Transformed Institutionalization. A Literature-Based Study of ‘Independent Living’ Among Persons with Intellectual Disabilities in Three Nordic Countries

Background

At the beginning of the twenty-first century, the Nordic countries were considered leaders in the development of welfare services and practices for people with intellectual disabilities (Brennan et al. 2018; Mansell and Beadle-Brown 2010; Mansell and Ericsson 1996; Tøssebro et al. 2012; Tøssebro et al. 2025). This reputation was, in part, the result of a strong reaction to a shared history of segregation and institutionalization of people with intellectual disabilities. As Hamre and Villadsen (2024) argue, the emphasis on inclusion can sometimes obscure or conceal the historical legacy of segregation.

Indeed, for most of the twentieth century, the dominant approach was institutionalization, accompanied by policies aimed at preventing parenthood—such as marriage bans and forced sterilizations—and legal frameworks that denied people with intellectual disabilities full legal agency (Engwall 2000; Grunewald 2008; Katsui et al. 2024; Kirkebæk and Hornemann Møller 2020). In the 1960s, criticism of institutionalization began to grow, and the concept of normalization emerged as an effort to reform and improve institutions rather than to abolish them (Tøssebro et al. 2012, 2025). Tøssebro et al. (2012, 135) describe this as the first wave of ‘normalizing institutions’, distinguishing it from the second wave in the 1990s, characterized by the closure of institutions and what they term deinstitutionalization.

During the 1990s, Norway and Sweden were the first Nordic countries to close large-scale institutions, replacing them with group homes. Denmark and Finland maintained institutional structures but transferred responsibility to municipalities while pursuing policies that promote deinstitutionalization and the development of smaller residential units (Tøssebro et al. 2025). Although this period of reform is often portrayed as a success story, the decades that followed require closer scrutiny, not least due to the increasing influence of international trends—such as marketization, new public management, and consumer rights—on disability policies in the Nordic countries (Katsui and Laitinen 2024; Miettinen and Teittinen 2014; Tøssebro 2016; Tøssebro et al. 2025).

Deinstitutionalization is often portrayed as a process that ended the oppression of persons with intellectual disabilities, ushering in a new era in which they were recognized as equal citizens. This narrative frames deinstitutionalization as a definitive break from a cruel and unjust past, symbolizing the beginning of more humane and equitable conditions for people with intellectual disabilities. However, such a linear and celebratory account risks obscuring the persistent power structures and subtle technologies of control that continue to shape the lives of people with intellectual disabilities today (Altermark and Svensson Chowdhury 2024).

Niklas Altermark (2017) challenges this conventional interpretation by drawing parallels with postcolonial theory, where relationships of dominance are not dismantled but reconfigured in new forms following decolonization. He introduces the concept of the post-institutional, which emphasizes that the dissolution of formal institutions did not eliminate the mechanisms of control but rather transformed them. Within this framework, the continued domination of people with intellectual disabilities is evident in practices aimed at guiding, training, and correcting their behavior in order to shape them into autonomous subjects. These interventions often reinforce normative expectations of independence without acknowledging the structural constraints that hinder genuine autonomy. In line with Altermark (2017), Tøssebro (2025) points out that we have undergone an era of deinstitutionalization in the Nordic countries, but that we at the same time may see signs of institutionalization in a ‘new wrapping’. Tøssebro and Gustavsson (2025) argue that the concept of institutionalization may be seen as a sensitizing concept characterized by themes such as ‘segregation’ from mainstream society; ‘totality’, in the sense of all aspects of life being organized by one authority, with block treatment containing rigid routines and depersonalization; the ‘size’ of housing facilities that can turn into institutionalized settings; and even some ‘legal’ aspects concerning how institutions are run in some Nordic countries.

