Care for adolescents with behavioural problems could be improved.Care providers and sources of financing could work much more closely together and academic standards should be followed more, is the opinion of University of Groningen professor of Social Medicine Menno Reijneveld. C4Youth, the Collaborative Centre for Children and Youth with behavioural and emotional problems that will open in Groningen on 15 February, intends to investigate the possibilities.
From concentration problems to cases of serious violence – the number of children and adolescents who have to be dealt with by care institutions is increasing.But although the amount spent on youth care is increasing, the waiting lists remain as long as ever. Professor of Social Medicine Menno Reijneveld says that the work is not being done as efficiently as it could be. ‘It’s perfectly possible for a child with behaviour problems to be treated first by a child psychiatrist, then to go to a youth care institution, and finally end up in a youth prison, without anyone having any overview at all.’
The fact that more and more children are coming into contact with care institutions is because higher and higher demands are being made of them.Guardians, schools and care providers act more quickly now if the development of a child looks like going off the rails. Reijneveld does not consider this to be a luxury problem. ‘We take the rights of a child seriously, it’s got nothing to do with luxury’. However, there can sometimes be too much care, in the professor’s opinion. ‘That’s due to the high demands that are placed on care providers. Take a look at the public reaction to the death of the toddler Savannah who died in 2006 after long-term abuse by her mother and stepfather – at all costs professionals want to avoid being accused of having done too little too late. When care providers are not sure of their approach, children are sometimes treated more intensively or for longer than necessary.’
By providing a better academic underpinning for youth care, the uncertainty of the professional would be reduced and the care can become more effective, thinks Reijneveld.‘For example, we all consider it perfectly normal for the results of angioplasty treatment to be investigated down to the last detail. Youth care in that sense is really lagging behind. Much more research needs to be done.’ The insights that are there must also percolate down to actual practice much faster. Reijneveld: ‘Far too often, care providers simply don’t know that there’s an effective treatment available. Research and training are far too far apart.’
Efficiency is not helped by the fact that care for adolescents with behavioural problems is financed from several different sources.Reijneveld: ‘If you have a heart problem, you end up in a clear care chain. From doctor to specialist to aftercare, everything is paid for by your health insurance. It’s in the health insurer’s interests that efficient care is provided. Youth care is in that sense much too fragmented. Child and youth psychiatry is paid for by the insurance, youth care is financed by the province and youth health care by the municipalities. Only once the funders start to work together better will more efficient care be provided.’
In the next few years, the province of Groningen will be investigating in detail how care for adolescents with behavioural problems can be improved.The UMCG and the department of Orthopedagogy of the University of Groningen have been awarded EUR 1.5 million by ZonMW, a body that stimulates innovative care projects, to set up a Collaborative Centre for Children and Youth with behavioural and emotional problems. The municipality, the province, Hanze University Groningen and numerous youth care institutions in the north are participating in the project, which hopes to bring research, training, policy and actual practice closer together. The official opening of the centre on 15 February will be attended by the Minister for Youth and Families André Rouvoet.
Prof. S.A. (Menno) Reijneveld (1960) has been professor of Social Medicine at the University of Groningen since 2004.He was previously head of TNO Kwaliteit van Leven [Quality of Life] in Leiden and a socio-medical practitioner for the GGD in Amsterdam. In the next four years, Reijneveld and University of Groningen professor of Orthopedagogy Erik Knorth will head the Collaborative Centre for Children and Youth with behavioural and emotional problems.
More information: Menno Reijneveld
You can get more information by sending a mail to: C4youth med.umcg.nl.
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