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Reading: Re-designing the integrated care program for Asylum Seekers in the Netherlands


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Re-designing the integrated care program for Asylum Seekers in the Netherlands


Ferdy Pluck ,

GGz Centraal; Hogeschool Utrecht, NL
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Roelof Ettema,

Hogeschool Utrecht; UMC Utrecht, Julius Center, NL
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Marlou de Kuiper

Hogeschool Utrecht, NL
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Asylum seekers often have serious and complex mental health problems mostly due to experiences either in their home country or during their travel to the Netherlands. During the asylum procedure, people seek treatment from the GP or a primary health care provider. However, often their problems are more serious and complex and they need to be referred to specialized primary and secondary mental health care.

Asylum seekers are, as a group, characterized by diversity and multiple cultural backgrounds.

Problem statement: The consequences are mental trauma such as depression, psychotic symptoms, sleeplessness, suicidal behavior, conflicts, insufficient social support. For professionals in the first echelon of care, this group is problematic and requires resources which are not always available which is why many problems are underdiagnosed and undertreated Asielzoekersteam GGz Centraal, n.d.

The problem statement provides the rationale for the design of an integrated specialized care program for asylum seekers, including first and second echelon health care providers, social work, specialized care and preventive care.

At the moment, there is no national guideline for the care of these clients. At GGz Centraal, which is a large Mental Health Care Institute in the Netherlands, there are 8 facilities for refugees and asylum seekers for a total of around 3500 people "Asielzoekersteam GGz Centraal", n.d.. For people with mental health problems, a program was designed and implemented which is carried out by multidisciplinary teams of Mental Health Care professionals such as psychiatrists, Nurse Specialists, psychologists, etc. Due to a lack of a methodical evaluation, the effects of this program are unknown.

Research proposal:

At the moment, there are three main research questions:

What are the effects of the current program on long-term symptoms and perceived quality of life of clients and what is the opinion of professionals on the different aspects of the program such as feasibility en demands on professional resources?

Which are the underlying mechanisms of the outcomes in the 8 facilities of this program from a realist perspective and how can these findings be applied to the improvement of the current program with the aim to reduce long-term effects of the consequences of traumatic experiences due to forced migration in all its forms

How to design an experimental research approach in which the improved design can be tested?

The theoretical framework for the design of the program will be the Neuman Systems Model because of its combination of systems theory, stress-coping theory and prevention theory which suits an integrated care approach Merks, Verberk, De Kuiper, & Lowry, 2012.

The research method involves both qualitative and quantitative data and the design of this research will be from a realist perspective.

A theory-based evaluation from a realist perspective provides a sound basis for a study into the general design principles for integrated care programs which may provide a framework for future designs Pawson, 2006 Pawson & Tilley, 1997. This basis would need to be discussed with researchers and practicing professionals to share the possibility of collaboration around the world from a methodological perspective. 

How to Cite: Pluck F, Ettema R, de Kuiper M. Re-designing the integrated care program for Asylum Seekers in the Netherlands. International Journal of Integrated Care. 2018;18(s2):301. DOI:
Published on 23 Oct 2018.


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