Method

This literature-based study examines the ongoing challenges in achieving full deinstitutionalization in three Nordic countries: Denmark, Finland, and Sweden. All authors have been involved in national research projects on institutions for people with intellectual disabilities. Through joint discussions and by sharing information about the current situation in each country, we have identified common traits of challenges experienced in recent years. Despite the national variations in how deinstitutionalization had been handled in the different national contexts, these shared experiences were similar. The challenges identified are thematically categorized into three key dimensions: (1) the increasing number of residents per living unit, (2) the persistence of institutional cultures, and (3) the lack of individualized support. These themes also refer to some of the characteristics regarding the concept of institutionalization identified in the recent book by Tøssebro and Gustavsson (2025).

Empirically, a significant portion of the literature reviewed here stems from empirical research conducted by the authors and their respective research teams within each national context. These studies are based on observations, interviews, surveys, and register data. The quotes we use in the article are occasionally taken from our own fieldwork, and we cite them by reference to previously published works. All primary studies have received appropriate ethical approvals. We are inspired by a narrative review approach, which allows for a less rigid methodology and makes it possible to include recent Nordic literature on the institutionalization of people with intellectual disabilities, with a focus on the three themes outlined above (Sukhera 2022).

The article is supported by a range of sources from each country, addressing the three key dimensions. This includes: (1) official reports and statistics from national authorities (including the National Board of Health and Welfare and SOTKANET), (2) international documents on disability (including from the United Nations and the European Commission), (3) reports by disability rights organizations (including Danske handicaporganisationer and the Finnish Association on Intellectual and Developmental Disabilities), and (4) media reports on public and political debates about people with intellectual disabilities (including from Yleisradio Oy). The literature thus stems from a wide-ranging field, and these three key dimensions are explored presenting a diverse array of material while offering a nuanced understanding of the challenges in achieving full deinstitutionalization. The material used in this article is intended to provide a critical review of the developments concerning deinstitutionalization. Rather than systematically covering all material published on the topic, the selected key material combines perspectives from several actors within the area of disability, from stakeholders to governments. The literature-based study is therefore thematic—focusing on the three themes—with the aim to achieve an understanding of the complex process of deinstitutionalization rather than to find evidence for a narrow and precise research question.

A recently published book analyzes the last 60 years of development concerning institutionalization and deinstitutionalization in the Nordic countries. The authors conclude that the recent development ‘resembles a reinstitutionalisation’ (Tøssebro et al. 2025, 36). In this article, we explore the current manifestations of what we term transformed institutionalization in the Nordic context. This concept and the related ‘transformed institutions’ refer to living arrangements for persons with disabilities that are formally classified—both administratively and discursively—as group homes or non-institutional settings, with the purported aim of promoting independent living. However, in practice, these environments often hold on to key features of traditional institutions, particularly in terms of restrictive cultures and insufficient individual support for the realization of self-determination rights (Tøssebro et al. 2025).

Through this critical lens, we investigate the multiple characteristics of transformed institutionalization, shedding light on the gap between policy intentions and lived realities. By doing so, we aim to contribute to a deeper understanding of how institutional logics persist beneath the surface of contemporary disability services as well as how they may continue to constrain the autonomy and inclusion of persons with intellectual disabilities in ostensibly post-institutional settings.

The Increasing Number of Residents per Living Unit

Deinstitutionalization has been approached somewhat differently across the Nordic countries. Although the overarching goal was to end institutionalization, the methods employed to achieve this aim have varied.

In Sweden, specific regulations govern the location and construction of group homes (NBHW 2018; SOSFS 2002). Group homes must not be situated adjacent to one another or alongside other social service facilities such as elder care centers or day centers. This regulation intends to prevent the perception of living in a segregated area dominated by different types of service users. Similarly, rules limit the maximum number of residents in each group home to avoid an institutional atmosphere. Ideally, no more than three to five service users should reside together, facilitating communication and social interaction within a small group (NBHW 2020).

