Evaluering av forsterket avdeling (2007)
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Following 1-2 years of operation, AGENDA has evaluated "special needs departments"1 (FAs) in immigrant reception centers. The evaluation was commissioned by the UDI (the Norwegian Directorate of Immigration). The purpose of the evaluation has been to ascertain how the FA system has functioned in relation to the objectives set, as well as to make proposals for improvements. Resource utilization and the relationship between resources and tasks in FAs have not been addressed in this evaluation.
The main sources of information have been:
- interviews with representatives of the FAs and key local cooperation partners at all of the four reception centres that have FAs, other reception centres, various levels of the UDI and other relevant persons at a central level
- a dialogue conference with participation by a selection of the interviewed persons
The main conclusion is that there is no doubt that the FAs provide a good service for their residents, given the existing organizational and resource framework. The cost of an FA-place is about five times higher than for a regular place, 20-25% of the cost level at an adult psychiatric residential institution and about 5% of the cost level at a BOI.2. In the opinion of the evaluator, municipal assisted living homes with a 24-hour staffing are most similar to an FA, which also makes "reception centre with 24-hour staffing" a possible alternative name.
The organization of the service as a residence with 24-hour staffing for asylum-seekers who need special help raises many challenges, among others:
- Determining who will benefit most from the service
- ability to cooperate with other services
- composition and size of the staff at the FA
- The resources of the host municipalities.
In addition, the staffing requirement and the name itself leads to confusion as to whether the FA is anything other than a reinforced residence option.
The greatest challenges are linked to psychiatric health care. Asylumseekers do not receive the same access to psychiatric care as others. This is due to a combination of a lack of capacity and uncertainty regarding whether available methods work within trauma-related help, language problems as well as the safety and future prospects for asylum-seekers in light of the application process and not the issue of rights.
The other major challenge is the lack of procedures for setting goals for residents stay at the center and determining criteria for when residents are released, while the third challenge is linked to extremely marginal financing of the host municipality's tasks. The last challenge is largely resolved through the proposed state budget for 2008.
The most important recommendations are therefore:
- That the reception centres maintain and, if possible, increase the skills of their staff through continued determined recruiting and good, firm relationships with various cooperation partners such as the police, the child welfare authorities, the municipal health service and, not least, psychiatric health care. These are all relationships that can be used to improve skills and to enhance mutual understanding of problems and expectations.
- That the UDI facilitates and actively contributes to retaining and, if possible, further developing good and firm cooperative relationships between the reception centres and various partners - not least in relation to psychiatric health care.
- That the UDI ensures that clear procedures and routines are developed for setting goals for individuals who move into the FA, and in connection with moving out from the FA.
- In connection with moving out from the FA, consideration should be given to utilizing the competence and evaluations of the primary and specialist health services.
- It should not be ruled out that such a procedure review may end with a conclusion where return to the "parent reception centre" is not part of the objective for a relatively large number of residents.
- That the UDI should actively seek cooperation with the Directorate for Health and Social Affairs and the RVTSs3 to ensure the necessary development of expertise within professional disciplines, 3 RVTS is an abbreviation for regional resource centre for violence, traumatic stress and suicide prevention. RVTS is organised with a centre in each main health region in Norway (two in the South/East, of which one is in Kristiansand). R5794 particularly as regards psychiatric health care, which is important in the treatment of asylum-seekers.
- That the UDI should, in cooperation with the Directorate for Health and Social Affairs, take the initiative to implement a debate on and evaluation of what types of treatment can ethically be initiated visà-vis asylum-seekers whose applications have not been processed, or who have received a final refusal.
- Rights in connection with elective psychiatric health treatment for asylum-seekers with final refusals is part of this issue. Our findings indicate that there are differing practices.
Bestilt av: UDI
Utført av: AGENDA Utredning & Utvikling AS