General practitioner Henk Veentjer knows Veendam well, he has been working there for 35 years. He has been fighting bureaucracy in youth assistance for ten years. Take that one patient, she came up with a medical question, but turned out to have much greater worries. She was in panic, gloomy and tired. Her ten ten son was suspended at school for ‘verbal aggression’ and so she could not work, because he could not stay at home alone.
Veentjer: “Twelve care providers were involved with that family.” Her son wanted to go back to school after the summer vacation. But that was only allowed when the twelve had consulted in mid -September. “
Veentjer: “The psychologist who works in my practice then started calling all those people and said,” Make sure that young can go back to school right away! ” Because they know our practice and our psychologist was clearly expert, they listened. “
These kinds of experiences served as an inspiration for the new youth assistance system in Veendam. Youth assistance is all help to minors with psychological complaints – from small to large. Two and a half years ago, the municipality decided to completely change this. Now all general practices and primary schools have a qualified practitioner one day a week. A psychologist, behavioral scientist or remedial educationalist. The number of hired youth care providers in Veendam is limited from eighty to six organizations that work together under the name ‘Youth expertise point’, or JEP.
Waiting lists
The demand for youth assistance increases every year throughout the country. Now gets one in seven children and teenagers Professional help. And in Veendam, a small municipality south of Groningen, even one in six.
In Veendam are villas next to neighborhoods full of social rental houses. Workers arrived in the nineteenth century to work in the factory – later the factories disappeared, but the workers remained. There is relatively much unemployment and poverty.
The youth aid system throughout the Netherlands is burdened by waiting lists. Families report to their municipality with all their problems. Because distinguishing between serious complaints (an eating disorder) and lighter (an extremely large mouth) is difficult for municipalities in advance, waiting lists arise, in which children with major problems (think of violence at home) sometimes hear nothing for six months.
In addition, many small problems are running Through Anne Hueting, says the waiting lists, says an orthopedagogue working in Veendam. A somewhat uncertain teenager does not want to eat at all; A child who does not want to go to school does not go at all at all and joins his room for days.
Delaying at the beginning: a good conversation with parents and children. ‘That takes time but provides better help’
Veendam changed the youth assistance because of the waiting lists. Since two years there has only been one provider for ambulatory youth assistance: JEP. With a few organizations behind, when it gets too busy.
Jep has no office. Parents report to a highly educated professional from JEP, such as Hueting, who immediately separates, within a few conversations, light from serious problems. In the case of light problems, solutions follow – 65 percent of those parenting questions, Hueting says, has been dealt with within four good conversations. For example a starting fear of groups or tests. With complex problems, she makes a ‘explanatory analysis’ with the family about the causes.
What turned out? Within two years the waiting lists in Veendam disappeared, the school dropout and there are fewer crisess situations. And the costs are lower than in 2021. Meanwhile, municipalities from all over the Netherlands are requesting information about the Veendam working method.
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Normalize
Why has the demand for professional youth assistance grew so much? Uncertain parents, says Hueting. Much of what she does is “normalize”. Explain that the behavior of their child is part of the development and passes. Children who are afraid of dogs, toddlers who bite, teenagers who are brutal or experiment with smoking. Usually that is temporary, but parents don’t know what to do with it.
“The threshold for parents to ask psychological help for their child has become low,” says Hueting. “They are really worried. Because we no longer have a waiting time, those parents themselves dare to get started with our tips. Because they can come again immediately if it doesn’t work.”
Market forces was the motto after the government had transferred the budgets for youth assistance in 2015 to municipalities. Anyone who calls himself a social worker can have been registering for tenders since then. In Veendam, Groningen and eight municipalities in the region, for example, the number of providers from 30 to 220 grew within seven years.
These are single-pair that provides psychological help, offering children’s sports or offering creative activities, but also established youth care and mental healthcare institutions. “They all work with the best intentions, but the whole was uncoordinated and collaborating with such numbers is impossible,” says Maarten Wetterauw, director of the GGZ institution Molendrift. Civil servants of the municipality divided, such as everywhere, the demand about the supply.
In the meantime, alderman Ans Grimbergen (Social Domain, PvdA) was cleaned enough that the youth assistance in Veendam became more and more expensive, up to 6 million euros per year. The prices were high and the question continued to grow. “We had no insight into quality,” says Grimbergen. Young people often went from a social worker to a social worker and the municipality had to pay the bill every time, sometimes for five years. “In the meantime I had good experience with, for example, domestic help and I wanted that for youth assistance. A small number of parties who know each other and work in the living environment of the family.”
That’s how Jep.
General practitioner Henk Veentjer (left) and orthopedagogue Anne Hueting (right).
Photo Kees van de Veen
Juvenile
There are a billiard table and bean bags in the spacious youth center. Seventy young people use it after school. Sports facilities are available in Veendam, but hardly cafes and other entertainment. The Jeugdhonk is busy. Every two weeks Hueting consults with people from JEP. “We arrange all outpatient youth assistance (guidance at home or conversations with a therapist) and we are responsible for the costs,” says Hueting. JEP now receives a fixed amount of 6 million euros per year from the municipality.
To limit the costs in youth assistance, it was a long time the idea of governments that help for ‘slight’ problems could be offered by lower-educated people and the more serious the problems were, more expensive people (a GGZ psychologist, orthopedagogue or psychiatrist) could be engaged.
In Veendam this now works in reverse: a scientifically trained professional first analyzes the situation well, then – if necessary – will only be intervened.
Often, says orthopedagogue Hueting, families received help in the form of small ‘interventions’ on a waiting list for specialized care aimed at symptom control. That rarely works, she says. “Example: you learn to deal with a child with emotions, because it is often angry and kicks others, hits or scolds. But if you do not investigate why the child is angry, the problem will often come back.”
Market forces was the motto: the number of providers grew from thirty 30 to eighty 80s in seven years
In fact: for every child who is placed out of the house, on average seven interventions have already failed. Hueting: “We are now saying: it doesn’t benefit, it does harm.” Alderman Grimbergen: “” Just try something ” – we don’t do that anymore.” According to GGZ director Wetterauw, JEP manages to help half of the clients for an average of 600 euros; Before JEP started, the cheapest route was 1,500 euros.
General practitioner Veentjer also swears by the new system. He sends all young people who turn to him to the practitioner who brought JEP in his practice. Often four or five conversations are sufficient. “After one year she had helped seventy families: thirty she referred to specialized help, for forty that was unnecessary. If those patients had reported to the municipality, it would have been seventy. On a waiting list.”
Truancy
Take a girl of sixteen who was depressed, cut herself, truant, stole from shops and hanging around in a squat. Each time the police arrived at the door. Mother was overstrained. Wetterauw: “JEP set up a small network around that family. The caretaker applied the practitioner every day that the girl did not appear at school. The agent walked through the squat every day and took her when she was sitting there. For the mother it became clear: you do it well if you make sure that she had gone to school.
Thanks to the new working method, the crisis shelter has less to do and the overall costs are already lower than in 2021. The entire ‘reporting circus’ – the cost accounting per family – has reduced Alderman Grimbergen. Once a month someone from JEP talks to a civil servant, once a quarter with her about the costs.
The assignment was that in 2025 and 2026, JEP would come 10 percent under the Veendam youth aid budget of 2021. Wetterauw: “We are already far below. But the really special thing is that there are no longer waiting lists.”