Despite these measures intended to prevent institutionalization, there are clear violations of these specific rules regarding both location and the number of residents. The National Board of Health and Welfare (NBHW 2020) reported that only 56% of all group homes accommodate no more than five residents. Additionally, evidence indicates that group homes are frequently constructed adjacent to one another (The Swedish Health and Social Care Inspectorate 2015). A further challenge exacerbating non-compliance is the shortage of group homes: 127 out of Sweden’s 290 municipalities report a deficit of such facilities, resulting in waiting lists and decisions that contravene regulations (Boverket 2025). Consequently, despite formal rules, group homes increasingly accommodate larger numbers of residents, heightening the risk of institutionalization.

In contrast to Sweden, Finland has no legally mandated maximum number of residents for group homes, which results in larger group sizes compared to Sweden and Denmark. According to a government resolution issued in 2012, no person with a disability was to reside in an institution by the end of 2020. Nevertheless, individuals with intellectual disabilities continue to live in institutional settings; as of the end of 2023, 372 persons remained institutionalized (SOTKANET 2024). The majority of those residing in institutions today are persons with severe intellectual and multiple disabilities.

The majority of persons with intellectual disabilities in Finland (82% in 2021) live in group homes. Typically, Finnish group homes accommodate 15 or more residents (Finnish Association on Intellectual and Developmental Disabilities 2016). In a presentation at the Nordic Seminar on Independent Living in February 2025, Hannu Vesala highlighted that among the new housing units established between 2005 and 2019 that were financed by the Centre for State-Subsidised Housing Construction (ARA), more than 40% house 15–19 residents, while over 10% accommodate more than 20 residents. Notably, one group home reportedly houses as many as 103 residents.

In Denmark, regulations stipulate that people with disabilities are to be able to live independently and be included in society. Although there are no specific legal limits on the maximum number of service users per group home, the Social Service Act requires municipalities to develop housing facility plans if more than 100 people are living together. This suggests that the size of housing units for people with intellectual disabilities may be officially recognized as a potential problem, but it also raises questions about when and how size thresholds become problematic.

According to the Danish Institute for Human Rights, there is an increasing trend towards constructing larger clustered housing for people with disabilities who receive support under §§ 107–108 of the Social Service Act. The Institute describes these homes as becoming increasingly institutionalized. They also reference a 2012 study indicating that nearly half of those living in residential housing reside with 30 or more other individuals (Institut for Menneskerettigheder 2016). This suggests a correlation between the number of residents in a housing unit and the degree to which it resembles an institution. The Committee on the Rights of Persons with Disabilities (2014) expressed similar concerns, urging Denmark to cease constructing large group homes because such housing risks becoming institutional in nature. These concerns were reiterated in the Committee’s concluding observations (2024), signaling ongoing challenges in Denmark’s implementation of independent living provisions as stipulated in the Convention on the Rights of Persons with Disabilities.

Research into the current situation in Denmark regarding the size of housing units for people with disabilities and the impact of housing size on residents’ lives remains limited (Dalhoff, Merrild and Jørgensen 2022). Although the Ministry of Social Affairs and Housing regularly collects relevant data, these are seldom utilized in research to document living conditions for people with intellectual disabilities. Recent Danish studies (Dalhoff, Merrild and Jørgensen 2022) have analyzed housing unit sizes using official data and geospatial mapping of housing facilities. In the official data, apartments are clustered according to how municipalities organize housing within different group homes. The geospatial mapping approach, however, identifies all group home addresses from the official dataset and clusters all group homes located within 100 meters of one another to capture proximity.

The register data indicate that on average, about 12 apartments are clustered together per group home. However, geospatial mapping of group homes within 100 meters of one another reveals an average cluster size of approximately 19 apartments. The discrepancy between register data and geospatial mapping is also apparent in the distribution of housing unit sizes. According to register data, one in five adult residents with intellectual disabilities lives in a cluster of group homes with 30 or more residents. In contrast, geospatial mapping shows that when group homes located within 100 meters of one another are considered collectively, the proportion of residents living in units housing 30 or more people doubles (Jørgensen 2023).

