan jeg vise til Island hvor personer med utviklingshemming også får anledning til å delta i høyere utdanning, sier den alltid engasjerte Anna Kittelsaa.

 

Jens Petter Gitlesen

14 januar 2019

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