7.6 Mechanisms of early detection and signposting of young people facing health risks
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As described in the Youth Act, municipalities are responsible for prevention and early detection of young people facing health risks. Municipalities are responsible for the offer of (preventive) interventions and for facilities in their municipality that are able to identify young people at risk, for instance schools, consultation clinics, child day care, youth work, youth health care, GGD, specialised mental health care (GGZ), neighbourhood teams and/or centres for youth and family.
The most recent policy document regarding youth health care was presented in 2009. This document describes that all municipalities have to offer youth health care to children from 0-19 years and their parents. This care is framed in the basic task package of youth health care. Together with the new Youth Act in 2015, a new basic task package of youth health care was introduced. The purpose of this renewal was to modernize the basic youth health care package based on new scientific insights and social developments, and to better align it with the system changes for youth, as a consequence of the new Youth Act. Municipalities are responsible for ensuring that the new youth health care package is available and actively offered to all children and adolescents up to 18 years. They implement it together with the Youth Health Care (JGZ) organizations. Before 2015, there used to be both a universal part and a customer tailored part, but this has been abolished and included in the Youth Act. A contact moment for adolescents has been added as a task to the basic youth health care package. There is a structural offer available to young people from the age of 14. In any event, activities must be available focusing on healthy weight, smoking, alcohol and drug use, sexual health, sport and physical activity, internet use and game addiction, resilience, depression and school absenteeism. The new basic youth health care package indicates which activities should be available to all children and young people. Carrying out specific programmes or (group) activities after identifying risks or problems is not part of the basic package. These programmes and activities, carried out when risks or problems have been detected, are partly covered by prevention in the Youth Act.
The following tasks form part of the basic youth health care package:
- Systematically follow the physical, psychosocial and cognitive development of children and adolescents;
- Assess development in relation to the social, pedagogical and physical environment of the children and young people and the family in which they grow up;
- Identifying problems and early detection of specific disorders on time;
- Providing preventative information, advice, instruction and guidance;
- Descale care and normalize by providing information, advice and support or by conducting a few meetings to support and reassure parents, if necessary;
- Assess whether additional support, help or care is needed and get the right care or help right away;
- Collaborate with professionals in schools, preschool facilities, youth care, obstetricians, maternity care, general practitioners (GPs) and other curative care providers, neighbourhood teams and other relevant stakeholders;
- Advising municipalities and schools on collective measures / activities based on analysis of data obtained.
As mentioned in 7.2 , youth health care is in most municipalities performed by the GGD. More information about youth health care can be found in 7.2.
There is no other top-level policy or legal framework on early detection or identification of young people at risk.
As described above, municipalities are responsible for providing the facilities in their municipality that are able to identify young people at risk. Municipalities decide which stakeholders carry out this task but usually it is carried out by the GGD. For early detection and identification and good care and support it is important that stakeholders cooperate at a local level. Therefore cooperation takes place with professionals from education, preschool facilities, GGD, youth work, youth health care, obstetricians, consultation clinics, general practitioners (GPs), other care providers and neighbourhood teams. Dependent on the municipality and the local situation, other stakeholders may be involved. The role of the stakeholders involved may also differ from one municipality to the other. The GPs and paediatricians have the possibility to directly refer youth to specialized youth care, which is described in the Youth Act.
Guidance to stakeholders
The Dutch Centre of Youth Health Care (Nederlands Centrum Jeugdgezondheid, NCJ) has developed a toolbox as support for the youth health care professionals at executive, policy and management levels. Also a national professional framework has been developed to support the youth health care package. The framework describes the JGZ contacts for the various developmental stages of a young person, as they have to be offered within the basic youth health care package. tThe national professional framework and the toolbox can be found on the website of the NCJ. NCJ also offers other ways of support to professionals in youth health care. Professionals in the field can also seek support from other professionals, for example from the GGD or from local Centres for Youth and Family.
The Netherlands Youth Institute also supports youth workers and other professionals. For example, they presented 11 tips for better collaboration at local level, between for example youth workers, municipalities, schools, police and neighbourhood teams, including descriptions of good-practices.
Trainings and events are often organized at a local level by local stakeholders.
There are no specific target groups within the youth population identified by the policy framework as being particularly at risk.
Local municipalities receive funding from government for the organization and the performance of youth health care and early detection andidentification. Municipalities themselves decide how to allocate the money, which organizations will carry out the youth health care tasks and how much funding they will receive.