Decentralisation of youth care

Since the decentralisation of youth care in 2015, local authorities have been responsible for organising and funding youth care. The aim was to bring care closer to children and families and to better tailor it to local needs. In practice, however, the way in which municipalities implement this varies greatly. This raises questions about the impact of municipal policy on the accessibility and quality of youth care.

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

Hermien Dijk emphasises that the research is not about politics. ‘We don't 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 has to be taken into consideration.’

Ultimately, behind every policy decision lies the question of whether young people are getting the help they need.

Personal motivation for the research

Caitlin Kiernan has a background in economics and health sciences and worked for two years at the Accare Child Study Centre. There, she gained insight into the importance of research into the mental health of young people. ‘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 themselves determine how they purchase and finance youth care, the outcomes sometimes vary greatly from region to region. ‘Municipalities contract youth care providers and determine 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 local authorities influence the care children receive and their ultimate care outcomes.

The search for reliable data

One of the biggest challenges in the research is the lack of uniform and accessible data. ‘Youth care data is 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 manner.’

To overcome these limitations, the researchers are working with data from Statistics Netherlands (CBS) and long-term studies such as Lifelines. ‘By combining this data with administrative data, 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 strike a better balance between accessibility and quality in youth care.

‘We do not take political positions,’ Dijk emphasises. ‘But we hope that our analyses will contribute to a better-informed youth policy.’

By making the consequences of policy choices tangible, the researchers want to help make decisions that can 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. 

Text: Djoeke Bakker
Image: Reyer Boxem