To illustrate how these group homes can appear, the following field note offers a vivid description of a physical setting that evokes associations with past institutions:

Arriving at a group home for eight people, we encountered several minibuses and a sign indicating the ‘housing unit’. The main entrance featured an automatic glass door, and inside, we were greeted by a large doormat and hand sanitizer dispensers. Long hallways, divided by glass doors, stretched ahead. Many doors stood open, seemingly leading to offices, storage rooms, and laundry facilities. The living room floor was covered in linoleum, reminiscent of a hospital setting. The kitchen contained ample cupboard space and stainless steel tables designed for easy cleaning. Signs on the kitchen doors displayed instructions, such as hygiene guidelines and service providers’ timetables. (Jørgensen et al. 2023, 42)

This excerpt illustrates how many of the housing units visited by the researchers gave an impression of institutionalized environments, in contrast to more individualized housing facilities. Danish research further documents that living in residential facilities for adults with intellectual disabilities can be stigmatizing for residents and negatively affect their self-perception; individuals may be perceived as ‘not normal’ precisely because they live in such institutionalized settings (Jørgensen 2020).

The Culture of Institutionalization

Transformed institutionalization is not only evident in the increasing number of residents per unit but also manifests in the everyday culture within group homes. This culture perpetuates asymmetrical power relationships between staff and residents, expressed through paternalistic behaviors, disciplinary measures, and restrictions on residents’ rights.

Physical relocation to group homes and deinstitutionalization alone have not been sufficient to transform institutional attitudes and working methods. In Finland, for example, relocation has not effectively fostered a cultural shift from an institutional to an independent living culture—one in which persons with disabilities are expected to exercise self-determination and are supported in doing so (Tuokkola and Katsui 2018). As a representative of a local organization for persons with disabilities explains:

Lack of choice means that you are always simply informed where the place [to move into] is now. [The way the city offers the place is] more or less ‘take it or leave it’. In those cases, they don’t listen to you. So when the city makes some decision, you just have to live with it. (Tuokkola and Katsui 2018, 41)

A local policymaker adds:

There can’t be a jump directly from an institution to fairly independent living. It’s a huge change. I think that this group home phase is a necessary phase in this. (Tuokkola and Katsui 2018, 14)

Consequently, many persons with intellectual disabilities end up living in group homes rather than in their own apartments, because meaningful choices are often not available to them. Even though conventional institutions have been closed, social attitudes have not changed substantially; historical perceptions of disability remain deeply embedded in the implementation of disability policy, as noted by a representative of the National Coordination Mechanism of the Convention on the Rights of Persons with Disabilities:

Looking at the big picture, deinstitutionalisation means going from a culture of institutionalisation more towards a form of living, which respects the disabled person’s right to autonomy. And that may actually be the biggest challenge here. The culture of institutionalisation is so embedded in the practice of care. […] For example, the social welfare for persons with intellectual disabilities in Finland has had an emphasis on nursing culture. Persons with intellectual disabilities have been nursed, treating them as objects. [Therefore] hearing of the person’s [wishes] and taking their views into account has not been developed. (Tuokkola and Katsui 2018, 34)

Sometimes, residents and staff members from institutions are relocated to group homes together, where they find it difficult to unlearn the institutional culture—in which persons with disabilities are not expected to exercise their right to self-determination (Tuokkola and Katsui 2018). A similar pattern has been observed in Sweden, where staff with long tenure in the same group home were less inclined to change their attitudes and promote service users’ participation (Berlin Hallrup, Kumlien and Carlson 2019).

