de-escalation supporter in the intensive and forensic health care minco ruiter, project leader...
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de-escalation
supporterin the Intensive and Forensic
health care
Minco Ruiter, Project leader Inforsa Arkin Lex Brouwer, de-escalation supporter Inforsa
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Contents
• Introduction
• Escalating situations
• Context of changes
• Aggression versus escalation
• De-escalation, the ingredients
• De-escalation supporter, the roles
• Some Results
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introduction
• Arkin: Mental Health Care Amsterdam
• Inforsa: KIB (High Intensive Care short term),
LIZ (High Intensive Care Long term) FPK
(Forensic Care)
• 17 wards, 300 caregivers, 155 patients
Forensic and Intensive Psychiatric Hospital Inforsa
It happens fast…
1. Molestating the ward…
2. Refusal of medicines
3. Drunk in the garden
4. Provocations during Xmas celebrations
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Context of changes
• Project Diminishing coercion and seclusion
• Nationwide developments:
– Governement pressure
– No solitary confinement
– HIC development
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Results in numbers
Culture of connection
• From controlling to connecting
• Inner safety
• Feeling comforted
• Hospitability
• Relation based care
• Living climate based on support, positivity, trust,
hope, honousty, flexibility versus structure
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Aggression
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Escalation
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De-escalation, using the space
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escalation// de-escalation
We need more people!
He’s really aggressive!!
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escalation// de-escalation
Don’t overreact guys!
I know how he feels!
it happens fast…but there is help…
1. Molestating the
ward…
2. Refusal of medicines
3. Drunk in the garden
4. Provocations during
Xmas celebrations
1. Dive and connect
2. Acting naive
3. Calculated safety
4. Using the relation
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16
De-escalation supporter
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De-escalation: the ingredients
• Inner drive to connect
• Using all senses
• Being congruent and sincere
• Recognition of the suffering
• Dare to speak
• Use your position and power
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Different roles
• De-escalate
• Mediate
• Cool down
• Slow down
• Support and Train
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Effects and Results
• Prox. 3 times a week in action (registered)
• Prox. 50% about escalation or escalated situation
• Prox. 20% about refusal of medication
• Prox. 60% prevention of further escalation
• Far less forced physical restraint
• A growing culture of focus on de-escalation
Questions??
minco.ruiter@inforsa.nl, lex.brouwer@inforsa.nl
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