Committee on the Rights
of Persons with Disabilities
41. The Committee observes with concern:
(a) The perpetuation of institutionalization of persons with intellectual disabilities, persons with psychosocial disabilities, elderly persons with disabilities, persons with physical disabilities and those who require more intensive support, particularly living arrangements outside the community, and of children with disabilities, particularly children with intellectual, psychosocial or sensory disabilities and those who require more intensive support – through the Child Welfare Act, in various types of facilities, depriving them of family and community life;
(b) The promotion of institutionalization of persons with psychosocial disabilities and persons with dementia in psychiatric hospitals, both public and private, and particularly the continuance of indefinite hospitalizations of persons with psychosocial disabilities;
(c) The limited opportunities for persons with disabilities to choose their place of residence and where and with whom to live, including for those dependent on parents and living in their homes, and those placed in particular arrangements such as group homes under the Act on Comprehensive Support for the Daily and Social Life of Persons with Disabilities;
(d) The lack of a national strategy and legal framework for the deinstitutionalization of persons with disabilities residing in residential institutions and psychiatric hospitals, and for their independent living in the community on an equal basis with others, including the lack of recognition of their right to autonomy and full social inclusion;
(e) The insufficient support arrangements for persons with disabilities for living independently in the community, including accessible and affordable housing, in-home services, personal assistance and access to services in the community;
(f) Assessment schemes for granting support and services in the community that are based on the medical model of disability.
42. With reference to its general comment No. 5 (2017) on living independently and being included in the community, and to its guidelines on deinstitutionalization, including in emergencies (of 2022), the Committee urges the State party to:
(a) Take expedited measures to end the institutionalization of persons with disabilities, including children with disabilities, by redirecting its budget allocations from the placement of persons with disabilities in residential institutions towards arrangements and supports for persons with disabilities for living independently in the community on an equal basis with others;
(b) Review all cases of persons with disabilities who are hospitalized in psychiatric hospitals to cease any indefinite hospitalization, ensure their informed consent and foster their independent living, along with the required mental health support in the community;
(c) Ensure that persons with disabilities have the opportunity to choose their place of residence and where and with whom they live in the community and are not obliged to live in a particular living arrangement, including group homes, and enable persons with disabilities to exercise choice and control over their lives;
(d) Launch, in consultation with organizations of persons with disabilities, a legal framework and national strategy with time-bound benchmarks, and human, technical and financial resources, aimed at the effective transition of persons with disabilities from institutions into independent living in the community on an equal basis with others, with recognition of their right to autonomy and full social inclusion, and obligations on prefectures to ensure its implementation;
(e) Strengthen support arrangements for persons with disabilities to live independently in the community, including independent, accessible and affordable housing outside any type of congregated premises, personal assistance, user-led budgets, and access to services in the community;
(f) Revise existing assessment schemes for granting support and services in the community to ensure that they are based on the human rights model of disability, including the assessments of the barriers in society for persons with disabilities and of the support for their social participation and inclusion.