Trimbos jv engels 2011

PREPARED FOR THE FUTURE Primary mental health care Annual report summary 2011

ANNUAL REPORT 2011 It was not an easy year. Drastic cuts were made to Dutch health promotion budgets. The Lifestyle Programme of the Netherlands Organisation for Health Research and Development (ZonMw) was scrapped, its Health Promotion and Disease Prevention Programme was curtailed, and many agencies that promote disease prevention and healthy lifestyles faced cuts in funding.

The cutbacks could not be avoided.

Despite the economies, the Trimbos Institute still succeeded last year in conducting numerous projects, developing new knowledge and establishing promising collaborations. Working with the mental health care sector, as well as with newer stakeholders such as employers, local authorities and educational institutions, we launched high-quality initiatives designed to further promote mental health and resilience.

This is a publication of the Trimbos Institute (Netherlands Institute of Mental Health and Addiction) in Utrecht.

Text:

Editing: Project leaders: Design: Cover photograph: Translation:

Trimbos Communication and Public Relations Service Wybo Vons Journalistieke Producties Laila Zaghdoudi and Marjan Heuving Puck Grafisch Ontwerp iStockphoto Michael Dallas

We thank everyone who contributed to the annual report. The full report in Dutch can be accessed at www.trimbos.nl/jaarverslag. Should you have any questions or comments about the annual report, please contact our Public Relations Service on +31 30 297 1100, or e-mail us at info@trimbos.nl You can scan the QR code with your smartphone.

2

www.trimbos.nl

This annual report summary gives an impression of our work. It provides just a brief indication of the accomplishments and encouraging developments at Trimbos in 2011. Highlighted in this year’s report are our joint efforts and ambitions to improve mental health care in the primary care sector.

PRIMARY HEALTH CARE ‘Mental health begins in primary care’

Read the full report in Dutch at www.trimbos.nl/jaarverslag

3

MENTAL RESILIENC

Mental health begins in primary care Primary health care providers encounter mental health problems in many different ways. Mostly they notice psychological symptoms such as anxiety or gloom. They also see many physical symptoms that are difficult to explain, such as headaches, lower back pain or fatigue.

Often a clear connection exists between physical and psychological symptoms. Many people with a chronic physical illness develop mental health problems in conjunction. Comorbid physical and psychological illness makes many demands on primary care providers.

It is their job to recognise the symptoms, make a diagnosis and provide whatever treatment they can.

Many initiatives have been developed in recent years to aid primary care providers in addressing such problems.

Mental health practice nurses have been engaged, and mental health agencies increasingly work together with primary care. The Trimbos Institute supports such vital initiatives with its own research expertise.

Collaborative care Last year, Trimbos research focused on primary mental health care in numerous ways. First of all, we studied the effectiveness of collaborative care – arrangements by which general practitioners work directly with mental health care providers. Collaborative care not only ensures better care, but it also increases the options for transferring specialised services from the secondary to the primary sector.

E-mental health Other studies explored e-mental health care and low-threshold Internet-based therapies. When GPs encounter patients with incipient mental health problems such as depression, they can now give them access to an online intervention and then monitor whether the intervention is helping. This is a cost-effective approach, highly consistent with the current health policies that encourage people to resolve their minor health problems for themselves whenever possible.

Institute supports the primary care sector with concrete interventions. Examples are our Mental Vitality programme, a number of breakthrough projects to improve cooperation between the mental health and primary care sectors, an intervention for depression designed for women from Turkish and Moroccan backgrounds, methodologies for collaborative care, and a range of e-health interventions.

Future follow-up in the primary care sector In the years to come, the Trimbos Institute will continue to support primary care by delivering expertise and pertinent examples from practice. This will enable primary care providers to better address the wide array of mental health problems they encounter in day-today practice. In cooperation with the primary care sector, Trimbos will continue developing innovative solutions and conducting outcomes research. Our collaborative efforts with primary care are a source of inspiration to us, pointing to new opportunities to strengthen mental health and resilience.

We are pleased to share our ambitions and enthusiasm with you in this annual report brochure.

Jan Walburg Chair of the Board of Directors Trimbos Institute, Netherlands Institute of Mental Health and Addiction

Social workers can now also help relieve the strain on the primary care sector. A Trimbos mental health enhancement study developed several new interventions with a social focus, in cooperation with primary care providers and social workers. Social workers administer the interventions on prescription from GPs. The programmes have proved highly effective in helping clients learn to deal with difficult life issues and fend off mental health problems at early stages.

