Decentralization of youth care

Since the decentralization of youth care in 2015, municipalities have been responsible for organizing and funding youth care. The aim was to bring care closer to children and families and to tailor it more closely to local needs. In practice, however, implementation varies considerably between municipalities. This raises questions about the impact of local policy on the accessibility and quality of youth care.

_{Text: Djoeke Bakker, Ubbo Emmius Fund}

PhD candidate Caitlin Kiernan, supervised by Assistant Professor of Health Economics Hermien Dijk, Professor Gerard J. van den Berg and Dr Jana Knot-Dickscheit, is investigating how this policy change plays out in practice. The research focuses on whether and how differences in municipal policy choices affect the care that young people receive.

Dijk emphasizes that the research is not about politics. ‘We do not need to sit in a politician’s chair,’ she says. ‘But we can provide insight: if a municipality implements this policy, it will have these consequences. That must be a consideration.’ Ultimately, behind every policy decision lies the question of whether young people receive the help they need.

Personal motivation for the research

Kiernan has a background in economics and worked for two years at the Accare Child Study Centre. There, she gained insight into the importance of research on young people’s mental health. ‘With this research, I hope to contribute to a better understanding of the effects of policy choices within youth care,’ she says.

Differences in municipal policy

Because municipalities determine for themselves how they purchase and finance youth care, outcomes can vary widely from region to region. ‘Municipalities contract youth care providers and decide how many providers there are and what care children have access to. This can have consequences for the care that young people actually receive,’ explains Kiernan. One of the central questions in the research is whether and how the funding systems used by municipalities influence the care that children receive and their ultimate outcomes.

The search for reliable data

One of the main challenges in the research is the lack of uniform and accessible data. ‘Youth care data are not kept centrally. Municipalities and procurement organisations use different systems, which makes it difficult to analyse national trends,’ says Kiernan. In addition, staff changes within municipalities add to the complexity.

‘Every time a new policy officer joins, we have to explain again why participation in our research is important,’ says Dijk. ‘This hinders a consistent long-term vision and makes it difficult to collect data in a structured way.’ To address these limitations, the researchers work with data from Statistics Netherlands (CBS) and long-term studies such as Lifelines. ‘By combining these data with administrative sources, we gain a better understanding of how differences in municipal policy affect the lives of young people,’ explains Dijk.

From figures to better policy

Although the analyses are still ongoing, certain patterns are already emerging. The researchers hope that their findings will help policymakers to strike a better balance between accessibility and quality in youth care. ‘We do not take political positions,’ Dijk emphasizes. ‘But we hope that our analyses will contribute to better-informed youth policy.’ By making the consequences of policy choices visible, the researchers want to help inform decisions that truly make a difference for young people.

This project is funded by the Ubbo Emmius Fund and is embedded in the Aletta Jacobs School of Public Health.

More information

• Caitlin Kiernan