Successful community living: a Utopia? A survey of people with severe mental illness in Dutch regional institutes for residential care

PhD ceremony: Ms. C. de Heer-Wunderink, 14.30 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Successful community living: a Utopia? A survey of people with severe mental illness in Dutch regional institutes for residential care

Promotor(s): prof. D. Wiersma

Faculty: Medical Sciences

The UTOPIA study investigates Dutch deinstitutionalization, as illustrated by the care provision of Regional Institutes for Residential Care (RIRCs; Dutch acronym RIBW). We found service users of supported housing programs to be quite similar between European countries, despite different deinstitutionalization processes. The similarity of service users in supported housing and supported independent living programs in the Netherlands and England is discussed. A large part of the current residents is probably able to move to an independent living situation. This is an important finding, in the context that RIRCs are facing budget cuts and need to reconsider their residential population. Furthermore, we discuss RIRCs’ relative success in enhancing the social inclusion of their service users. Still, RIRC support appears to be mainly focused on providing ‘something to do’, instead of on regular employment. Independently living service users have a higher level of social inclusion than residents. We studied the integration of rehabilitation principles in RIRC’s as described in treatment plans. These principles are rather well documented in the majority of the plans, although without substantiating the consequences for the service users’ needs for care. We investigated the therapeutic relationships, which appear to be a means to reduce service users’ unmet needs. In supported housing, a good therapeutic relationship also contributes to the consensus between service users and key workers concerning the direction of support. Finally, implications for future research are discussed. European research into (the effects of) recovery-oriented community care is needed, using internationally valid data collection and monitoring.