Standards of Care for Depression An additional accomplishment was the release of the Standards of Care for Depression. In publishing these key normative criteria for good care throughout the integrated multidisciplinary framework, the Trimbos

4

www.zelfhulpwijzer.nl

Read the full report in Dutch at www.trimbos.nl/jaarverslag

5

KNOWLEDGE Mental Health Care Knowledge Day 2011 The theme of this event on 20 January was Body and Mind. Slide sets and videos of the presentations and lectures in Dutch can be retrieved online at www.lichaamengeest.nl New publications from Nemesis 2 A whole series of publications, reports and articles based on Nemesis 1 and 2 (the Netherlands Mental Health Survey and Incidence Studies) appeared in 2011.

These included Verzuim door psychische en somatische aandoeningen bij werkenden (Work absenteeism due to psychological and physical illness), Nieuwe gegevens over suïcidaliteit in de bevolking (New data on suicidal behaviour in the community) and ADHD, gedragsstoornissen en antisociale persoonlijkheidsstoornis (ADHD, conduct disorders and antisocial personality disorder).

Knowledge Centre for Body and Mind The national Knowledge Centre for Body and Mind was founded on 20 January on the initiative of the mental health agency GGz Breburg and the Trimbos Institute. Its purpose is to carry out innovative research on the aetiology, prevention, diagnosis and treatment of illnesses that involve both physical and psychological symptoms.

Leo Kliphuis, chair, National Association of Organised Primary Care (LVG) ‘Many past projects have shown that it is difficult to put mental health expertise to work in primary care. In a certain sense, the mental health care system remains a black box, partly because referral patterns there are more complicated than in the health sector. That’s why we need to support primary care with practical knowledge!’

‘Most mental health problems don’t really require treatment, but they do need good care and guidance’ Niek de Wit, general practitioner, Julius Centrum in Utrecht ‘Most mental health problems don’t really require treatment, but they do need good care and guidance.

We must tap the strengths of the individuals and the social systems they’re part of. Primary care providers are well placed to estimate how much resilience people have and what kinds of additional support they need.’

6

www.kopopouders.nl

Read the full report in Dutch at www.trimbos.nl/jaarverslag

7

ALERTNES

Interagency cooperation bolsters youth services The National Knowledge Centre for Child and Adolescent Psychiatry, the Netherlands Youth Institute and the Trimbos Institute signed a cooperative agreement in March whose purpose is to keep practitioners in child and adolescent welfare and mental health services informed about good-quality instruments and interventions.

Monitoring System for Mental Health Care for Older People (MEMO) The purpose of this monitoring scheme is to assess the quality and effectiveness of the mental health care of older people. The first wave of findings from the MEMO evaluation was published in April. www.nkop.nl Health and vitality on the job Together with the Netherlands Heart Foundation, the Trimbos Institute initiated a programme designed to promote healthy lifestyles, mental vitality and smoking cessation in workplaces. The website www.wijwerkengezond.nl provides employers with a comprehensive listing of interventions and examples from practice that they can implement to promote healthy lifestyles for their employees.

‘I’d like primary care

Rene van der Most, Parenting and Education Programme, Trimbos Institute ‘Last year we supported a number of partners in their strategies for the early detection of alcohol problems.

That’s the approach we like to take, as it provides support at the grass-roots level. Primary care is more cost-effective than specialist care, but it can’t solve all problems. Local health authorities and primary care providers need one another, because both of them are close to the local community. What’s also needed are more connections between the primary care sector and schools, the youth and family centres, and the child and adolescent health care sector. Only that will ensure a quality impulse, only that will enable the detection and resolution of problems that are currently being treated in specialist settings.’

providers to be given a truly pivotal function’

Filip Smit, Public Mental Health Programme, Trimbos Institute, and VU University Amsterdam ‘I’d like primary care providers to be given a truly pivotal function. That would require the continual monitoring of outcomes. It’s the only way to really know which services produce satisfaction, improve quality of life and stimulate recovery.’

