people with severe mental health problems

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(Trimbos Institute)

Around 300,000 Dutch people with severe psychiatric health issues who have been used to receive home care are currently facing enormous uncertainties. The impact of social isolation on these groups and their caretakers is unclear. This subproject focusses on: 1) clients who are used to having day activities or sheltered work; 2) clients of outreach services (such as Flexible Assertive Community treatment (FACT) or “bemoeizorg”); 3) clients in residential facilities; 4) people who should receive crisis care (such as Intensive Home Treatment (IHT). Among them are subgroups of specific concern, such as people that suffer from anxiety, dual disorders (including substance use disorder), and patients that normally receive long-acting injectable antipsychotic medication.

Provisional Results

The corona crisis gives people with psychological vulnerability new challenges to cope with the existing psychological problems, to deal with the insecurities about the future and filling the day with meaningful activities. Some are – beyond their expectations – successful; some are thriving because of a lack of stimulation and expectation. Or they feel empowered by the increased solidarity because ‘everyone is in the same boat’. Others experience an increase in complaints.

For many people with severe psychological problems, not much has changed in their daily life, their social network and social participations were already limited. The crisis makes it painfully clear that support work is their only contact with the ‘outside’ world. At the same time, this period of distance to social work some experience a renewed sense of self-control. There is a certain dynamic where some people at the beginning of the crisis experienced very little problems but this increased later on. Whereas others experience the opposite. In future research, we will try to understand this dynamic.

Story 1: she normally receives living assistance twice a week in her home, this contact is now via video calling. [..] But it worked, I was so surprised. ‘[..]’ ‘I always have trouble to keep my house in order or to cook food. They can’t do anything while video calling but they are still there. When I am for example doing the dishes or cooking. And there was someone there to talk with. The contact with the living assistant is going great. I miss her terribly. But video calling is a good alternative.’

Story 2: Madam indicates that her psychological issues have only worsened because she is chained to her house. She has no network so she is alone all day. Once a week she has contact with RIBW via an app. Psychotherapy is now via video calling but she noticed that her treatment isn’t going well this way. [..] ‘I am not bored, I am used to the loneliness. I am mandatory at home. When my depression rules, I just go to bed. Then you will sleep away the hours. I am used to the loneliness and being alone for years, every weekend. So maybe that is why it is easier for me. I keep thinking: yes, now other people feel what it is like to be lonely.’

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