On a broader level, potential changes are reflected in Danish regulations concerning the management of housing facilities. The government-appointed committee (Tranæsudvalget) has proposed improving the financial management of housing units, which also includes enabling municipalities to relocate residents without their consent and increasing the use of restrictions, such as locking external doors (Ekspertudvalget på socialområdet 2024). This means, among other things, that adults with intellectual disabilities may risk losing the ability to decide where to live.

Observational studies in Sweden demonstrate how ‘institutional characteristics’ limit self-determination and access to activities in group homes. Staff hold the authority to decide which activities to support and when (Larsson 2021; Svanelöv 2020; Svanelöv and Talman 2021). This may stem from resource constraints but also from tradition and a belief that staff are acting in the best interest of service users. The tendency of staff to enforce ‘correct’ behavior and emphasize conformity to cultural norms is described by Altermark and Svensson Chowdhury (2024) as ‘technologies of power’. They argue that power relations from the institutional era have not disappeared but rather transformed into more subtle forms.

The field note below, taken during an evening meal in a Danish group home, illustrates how social workers control food intake, believing they are acting in the service user’s best interest. This example highlights the power relations that continue to exist:

The social worker (SW) serves the evening meal for each resident. Dinner consists of roast pork with potatoes and brown gravy, as well as mixed salad. The SW asks each resident how much potatoes and salad they want, but does not ask about the roast pork and gravy. One resident finishes his portion and tells the SW that he is very hungry today. The SW replies that he needs to lose weight, and the resident agrees. The SW then turns to me and says she cannot decide how much he should eat but knows he might have stomach problems if he eats too much. (Jørgensen 2023, 47)

Field notes from a Swedish service house, which includes a common area for resident activities, reveal staff exercising power by reducing the opening hours of this space without consulting the residents. One resident expressed his frustration:

I miss all the days that were. Being able to come to services and drink coffee. […] now it’s only one day I get to be there, and then I get irritated and think, SHIT! […] I think it’s so damn stupid that we can’t come and have coffee every night. I think it was nice to be able to come down and sit and have coffee, even if you had been working and you were tired, you could come down and have coffee later. Socializing, having a cup of coffee and talking and having fun. I miss those parts. (Hagström 2016, 43)

Lack of Individualized Support

Another common trend across the three countries is the increasing difficulty for people with intellectual disabilities to access individualized support. The consequences of reduced individualized support include challenges in living independently and limited access to personalized activities. In Sweden, the Disability Act is increasingly interpreted locally in local guidelines, often with the intention to restrict rights under the Act. Concerns have been raised, for example, about how living in a group home can lead to support in the form of a contact person or escort service being denied. This results in limited access to individualized leisure activities, with collective activities being organized instead (NBHW 2024; Segnestam Larsson and Tideman 2023). Due to a lack of resources and staff, spontaneous or external activities are largely restricted (cf. Norberg 2022). Field notes from a study in a Swedish group home exemplify this lack of individualized support:

‘Can we go to the graveyard today? I want to put flowers on the grave’, was a question posed by a resident to a staff member. The answer given was that there was no time to go to the graveyard today because other planned activities or support services for other residents were scheduled at the group home. For example, that same evening, a joint TV-watching session was planned. (Svanelöv and Talman 2021, 164)

Similarly, two Danish studies point out that residents in institutionalized settings are treated routinely and in line with a strict time management logic, which risks undermining opportunities for individual care and support (Dalhoff, Merrild and Jørgensen 2022; Engen 2014). Another study (Jørgensen 2020) highlights how service providers’ norms can limit possibilities for self-determination. For example, one staff member acknowledged that people with intellectual disabilities have the right to make their own choices, including in regard to pregnancy prevention. However, the same social worker stated that she must ‘nudge’ adults in a certain direction to prevent potential harm, hoping to reduce the risk of poor decisions because they may not fully understand the implications of their choices. This new norm is not about coercion but about nudging—as the social worker described it—or using governance as a form of power (Jørgensen 2020). This illustrates how power relations have not disappeared but rather re-emerged in more subtle forms (Altermark 2017; Svanelöv 2020), remaining hidden within institutionalized settings.

