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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!