good practice example: an integrated social support and ...integrated approaches in amsterdam in the...

Good practice example: an integrated social support and care approach in Amsterdam

Amsterdam

1.000.000 inhabitants 7 boroughs 22 neighbourhoods 20 NGO’s 5000 facilities for homeless people/long term

psychiatric patients Total budget for the City: 180 million Health Insurance company finances health care 150.000 rent controlled dwellings

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Integrated approaches in Amsterdam in the past 20 years Often born out of public nuisance issues:

Open drugscenes in parts of the citye.g.: renovation Bijlmermeer, central station, center

of the city Homeless people with psychiatric problems living in

the street

Local and national police urging for action 3/22/19Via Invoegen | Koptekst en voettekst kunt u de tekst wijzigen | 3

Examples

Support Project: aimed at homeless people with substance abuse

Late 90’s South East (Bijlmer) integrated approach Early 2000 G4 plan against homelessness 2006-2014 A variety of other integrated approaches at certain

target groups

Making the integrated approach the standard thing to do


The G4 (2006-2014) integrated approach for homeless/substance abuse/psychiatry Local authority takes responsibility Governance through finance and cooperation with

other financers Health department/care department of the city is

coördinator It is a personal approach, never just policy It operates on three levels, client, management, policy It generates data that help adjust operation on those

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The standard integrated approach for homeless/substance abuse/psychiatry 5000 people per year, more than 2000 new

admissions every year Brings together at least the following services:

Health Care (somatic, mental, substance abuse) Housing (both temporary and permanent) Income/debt assistance/work General support/care/guidance Outreach services


The standard integrated approach for homeless/substance abuse/psychiatry Based on the personal itineraries of thousands of

people People have a legal position, Central admittance system The local authority formulates criteria for admission

into the program (based on national law) Clients are being followed during their itinerary, this

requires a realiable system for generating data


Results G4 planPositive:

18.000 cliënts in an indidviual integrated program 12.000 of whom in a stable situation (housing, care,

income, work) 53% percent decline of criminal acts in the stable

group 22 % decline in evictions Fewer people sleeping rough


Results G4 plan

Not so positive:

Goals for prevention of evictions were not met People were institutionalised, not housed Following the financial crisis we saw a rise of homeless

people with a different profile: economic homelessness, people from Eastern Europe, undocumented people


Our local policy plan

Not like this

But like that


Working towards inclusion


Amsterdam breakthrough

Housing First/Housing Led policy since 2016 30% of available social housing is allocated to

vulnerable people Houses allocated to homeless people/people with SMA

rose from 250 a year to 750 per year


Challenges/tips Integrated approach is expensive, so save it for serious

problems

One party should take the initiative and be the coördinator

When you’re in, you’re in it for the long run

There should be collaboration on different levels: professional, management, political

Co financers must work together

There must be reliable aggregated information based on client journeys.


Challenges Dare to outlive your initial success

Housing is most crucial, so develop Housing First

An integrated method does not stand on its own: use information for agenda setting towards other parties

Does the program work for all people? The computer can not say no

Always doubt the sanity of your own policies


Challenges

Do not shy away from the public nuisance/criminilisation issue. Use arguments from their realm to advocate an inclusive approach


good practice example: an integrated social support and ...integrated approaches in amsterdam in the...

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