In Finland, the most recent and most significant developments include the social and health care reform (known as the SOTE reform) of 2023 and the Disability Services Act enacted in 2025. Disability services are becoming increasingly bureaucratic and difficult to access, particularly under the austerity measures implemented by the current government led by Prime Minister Orpo (Katsui 2024; Katsui et al. 2023; Lindh et al. 2023).

Some [persons with intellectual disabilities] have had to return to a more assisted form of living because of mental health problems. They are left alone. They’re lonely. It’s a long wait from 4 p.m. until the next morning because they can’t […] go out alone; they don’t necessarily have the skills, even though they have been taught, so they’re left alone. They’re lonely. (Employee of a community-based service) (Tuokkula and Katsui 2018, 36)

It somehow makes me sad at times that they have to go as a group. The attendants don’t always have the resources to attend to them as individuals even if they wanted to. For instance, if they say, ‘Can you come swimming with me?’ then the attendant says, ‘Sorry, I don’t have time. I’m alone on the night shift.’ So they always have to do everything as a group. (Member of the local community) (Tuokkola and Katsui 2018, 40)

The amount of transportation services granted is not sufficient to meet my needs of visiting nearby places. I cannot meet my loved ones or participate in associational activities and hobbies. (Online survey) (Katsui et al. 2023, 48)

This lack of sufficient and timely provision of disability services is a crucial barrier to independent living, as many persons with disabilities cannot live independently without appropriate support and services. The absence of individualized services has widely been documented in recent research (Katsui 2024; Katsui et al. 2023; Lindh et al. 2023). According to one study (Katsui et al. 2023), out of 194 respondents with intellectual disabilities, the majority (66%) reported inadequate support from disability services (rating it as poor, relatively poor, or variable, depending on the situation). Only 34% rated the support as relatively good or good. This group responded more negatively compared to respondents with other types of disabilities. The study highlights the uncertainty and precariousness persons with intellectual disabilities experience in their daily lives in Finland today.

Discussion and Concluding Remarks

Deinstitutionalization and independent living are enshrined in Article 19 of the UN Convention on the Rights of Persons with Disabilities (UN 2006) as well as in the European Union Disability Strategy 2021–2030 (European Commission 2021). All Nordic countries are obligated to adhere to these international frameworks and have demonstrated strong commitments to deinstitutionalization and independent living (Tuokkola and Katsui 2018; Tøssebro et al. 2025). However, recent studies and literature strongly indicate that transformed institutionalization continues to occur in the Nordic countries studied, despite institutions being formally closed (Sweden and Denmark) or largely dismantled (Finland). The synthesis report by Crowther (2019) on the independent living situation of persons with disabilities across all EU member states also highlights that the Nordic countries face challenges in realizing the independent living of people with intellectual disabilities. The trend is similar in other parts of the world, both in other European countries (Siska and Beadle-Brown 2020) and globally (CRPD 2022a).

Physical relocation has largely involved moving persons with disabilities out of conventional institutions and primarily into group homes rather than community-based, independent apartments. Group homes are increasing in size, even in Sweden, where there are limits on resident numbers. Across all studied countries, larger group homes or multiple group homes in close proximity to one another have become increasingly common due to regulatory loopholes. At the same time, many persons with disabilities are frequently denied self-determination in housing and living arrangements, as individualized services in these so-called community living settings remain inadequate (Holmskov and Skov 2007; Katsui et al. 2023; NBHW 2025).

Reduced opportunities for individualized support also hinder individuals with intellectual disabilities from participating in activities and engaging in self-directed pursuits. As Norberg (2022, 666) explains, ‘With the withdrawal of support, it is not the case that someone forcibly locks you in your room, but you would simply not be able to get out of bed’. The lack of individualized support impacts children with severe disabilities particularly hard and may lead to institutionalization.

