Introduction Marjet Zeegers Works as a policy consultant for IrisZorg Work experience in addiction...

Introduction

Marjet ZeegersWorks as a policy consultant for IrisZorgWork experience in addiction care since 1988

What is ?

IrisZorg is a large clinic employing 1200 people and consisting of 70 separate units in the eastern part of the Netherlands with the biggest cities being Arnhem and NijmegenThe service caters for 11,000 clients a year.IrisZorg was formed earlier this year after the merger of two separate units catering for substance misuse and social exclusionIrisZorg provides nearly all the needs for those with drug, and alcohol problems as well as homelessness

A boat as bridge to society

Homeless people with severe drug addictionproblems: 150 (policefigures before 2004) Local authority and police aimed to reduce social disruption

Land: Netherlands

City: Arnhem River: Rhine Citizens: 150,000

Context

Homeless people with severe drug addictionproblems: 150 (policefigures before 2004)

Local authority and police aimed to reduce social disruption

Addiction care wished for a 24-our service to improve quality of life for this group

Opposition to any proposed siteLocal authority came up with an unconventional solutionCosts are remarkable!!But it must not nessesarely be a boat!

Not in my backyard!!

Moored on the Rhine, beside the famous bridge at ArnhemDistinctive black and white striped colour scheme created by the local art school

Boei

The boat was named Boei wich is Dutch for lifebelt

IrisZorg contacted all 150 persons with thorough physical and mental health assesment

159 individuals

120 underwent thorough physical and mental health assessment94 got an indication for night- and/or daycare in Boei100 % diagnosed with personality disorder90 % more or less severe psyschiatric problems (dual diagnoses)All female had Post Traumatic Stress Disorder of some kind

Being allowedNot when younger then 18Surrounded with much attention when younger 23Chronic drug usersSome are residents (35 beds)Some are visitors (about 70 ‘chairs’)

Push and pull

Police maintains strict rules at streetPolice focuses on specific areas in townAll visitors can be seen on monitor by security service on BoeiThis includes those who hang around close to Boei

Rehabilitation

AttitudeMethode

Aims at:EmpowermentEmancipationNormalisationParticipation

Starts with:Cliënts wishes and needs

Definition of Rehabilitation

Rehabilitation is a process in which

activities help to

create a better quality of lifein which the self determiniation is as large

as possible in order for the client to live to his personal and society ‘s

satisfaction in living arrangements, work,

or other settings of his choice

Daycare (till 23.00u)

Hanging around drinking coffee Having a decent meal

Activities like home (2)

Playing a gameReady to go out ….

Acceptance of the urge to use drugs

Rooms for supervised drug consumptionOne for smokers (picture)One for persons who inject there drugs Tools for safe use are provided for

No comment

Good Medical care

‘Methadon’ counterAlso for medicine depotsContact with doctor or nurse in case of health problems

Night care / Residentials

Rooms for 2, 3 or 4 personsEach person a small place of his own

Rehabilitation: Guiding principles for goalsetting

The wish of the clientThe vulnerability of the clientThe social context in wich the client lives

To open doors to individual choice residents and regular visitors have their own personal coach

Fitness

Cooking (1)

Cooking (2)

Handicraft

Art

Schizofrenic, addicted, but still an artist

Activities you get paid for

Being the laundrymanCleaning on deckCleaning outside (different projects)

Some factory-workEt cetera

Some staff rooms

Leaving the boat

Domains of Rehabilitation

Personal domainsSelf-careHealthSpiritualitySocial relations

Life domainsHousingWorkingLearningFree time spending

Results of BoeiFocus on personal domains wich results in at least 55 very regular visitors/residents

After one year about 30 visitors (= nearly 30 %) made further steps in life domains.

* motivational center * outpatient treatment * inpatient clinic with detoxification * supervised housing and/or working

If they succeeded? Some did; some did not

Thank you for your attention!