Care for persons with mental disability: dependency on inherited culture of services

Goal of this article is to identify main obstacles while transforming Lithuanian system of residential care for persons with mental and intellecrual disabilities from repressive and isolating Soviet tradition to individualised community care. During the Soviet times the goal of large residentiai institutions was to take physical care after individuais with mental and intellectual disabilities as weil as to isolate them from the rest of the society. These institutions were deeply anchored in the Soviet system of social assistance, based on the principles of defectology and stigmatizing attitudes towards persons with mental health problems. After collapse of the Soviet Union this system appeared to be eminently resistant to reforms: it withstood attempts of transformation and even managed to receive investments from the European Union structural funds thus strengthening the positions of large residential institutions over modern community care. More than two decades of investments in training of staff, reconstruction of buildings, modernisation of services and other components of mental health services in Lithuania have not resulted in the change of paradigm, as institutional culture and tradition of exclusion remains still very strong. Thus, current system of care for persons with mental and intellectual disabilities in Lithuania can be defined as a combination of strong effects of former Soviet system and selectively chosen components of modern mental health poliey and services