Adequate resources and competent staff are lacking. Perhaps most critically, there is a deficiency in awareness regarding the power dynamics that exist within group homes and other institutions for individuals with intellectual disabilities (cf. Altermark 2017; Svanelöv 2020). This can create an environment where rights are restricted, self-determination is denied, and, in some cases, abuse and violence occur. Institutional cultures persist in all three countries despite the official transition away from traditional institutions.

Historically, all three countries have a legacy of eugenic policies that legally permitted violations of the reproductive health rights and other rights of persons with disabilities, alongside segregation policies exemplified by institutionalization (see Hamre and Villadsen 2024; Katsui et al. 2024). Although the Nordic welfare states have promoted disability rights, the broader culture has not significantly changed when analyzed through the lens of transformed institutionalization. Altermark’s (2017) analysis of historical power relations in the context of deinstitutionalization offers valuable insight into this phenomenon. In other words, asymmetrical power relations favoring persons without disabilities have yet to be dismantled in practice.

Recent data indicates conflicting trends in Denmark, Finland, and Sweden. Although disability rights have been strengthened by anti-discrimination laws and ratifications of the Convention on the Rights of Persons with Disabilities, other trends are negatively affecting the living conditions of individuals with intellectual disabilities. Tøssebro et al. (2025) highlight international influences such as marketization, new public management, and consumer rights as well as the role of local communities in implementing disability services. The allocation of responsibility to the local level has exposed disability support to economic constraints and variations in the provision of support across municipalities. The repercussions of societal economic difficulties also significantly impact individuals with intellectual disabilities. This frequently results in a greater tendency towards institutionalization.

The Committee on the Rights of Persons with Disabilities (2022b) identified legal reform as necessary in Finland, a gap that is now addressed in the new Disability Services Act. Without sufficient individualized support, group homes risk becoming transformed institutions, contravening independent living policies and the UN Convention on the Rights of Persons with Disabilities (2006). Moreover, austerity measures have clearly impacted disability services across all three countries. Insufficient disability services have already contributed to deteriorating mental health and increased poverty among persons with disabilities (Danske Handicaporganisationer 2025; Katsui 2024; Katsui et al. 2023; The Swedish Agency for Participation 2023).

Policy Implications

As highlighted in this article, there is a significant gap between policy intentions and lived realities. Due to the transformation of institutional settings, the lack of public interest, and the limited research in this area, it has become increasingly difficult to identify institutionalized aspects of everyday life for people with intellectual disabilities. In the Nordic countries, we often assume that contemporary society is more humane than ever before. However, as Altermark (2017) argues, we risk overlooking the subtle structural power that shapes the lived experiences of people with intellectual disabilities. A stronger implementation of the Convention on the Rights of Persons with Disabilities in the Nordic context requires improved monitoring through systematic research on institutional practices for people with intellectual disabilities as well as a greater focus on policy implementation and resource allocation. Previous studies (Katsui 2024) suggest that the logic of liberalism may inadvertently create barriers within policy by emphasizing full inclusion as contingent upon individual responsibility and the ability to contribute to society on equal terms. When inclusion is framed as conditional, it conflicts with the principles of the Convention on the Rights of Persons with Disabilities, which guarantee the right to full inclusion regardless of ability. Policy should therefore aim to normalize opportunities rather than normalize individuals with intellectual disabilities before granting access to societal participation. Rather than reinforcing structural inequalities, legislation must actively create conditions that enable people with intellectual disabilities to live meaningful and inclusive lives.

Given the rapidly evolving political climate surrounding disability, further research is essential to monitor both disability policy and practice in the Nordic countries more broadly, and deinstitutionalization policy and practice in particular, with the goal of demystifying their reputation as leading welfare states (see Katsui and Laitinen 2024). From a disability perspective, the Nordic countries are far from exemplary and have considerable room for improvement.

Competing Interests

The authors have no competing interests to declare.