Brijder – Struggle in the City

Author: Sol Agüero

The information presented below has been summarized from an interview conducted with a social psychiatric nurse from Brijder den Haag concerning alcoholism. The interview took place in November, 2019. Additional information included has been sourced from the service provider’s website.

Concerning alcoholism, this addiction has the power to greatly impact many spheres of an individual’s life: affecting relationships within the family, between friends, and in work environments. In most cases, a mental or physical factor initiates substance use which, due to various and complex environmental and social pressures, may spiral and develop into alcohol-abuse and/or addiction.

Mission:

Brijder is an addiction treatment center that gives priority to the individual, allowing you to “become the director of your own life and recovery” (Brijder & Parnassia Groep, 2019). The center believes that successful prevention and treatment for addiction is possible for anyone— from young to old, with mild or severe addiction. Brijder focuses on customized prevention and treatment, and advocate that everyone has a right to participate in society, to continue to develop, and to “be in charge of their own lives again” (Brijder & Parnassia Groep, 2019).

About Us:

Brijder has more than 40 branches in North and South Holland. The center’s recovery support care consists of short and long-term services for prevention and treatment of addiction (relating to alcohol, cannabis, other drugs, gaming, internet use, and gambling) as well as for any psychiatric or physical disorders. Brijder is part of the Parnassia Groep, the largest provider of mental health care in the Netherlands.

How we work:

The process of registering to Brijder’s services necessitates that an individual does so with a referral from their GP. Individuals looking for help with their addiction often approach their GP out of their own initiative, or a partner or child of the individual will do so. After the individual has had initial contact with their GP and a referral has been made, the individual can begin the formal registration process through Brijder. After initial registration, it takes an average 3-4 month waiting period before the first intake with the service provider takes place. Unless the case is described, reviewed, and classified as an emergency (by the GP and Brijder), the intake never occurs before the full waiting time of 3-4 months. If needed however, Brijder may provide support for the individual until the intake date. The length of the waiting times at Brijder comply with the regulations of the Dutch Healthcare Authority (NZa) (Brijder & Parnassia Groep, 2019). A report by the NOS notes that “52 percent of doctors indicated that they have waiting lists because they have no time to help mental health patients immediately” and that “GP’s attribute the waiting lists to an increase in the number of people with mental health problems, combined with waiting lists at specialized institutions” (Pieters, 2016).

Treatment at Brijder is determined case-by-case. Often problems of addiction go hand in hand with psychiatric problems, so during treatment there is a strong focus placed on the causes behind the addiction as well as underlying mental health issues which may exacerbate substance abuse. The initial goal for all patients is to achieve abstinence for 6-8 weeks. This can be achieved through internal treatment in Brijder, but patients may also engage in ambulatory care. Sometimes it is the case that mental health issues already diminish through sobriety. After this initial period of abstinence, subsequent treatment places a bigger focus on the psychological factors affecting the individuals. From there, a ‘detox plan’ is generated, which tailors treatment to the needs and wants of the patient.

Our biggest challenges:

There are certain limitations that the registration process presents. Firstly, due to the long wait, it is not uncommon that individuals on the waiting list find themselves in the hospital before their intake. The long waiting periods may sometimes lead to tragic situations such as “mandatory institutionalization, psychosis or even suicide” (Pieters, 2016).

There are also barriers involved with making the initial connection to the GP in order to get the necessary referral; often people simply are not aware that they can approach their GPs in order to get referred to a clinic, and also, strong emotions of shame and embarrassment may hinder the process.

Our greatest accomplishments:

Every year the Parnassia Group publishes a report showcasing the achievements of the most recent year. In 2018, 185,000 people were helped with their mental health problems and have successfully entered the stages of recovery (Parnassia Groep, 2019). An important indicator for quality of care at Brijder is the degree of outpatient satisfaction which is measured with CQi (consultation quality index) questionnaire. Results of the CQi measurement give the treatment an average score of 8.0. At the different healthcare companies in The Netherlands this figure varies from 6.9 to 8.6.