Headaches. Care for young people with mild learning disabilities and/or psychological or psychiatric problems

In Strategy 2004-2009 the Netherlands Court of Audit announced that it would investigate the coherence of policy for young people with problems. We have worked out this proposal in our Headaches audit. The audit focused on two groups of particularly vulnerable children who are at risk from inadequate policy coordination and cohesion: those with mild learning disabilities and those with psychological/psychiatric problems.

Conclusions

We can conclude that the supply of care does not adequately meet the needs of young people with mild learning disabilities and/or psychological/psychiatric problems. Nor does it adapt to trends in demand. This is because care purchasers, i.e. care offices and provinces, do not have a clear picture of the care needed and because the intersectoral care necessary for the target group is not provided in a structural way. Furthermore, in many areas there is a lack of appropriate follow-up care and transition to new, more appropriate care. As a result, many young people do not receive the care they require when they require it. It is not the case, however, that they are always denied appropriate care; at an individual level appropriate care is often forthcoming, although it can take some time. However, at regional and national level supply frequently fails to meet demand, as the long waiting lists and waiting times testify. Young people with complex problems requiring a multidisciplinary approach often fail to get proper care or have to wait too long for such care. If they do not receive the right care at the right time, there is a major risk that their problems will escalate.

Recommendations

In our opinion, the main priority is to achieve a quantitative and qualitative improvement in the understanding of the issue. Such an understanding is also essential to determine the demand for intersectoral care, transfers to other types of care and follow-up care. To this end, we made separate recommendations to the main parties concerned: the Minister for Youth and Families, the Minister of Health, Welfare and Sport and the care purchasers.

Response of the minister

The Minister for Youth and Families responded to our audit on 7 September 2007. Speaking also on behalf of the Minister of Health, Welfare and Sport, the minister generally endorsed our analysis of the inadequate cohesion between supply and demand in youth care but did not fully respond to a number of our recommendations. He did not respond, for example, to our recommendations to improve follow-up care and care continuation, to ensure there was a clear allocation of authority at regional level and to improve monitoring and enforcement.

Status

The report was submitted to the House of Representatives on 16 October 2007.