Introduction Marjet Zeegers Works as a policy consultant for IrisZorg Work experience in addiction care since 1988

What is ? IrisZorg is a large clinic employing 1200 people and consisting of 70 separate units in the eastern part of the Netherlands with the biggest cities being Arnhem and Nijmegen The service caters for 11,000 clients a year. IrisZorg was formed earlier this year after the merger of two separate units catering for substance misuse and social exclusion IrisZorg provides nearly all the needs for those with drug, and alcohol problems as well as homelessness

A boat as bridge to society Homeless people with severe drug addictionproblems: 150 (policefigures before 2004) Local authority and police aimed to reduce social disruption Land: Netherlands City: Arnhem River: Rhine Citizens: 150,000

Context Homeless people with severe drug addictionproblems: 150 (policefigures before 2004) Local authority and police aimed to reduce social disruption Addiction care wished for a 24-our service to improve quality of life for this group Opposition to any proposed site Local authority came up with an unconventional solution Costs are remarkable!! But it must not nessesarely be a boat!

Not in my backyard!! Moored on the Rhine, beside the famous bridge at Arnhem Distinctive black and white striped colour scheme created by the local art school

Boei The boat was named Boei wich is Dutch for lifebelt IrisZorg contacted all 150 persons with thorough physical and mental health assesment

159 individuals 120 underwent thorough physical and mental health assessment 94 got an indication for night- and/or daycare in Boei 100 % diagnosed with personality disorder 90 % more or less severe psyschiatric problems (dual diagnoses) All female had Post Traumatic Stress Disorder of some kind

Being allowed Not when younger then 18 Surrounded with much attention when younger 23 Chronic drug users Some are residents (35 beds) Some are visitors (about 70 ‘chairs’)

Push and pull Police maintains strict rules at street Police focuses on specific areas in town All visitors can be seen on monitor by security service on Boei This includes those who hang around close to Boei

Rehabilitation Attitude Methode Aims at: Empowerment Emancipation Normalisation Participation Starts with: Cliënts wishes and needs

Definition of Rehabilitation Rehabilitation is a process in which activities help to create a better quality of life in which the self determiniation is as large as possible in order for the client to live to his personal and society ‘s satisfaction in living arrangements, work, or other settings of his choice

Daycare (till 23.00u) Hanging around drinking coffee Having a decent meal

Activities like home (2) Playing a game Ready to go out ….

Acceptance of the urge to use drugs Rooms for supervised drug consumption One for smokers (picture) One for persons who inject there drugs Tools for safe use are provided for

No comment

Good Medical care ‘Methadon’ counter Also for medicine depots Contact with doctor or nurse in case of health problems

Night care / Residentials Rooms for 2, 3 or 4 persons Each person a small place of his own

Rehabilitation: Guiding principles for goalsetting The wish of the client The vulnerability of the client The social context in wich the client lives To open doors to individual choice residents and regular visitors have their own personal coach

Fitness

Cooking (1)

Cooking (2)

Handicraft

Art Schizofrenic, addicted, but still an artist

Activities you get paid for Being the laundryman Cleaning on deck Cleaning outside (different projects) Some factory- work Et cetera

Some staff rooms

Leaving the boat

Domains of Rehabilitation Personal domains Self-care Health Spirituality Social relations Life domains Housing Working Learning Free time spending

Results of Boei Focus on personal domains wich results in at least 55 very regular visitors/residents After one year about 30 visitors (= nearly 30 %) made further steps in life domains. * motivational center * outpatient treatment * inpatient clinic with detoxification * supervised housing and/or working If they succeeded? Some did; some did not

Thank you for your attention!