Setting the scene: discovering the past – dismantling the present

This chapter focuses on how historical and contemporary influences have affected the development of policy and practice of services for people with intellectual disabilities in Austria. We start with an exploration of the production and development of eugenic discourses. We show how these discourses were explicitly adopted by institutions at the beginning of the twentieth century, reached their height during the Nazi regime, but, even though officially condemned, influenced service provision after 1945 through both ideological and personal continuities. In the post-war era, most people with intellectual disabilities who did not live with their families had to live in psychiatric hospitals or large Christian or state-run institutions. Parent-led organisations, which were developing from the mid-1960s, led to the first significant change in quality of services for persons with intellectual disabilities. In the late 1970s, discourses around normalisation and integration swept over from Scandinavia, impacting strongly on the field. In the following two decades, deinstitutionalisation programmes were implemented, which led to a ‘life in the community’ for most former inmates of psychiatric wards. However, these programmes mostly focused on psychiatric hospitals, leaving other large institutional settings untouched, thus the term ‘de-hospitalisation’ seems more appropriate than deinstitutionalisation. The chapter closes by indicating that – despite several policy changes and efforts to create a more personalised system of care since the 2000s – the institutional system of service provision contains serious problems. We point to the continuing influence of eugenic discourses and practices, and to illustrate the impact of disabling ideologies and practices, we feature some abbreviated life stories.

The historical and ideological roots of institutionalisation

Unfolding the history of institutionalisation in Austria is – just as in other countries – rather complex; a distinct starting point and single line of development cannot be identified. However, the foundation of the so-called Viennese ‘tower of fools’ in 1784, which is considered to be the first modern European psychiatric hospital, marks an important date for the history of psychiatric care in Austria (Ledebur, 2015).

In the course of the nineteenth century, reformist institutions were founded for persons with intellectual disabilities (eg the foundation of ‘Levana’ by Georgens and Deinhardt in 1854).