'Reference index for High-Risk Children unsuccessful'
The national Reference Index for High-Risk Children (Verwijsindex Risicojongeren), an ICT system introduced in 2010 to identify high-risk children at an early stage and to facilitate collaboration between various support agencies, does not work as intended nor can practicing professionals apply it effectively in daily practice. The system was implemented following the death of several children from abuse and domestic violence. In these cases, national support agencies failed to collaborate effectively on a timely intervention. The study by Inge Lecluijze, who will defend her dissertation at Maastricht University on 4 November, reveals the complex nature of collaboration in the field of youth care through a specially developed ICT system. 'The implementation was not successful which, in my opinion, calls for a reassessment of the Reference Index.'
The Reference Index for High-Risk Children was presented five years ago as a 'magic pill’ for addressing youth care problems. Youth professionals who worry about the health of a particular child or see risks that may threaten their development can flag these cases as high-risk in the system. As soon as a case is flagged by two or more professionals, a match is made and the agencies are notified of each other's involvement. In practice, however, the professionals interpret the term 'high-risk' in different ways and rarely flag these cases in the system. 'As a result, the Reference Index contains a strange combination of high-risk children and unclear definitions, which means the tool is not being used to properly flag appropriate cases,' says Lecluijze. ‘The focus by policymakers on risk identification not only restricts professional freedom and opinions, but also makes professionals less likely to use the Index as intended.' According to the PhD candidate, this explains why so many professionals advise against using the system or avoid it entirely.
Her analysis, which is based on the introduction of the Reference Index in four Dutch municipalities with different profiles, reveals that a strong focus on collaboration using a technological tool distracts from existing collaborative practices in the youth care sector. According to Lecluijze, an overarching administrative approach leaves little room for negotiation and makes it difficult for policymakers and professionals to initiate improvements and change inefficient processes.
So far, every evaluation of the Reference Index on the national and the local level has reported far too few cases being flagged by professionals. According to Lecluijze, the implementation of the Reference Index is not seen as an interactive learning process but as a performance indicator (the more high-risk children that are identified, the better the system is being implemented). 'My analysis shows that the focus by policymakers on management and quick implementation is giving professionals false hope and is making it even harder to implement the system properly.'
The wrong tool
Lecluijze concludes that the current Reference Index is the wrong tool for the job. 'It doesn't work in daily practice and doesn’t function as intended. Instead of making the youth care field more resilient, it's making it weaker.' Her dissertation provides the tools for developing an alternative policy for youth care. 'This alternative approach should control the risk regulation reflex, stimulate reflexivity and collective learning, and improve the lives of children without promoting a naive belief in manufacturability.'
Inge Lecluijze's PhD study is part of a ZonMw project under the programme Zorg voor Jeugd ('Caring for Youth').
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