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					  Collaboration of treatment centres for people with a (mild) mental
                 retardation and complex problems




                                      More results through
                                         cooperation

                                             Nico Overvest MHA
                                             Programme-manager




Dichterbij Specialistische Zorg, Venray. Trajectum-Hanzeborg, Zutphen
    Altrecht-Wier, Den Dolder. De Bruggen Specialistische Zorg,
      Zwammerdam.. Trajectum-Hoeve Boschoord, Boschoord                 1
Borg in English




                  2
Borg in Dutch




                3
                Outline

1.   Which 5 centres are collaborating?
2.   Client population and treatment vision
3.   Why do they collaborate?
4.   Which concrete issues?
5.   Organisation of the collaboration
6.   Conclusions
7.   Questions
                                              4
1. Which 5 centres are collaborating?
         The regions




                                   5
To what sectors do they belong?


             MR sector


                 Borg
         MH             Forensic
        sector           sector


                                   6
     2. Client population and
         treatment vision

Client population:
  – always a mild mental retardation
  – almost always a DSM IV disorder
  – a lot of challenging behaviour
  – DBD-MMR

                                       7
                   Treatment vision
•   Multidisciplinary
         •   standard clinical: behaviourist, psychiatrist, group
             therapy, specialist therapies, social work
         •   standard ambulatory: behaviourist, psychiatrist, case
             manager
         •   further diagnostics and treatment needs


•   Integral
     •       living/working/leasure


                                                               8
3. Why do we collaborate?
     Is it worth the while?




 1+1+1+1+1>5?

                              9
             Benefits

• Professionals: to improve
  treatment

• Management: to realise strategic
  advantage

                                     10
              Difficulties

• Professionals:
 •   Losing control on your own ‘products’
 •   Not-invented-here syndrome
• Management:
 •   Fearing strategic disadvantage



                                             11
     With a view to treatment

•   The client group is small
•   The problems are complex and have multiple
    causes
•   Treatment requires a lot of expertise and
    experience

First reason
Collaboration increases the possibilities to
    improve treatment
                                               12
   With a view to the care chain

Clients get stuck in
    • the MH system
    • the MR system
    • the judicial system
    • the public health care system of large cities

Second reason
Improvement of the position in the care chain
De Borg (the partner institutions) as focal point where work is done
     for the improvement of the care chain


                                                                       13
    With a view to legislation and
             regulation
•    Focused at large groups: MH, MR, the Justice
     Department

•    Tailored legislation and regulation regarding:
    • care financing
    • building requirements
    • the specification of judicial sanctions

Third reason
Influencing legislation and regulation
                                                      14
            Take together

1. To improve the treatment quality

2. To improve the care chain

3. To influence legislation and regulation

                                             15
       4. Which concrete issues?
                      With a view to treatment

Scientific research

•    Target group and measuring instruments: Koot and Tenney
     (2003 – 2007)
•    Effect evaluation: Wiersma, Drieschner and Hesper (2007-2012)
•    Research consortium with, among others,
     psychofarmaceuticals: Stolker, Heerding and Scheiffes (2008-
     2012)

Advantages:
•   more data
•   more reliable result

                                                                16
    Improvement of treatment

•   interchange between professionals
•   exchange of treatment modules
•   improvement of treatment modules
      1.addiction
      2.aggression
      3.in future: sexuality

•   diagnostic formulary


                                        17
   Group leader training

• in collaboration with a higher
  education college
• 16 teaching days,
• intervision, ‘own client’, project
• now for the fifth time
• planning 2008/2009: production of a
  basic textbook
                                        18
Improvement of the care chain
De Borg as nationwide interlocutor for

    • The construction of new treatment centres for treatment in a
      forensic framework
    • Probation Services: evaluation of diagnosis instrument
    • The prison system: work for the continuation of care
    • Health care in the cities: contribute to finding solutions
    • The Ministry of Justice as care buyer




                                                                     19
Improvement of the care chain (2)
• De Borg visualizes the target group
      • It promotes research
          – by academics
          – by inspections
      • It produces a leaflet for semi-skilled professionals
        with
          – suggestions for recognition
          – suggestions for treatment


                                                          20
     Influencing legislation and
             regulation

•   Legal framework for retention of
    specialism

•   Rules for care financing
     clinical
     ambulatory
     research and innovation
                                       21
     Influencing legislation and
           regulation (2)


•   Improvement of utility of sanctions in
    criminal law

•   Appropriate instructions for mandatory
    yearly accounts

                                             22
      5. Organisation of the
          collaboration

•   Legal person: Foundation
•   Management: Executive Committee
    and Management Consultative Body
•   Advisory groups
•   Office of De Borg

                                       23
            6. Conclusions
•   Clients get better treatment through the
    collaboration of these five centres.

•   Collaboration is never boring and often
    challenging

•   Therefore we think
    1+1+1+1+1= 10
                                           24
           7. Questions



• Questions following this
  presentation

• Other collaborative experiences?


                                     25
Many thanks for your
    attention!!

      www.de-borg.nl
   n.overvest@altrecht.nl


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posted:10/5/2012
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