Dia 1

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de-escalation supporter in the Intensive and
Forensic health care

Minco Ruiter, Project leader Inforsa Arkin Lex
Brouwer, de-escalation supporter Inforsa
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Contents

• Introduction
• Escalating situations
• Context of changes
• Aggression versus escalation
• De-escalation, the ingredients
• De-escalation supporter, the roles
• Some Results

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introduction

• Arkin Mental Health Care Amsterdam
• Inforsa KIB (High Intensive Care short term),
  LIZ (High Intensive Care Long term) FPK (Forensic
  Care)
• 17 wards, 300 caregivers, 155 patients

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Forensic and Intensive Psychiatric Hospital
Inforsa
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It happens fast

1. Molestating the ward
2. Refusal of medicines
3. Drunk in the garden
4. Provocations during Xmas celebrations

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(No Transcript)
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Context of changes

• Project Diminishing coercion and seclusion
• Nationwide developments
• Governement pressure
• No solitary confinement
• HIC development

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Results in numbers
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Culture of connection

• From controlling to connecting
• Inner safety
• Feeling comforted
• Hospitability
• Relation based care
• Living climate based on support, positivity,
  trust, hope, honousty, flexibility versus
  structure

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Aggression
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Escalation
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De-escalation, using the space
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escalation// de-escalation

• We need more people!
• Hes really aggressive!!

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escalation// de-escalation

• Dont overreact guys!
• I know how he feels!

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it happens fastbut there is help

1. Molestating the ward
2. Refusal of medicines
3. Drunk in the garden
4. Provocations during Xmas celebrations

1. Dive and connect
2. Acting naive
3. Calculated safety
4. Using the relation

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De-escalation supporter
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De-escalation the ingredients

• Inner drive to connect
• Using all senses
• Being congruent and sincere
• Recognition of the suffering
• Dare to speak
• Use your position and power

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Different roles

• De-escalate
• Mediate
• Cool down
• Slow down
• Support and Train

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Effects and Results

• Prox. 3 times a week in action (registered)
• Prox. 50 about escalation or escalated situation
• Prox. 20 about refusal of medication
• Prox. 60 prevention of further escalation
• Far less forced physical restraint
• A growing culture of focus on de-escalation

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Questions??

minco.ruiter_at_inforsa.nl, lex.brouwer_at_inforsa.nl