8

www.vroegsignaleringalcohol.nl

Happy Drinks – alcohol-free with a kick To promote non-alcoholic beverages and present a delicious alternative to alcohol, master chef Pierre Wind was commissioned by the Trimbos Institute to develop Happy Drinks. These were in hot demand at the Pinkpop music festival in June. The regional community health and addiction services deployed mobile bars specially designed for large events and parties attended by young people. To see how you could provide Happy Drinks, go to www.happydrinks.nl Weed-Check and Need for Weed Weed-Check is a brief intervention intended to supplement other harm reduction programmes focusing on cannabis use. An evaluation study on Weed-Check is being conducted via the addiction services Brijder, Maliebaan, Iriszorg, Jellinek, Novadic Kentron, Tactus and Mondriaan. The Need for Weed project was launched in cooperation with the University of Amsterdam to investigate how individual cannabis use evolves and what factors influence frequent use. www.trimbos.nl/wiet-check www.needforweed.nl

Read the full report in Dutch at www.trimbos.nl/jaarverslag

9

COOPERATION Innovating with new partners For the Trimbos Institute, 2011 was also a year of pioneering work. We shared available knowledge about mental health and addiction with our stakeholders, and this spawned interesting projects, new insights and innovative cooperative ventures with employers, local authorities, educators and health insurers.

Using e-health to reduce sick leave: Return@Work In cooperation with Achmea insurers, we helped launch a project to reduce the duration of sick leave for employees with mental health symptoms.

The Trimbos Institute developed Return@Work, an e-mental health intervention that supports individual employees, occupational health doctors and case managers in the reintegration process.

E-mental health hallmark of quality Working with other stakeholders, we also developed a hallmark of quality for e-mental health programmes.

Users can now see at a glance whether the quality of an online e-mental health intervention has been assessed as good.

‘Many people with severe or chronic mental illness still stand on the sidelines today’

Christina van der Feltz-Cornelis, Diagnostics and Treatment Programme, Trimbos Institute, and Tilburg University ‘Our research studies have shown that there’s loads of room for improvement in primary care treatment for depression. Currently, less than half of the people who go to their doctor with depressive symptoms actually receive treatment, even when they specifically ask for it. actually receive treatment, even when they ask for it. And only 20% of the treatment interventions help. In collaborative care, the rate rises to 71%! So that’s a model with tremendous potential.

My hope for the future is that many minor problems will be treatable with brief interven-tions in primary care. And for more persistent disorders, professionals should not just monitor the illness, but should aim for recovery.’

Cognitive fitness training in mental health care Cognitive fitness training combines physical exercises with cognitive elements that stimulate the brain. At the Kwintes, Altrecht and SBWU mental health agencies, forty long-term clients with psychiatric illnesses are taking part in this kind of training.

Frank van Hoof, Reintegration Programme, Trimbos Institute ‘Many people with severe or chronic mental illness still stand on the sidelines today. I hope we can help them lead a social and community life that they find worthwhile and productive. Both primary and secondary mental health care can assist them in this.

So can local authorities, employers and especially the government.’

10

www.dgsg.nl

Initial findings from the Psychisch Gezien panel An advisory group called Psychisch Gezien (‘psychologically regarded’), a broad-based panel for people with long-term mental health conditions, was initiated in 2010. People with various forms of mental illness are questioned regularly on a range of topics. The panel now has over 800 members, and new findings were announced in 2011. The Trimbos Institute manages the panel in cooperation with the Phrenos Knowledge Centre, the LPGGz (National Alliance of Client and Family organisations in mental health) and the Netherlands Institute for Health Services Research (NIVEL). www.psychischgezien.nl

Read the full report in Dutch at www.trimbos.nl/jaarverslag

11

STRENGTH

Hoepakjijdataan.nl In June, the Trimbos Institute and STIVORO, the Dutch knowledge centre for tobacco control, launched a joint campaign entitled ‘How Can I Help My Kids Say No to Tobacco, Alcohol and Cannabis?’ The campaign website hoepakjijdataan.nl provides concrete tips and information about parenting and various kinds of youthful substance use. Parents can also read the experiences of other parents and watch a video in which parents talk to their kids about resisting temptations.

Dementia Housing Monitoring Study The effectiveness of living arrangements for people with dementia does not just depend on adequate staffing or small-scale housing. Clear policy visions and management recognition of the professionalism of staff members are at least as important. These were key findings from the Monitor Woonvormen Dementie (Dementia Housing Monitoring Study), which can be downloaded in Dutch free of charge via www.trimbos.nl/webwinkel

Gerdien Franx, Innovation of Mental Health Care Programme, Trimbos Institute ‘The future of primary care begins now. I’d like to see more brief interventions for mild symptoms, and far more alternatives to medication. Community psychiatric nurses and general practice nurses need to play a greater role in support of GPs. Such professionals are highly capable of recognising and identifying mental health problems. So they have more to offer than pills.’

