Youth mental health, Netherlands
Sophie Eminson
Tuesday, June 26, 2018
Mental health problems have been rising rapidly in the Netherlands since 2015; mental disorders are responsible for 12 million sick days in the country, costing €2.7bn each year.
Mental health problems have been rising rapidly in the Netherlands since 2015; mental disorders are responsible for 12 million sick days in the country, costing €2.7bn each year.
According to the central bureau of statistics in the Netherlands the number of young people that received specialised mental health care in the Netherlands has risen from 366,000 in 2015 to around 405,000 in 2017.
Youth clinics such as Yes We Can have been set up to provide an alternative to hospital-based care, offering multidisciplinary mental health services in the community for Dutch young people.
SOCIETY AND POLICY
In the Netherlands, children and young people are referred to as "youth" until the age of 25.
In 2015, all Dutch municipalities became responsible for the whole range of care for children, young people and families in need of mental health support, which includes preventative services.
Despite a shift away from institutional care, the Netherlands continues to rely heavily on mental health services provided in hospitals. The Netherlands has 139 psychiatric care beds per 100,000 population.
By 2020, the country aims to cut the number of psychiatric beds by one-third as it moves more towards a community-based approach to treating mental health problems.
This is supported by the Youth Act 2014, which introduced requirements on local councils to develop services to help children to grow up in safety and in good health, become independent and productive members of society based on their own abilities.
Support, assistance and care under the Youth Act means local authorities support children, adolescents and their families in dealing with these behavioural issues.
According to GGZ Nederland, the Dutch Association of Mental Health and Addiction Care, the country spends €5.8bn on specialist mental health services delivering savings of at least €15bn.
PRACTICE
Yes We Can Youth Clinics is a treatment centre in the Netherlands that specialises in the rehabilitation of young people aged 13 to 25 with mental health issues, addictions and behavioural problems.
Based on his own experiences and the best practices of other clinics, Jan Willem Poot founded the clinics in 2010 alongside a multi-disciplinary team of healthcare professionals.
The team consists of psychiatrists, youth coaches and counsellors. Counsellors are experts by experience, which helps patients, known as fellows, to relate to them.
The intensive 10-week programme combines therapeutic treatment and sports.
Yes We Can Youth Clinics have one international clinic and one national clinic in Hilvarenbeek, aftercare locations in Abcoude and Heeze (also the location for the family programme) and offices in Eindhoven, Oirschot and London. The 24-bed international facility is housed in a specially converted 14th century castle set in 17 acres on the Groenedael estate on the outskirts of Hilvarenbeek. Treatment there is delivered in English.
Seven days a week, clients follow a structured schedule starting at 6.30am until lights-out at 11pm. Fellows receive four hours of intensive one-to-one therapy, 20 hours of group work, 27 hours of physical activities and 10 hours of education per week.
There is no access to the internet, phones, tablets, TV or any other device that can distract young people from their recovery.
Five weeks into the programme, family members are requested to attend a four-day family programme designed to motivate parents and carers to take responsibility for their changed role and to commit to a permanent recovery programme for both themselves and the fellow.
ORIGINS OF YES WE CAN
After overcoming his own addiction problems, Poot was inspired to start a business organising sports and outdoor activities in the Ardennes. The aim was to give youths a week in the great outdoors, combined with sport activities that stimulated co-operation, pushed boundaries and solved individual school problems.
In 2009, Poot met many teenagers and young adults at the camp who had been sent by youth care institutions and addiction clinics. A lot of participants also came from special needs schools. Poot recognised their stories - they were young people that did not benefit from regular and often ambulatory care. Poot set up a new clinic for young people and young adults who felt trapped within the system, the first pilot being run in 2010 with 12 teenagers and young adults with severe behavioural issues. After a number of further pilots Poot sold his company and started a new venture to set up a professionally-accredited youth healthcare facility.
IMPACT
Teenagers and young adults visit the treatment centre to address behavioural patterns and begin to make positive choices in their lives.
There are 120 fellows at the four Yes We Can clinics in the Netherlands at any one time. Each residential clinical care place costs €6,400 per week, which for under-18s is paid for by the government. Those aged over 18 and fellows attending the international clinic are privately funded, sometimes through personal health insurance. There are around 700 fellows of the Dutch clinics and 100 in the international clinic each year. The average length of stay is 10 weeks.
Since 2013, there have been 501 under-18s completing the programme.
Survey results from the end of 2017 have shown that, of the young people who completed the programme:
- 72 per cent no longer need intensive mental health care or additional assistance
- 96 per cent are better equipped to deal with personal problems
- 89 per cent of the patients were in recovery
- 74 per cent of patients have said that it was the right treatment approach for them
- 96 per cent of patients who have completed the programme go back to school or find a job following treatment.
FACTFILE
- Yes We Can Youth Clinics has been run in the Netherlands since 2010
- The clinics treat young people aged 13 to 25 for mental health, addiction and behavioural problems
- There is one international clinic and one national clinic in Hilvarenbeek. Two aftercare locations in Abcoude and Heeze (this is also the location for the family programme) and offices in Eindhoven, Oirschot and London
- Yes We Can Youth Clinics is ranked fourth out of 130 mental health institutes in the Foundation Benchmark Mental Health ranking
- The organisation has 170 employees and treats 800 young people each year
FOUNDER'S VIEW
By Jan Willem Poot, founder, Yes We Can Youth Clinics
The Dutch health care system is known for its wide coverage and accessibility to healthcare overall, which we think other countries can take as an example.
We believe our treatment method works for young people from everywhere. We have treated thousands of Dutch young people in the past and we have seen that it works very well for them.
The thousands of Dutch teenagers and young people we have treated with mental health issues and addictions over the past years in our clinic had their treatment funded either by the government or by their healthcare insurance. In the Netherlands, healthcare for young people under 18 is taken care of by the government and for those who are 18 years or older it is covered by insurance, making healthcare for young people very accessible.
Research has also shown that every €1 the government invests in treatment at Yes We Can, €1.44 is saved on any further assistance.
We opened our international clinic in August last year and haven't conducted any research yet, however we hear and see that the cost effectiveness and recovery of the fellows is most likely to be higher than that experienced by fellows in the national clinic.
Yes We Can has been in contact with healthcare trusts, mental health organisations and referrers such as psychologists and psychiatrists from the UK for a number of years. This has led to a close collaboration with Dr Paul Bain, a London psychiatrist, and the opening of our London office for consultations and pre-intakes.