Integrated approach for support and care for socially/psychologically vulnerable people with disturbed behavior

Abstract

Background: In recent years, a higher number of incidents has been reported by the Dutch police and local government caused by people with so called ‘disturbed behavior’. Those are people who lost control over their lives and have the potential to cause great harm to themselves or others. Often people with disturbed behavior have multiple disorders (psychiatric problems, addiction, intellectual disabilities, dementia) and experienced negative life events (debts, death of loved one, divorce). This causes them to be in a vulnerable position. However, an exact description and estimate of the number of people with disturbed behavior is not yet available. In 2015 the Dutch government appointed a taskforce “people with disturbed behavior”. This was done in reaction to some severe incidents in the Dutch society, such as the murder of a former minister of health and welfare by a person with disturbed behavior. Also, changing policies such as a reduction of inpatient care, let to more attention in society. The taskforce developed nine building blocks for an appropriate support for people who display disturbed behavior and their social network. The building blocks form an integrated approach for comprehensive care and support. The building blocks include the involvement of people with disturbed behavior themselves, prevention, early recognition, guidance to the right care, appropriate transportation and appropriate support, care and penalization. As of 2016 municipalities are supported to implement these building blocks. In October 2018 all municipalities should have an integrated approach in place. Aims and Objectives: In this workshop we will focus on the concept of people with disturbed behavior and present results form a qualitative and quantitative evaluation. The evaluations were carried out to study the number of people with disturbed behavior and the extent to which the building blocks are implemented. The quantitative evaluation aims to provide information on the number of people with disturbed behavior by combining data form police systems, local health care organizations and mental health organizations over time. The qualitative evaluation monitors the implementation of the building blocks in each municipality in the Netherlands. Whether the implementation of the building blocks lead to less reported incidents with people with disturbed behavior, remains to be seen. Format (timing, speakers, discussion, group work, etc): Three presentations will be given to introduce the concept of people with disturbed behavior and to present results from the qualitative en quantitative evaluation. We will discuss with the attendants how to perform an evaluation of such an integrated approach in regular practice. Target audience: Researchers and policy makers. Learnings/Take away: We will present an example on how to evaluate an integrated approach in a vulnerable population. We will discuss encountered issues, for example concerning data sharing, measurement of patient satisfaction and interpretation of the results. And we will share learned lessons.