Hallmark of quality for drugsinfo.nl The Trimbos Institute’s website drugsinfo.nl was awarded the ZegelGezond, the hallmark of quality for health websites that meet quality criteria for reliable information. www.drugsinfo.nl

‘The future of primary care begins now!’

Primary care on centre stage at the Mental Health Care Knowledge Day The Mental Health Care Knowledge Day on 2 February 2012 is to focus entirely on the crucial role of primary health care. More information about the knowledge day is available at www.toekomsteerstelijn.nl

Katharina Martin Abello, I.COM Programme, Trimbos Institute ‘A serious shortage of professional health care staff is expected by 2020. The use of e-health services can overcome that shortage to a significant degree, especially in terms of providing health care information.

Face-to-face contacts can then be more targeted. For that to succeed, investment is needed in the long-term implementation of e-mental health.’

12

www.ggzrichtlijnen.nl

Project LIVE A website was launched in 2011 for the National Support Centre for Experiential Expertise in Mental Health Care (LIVE), a joint project by the Trimbos Institute and the Phrenos Knowledge Centre. During this two-year project, we shall support a large number of mental health agencies in the mobilisation and improved utilisation of expertise by experience. www.live-ervaringsdeskundigheid.nl

Read the full report in Dutch at www.trimbos.nl/jaarverslag

13

e-mental health Knowledge-sharing days on offer Dutch local authorities have increasing duties and obligations with respect to mental health, alcohol and drugs, the youth, older people, and vulnerable groups and neighbourhoods. The Trimbos Institute helps them seek solutions. In November, we offered a number of free consultations to local authorities that submitted queries on policy issues relating to alcohol, drugs or mental health in specific target groups. Three local authorities and one community health service were awarded the one-day consultations, scheduled for January 2012.

Recovery-Oriented Practices Index (ROPI) The interest in recovery and in recovery-oriented services has created a need for an instrument to keep track of progress and developments in service delivery.

The ROPI is a process evaluation tool, revised by the Trimbos Institute in 2011. Three differently focused versions were developed. The evaluation results can be used to develop improvement plans for implementing recovery-oriented services. A Dutch-language guide to the use of ROPI can be downloaded free of charge via www.trimbos.nl/webwinkel

Linda Bolier, I.COM Programme, Trimbos Institute ‘The reluctance of GPs to make use of e-mental health services can largely be blamed on the novelty of the approach. It takes time to build confidence in e-mental health. In information sessions last year, we discovered that many GPs are still unfamiliar with the available services and with the potentials of e-mental health.

Making online interventions more attractive would give an additional impulse. Some ideas are to include more visual material and to offer more personalised, customisable interventions.’

‘It takes time to build confidence in e-mental health’

Anne Margriet Pot, Programme on Ageing, Trimbos Institute ‘Older people can benefit from the direct, low-threshold approach to mental health problems that is made possible by Internet-based interventions. The Mastery over Dementia website (www. dementiedebaas.nl) is used even by informal carers in their mid-eighties.

Primary care providers need more information about elder care and dementia. Geriatric psychologists and specialist geriatricians should therefore be engaged more actively in the primary care sector. More investment is also needed in professional development training for primary care providers.’

14

www.mentaalvitaal.nl

www.psyfit.nl

Steering towards Happiness Conference The purpose of the Steering towards Happiness Conference, held in The Hague on 24 November, was to put mental vitality and well-being on the agendas of policymakers, school governing bodies and employers. It was organised by the Netherlands Institute for Social Research (SCP) in cooperation with the Trimbos Institute, Erasmus University and the positive education organisation Positief Onderwijs.

Schizophrenia decision support tool For people with psychotic illness and their friends and relatives, a digital decision aid for schizophrenia is now available. It informs them about the nature of at disorder and it helps them, in consultation with a health care professional, to make optimal choices in terms of care and services. www.keuzehulpen.nl Additional information For a full listing in Dutch of our projects and the results achieved in 2011, please go to www.trimbos.nl/jaarverslag

Read the full report in Dutch at www.trimbos.nl/jaarverslag

15

Street address:

Postal address:

Da Costakade 45

Postbus 725

3521 VS Utrecht

3500 AS Utrecht

T 030 297 11 00

E info@trimbos.nl

F 030 297 11 11

I www.trimbos.nl