Children kept in extreme isolation in closed youth care institutions: Report

Young people in a special department of closed youth care live in extreme isolation. On average, they spend over 20 hours a day alone in the Very Intensive Short-term Observation and Stabilization department (ZIKOS). That is according to Jason Bhugwandass, who ended up in youth care as a child from a problem family and now works for other young people as an expert by experience. He was named Amsterdammer of the Year for that reason a few years ago.

Bhugwandass spoke to 51 young people who have been in youth care for a report that he will present on Tuesday. The young people say that employees use punishment to curb their psychiatric complaints. “It means that many young people no longer express their emotions and no longer dare to give their opinion.” Bhugwandass speaks of “an extremely repressive climate” with reports of “psychological, physical, and sexual violence” in which children are “belittled, humiliated, verbally abused, or manipulated by group leaders.”

According to Bhugwandass, not a single interviewed youth said the group leaders were able to help. He says that young people are not safe in the ZIKOS wards, that it has not been proven that the wards work and that they should be closed as soon as possible.

ZIKOS departments are intended for children aged 12 to 18 who have both acute psychiatric needs and complex behavioral problems. That makes them a risk to themselves. They could mutilate themselves or attempt suicide. One of the young people Bhugwandass spoke to for the study took her own life last month at the age of 19.

There are 18 places in ZIKOS departments in the Netherlands. Twelve of them are in Harreveld and six in Zetten, both in the province of Gelderland. The Healthcare and Youth Inspectorate (IGJ) recently visited both locations for an unannounced inspection. The Inspectorate concluded that the care in the departments was “insufficient.” The stories children told Bhugwandass were the reason for that visit.

Interest organizations MIND and ExpEx want the IGJ to tighten procedures and proactively monitor youth care and (adult) mental health care, they wrote in response to the Bhugwandass report. They called it “incomprehensible” that this study was initiated by Bhugwandass and not the IGJ itself.

MIND and ExpEx called on the IGJ to be proactive and not just reactive regarding mental healthcare. They suggest “not only looking at reported incidents but carefully looking for the cause and its context.” They point out that a report often signals a larger problem.

The organizations also believe that independent investigations should be conducted in the event of incidents instead of by an internal investigation committee of the institution in question. Finally, they urge institutions to also act proactively in the event of reports. “Work together with experience experts who are more sensitive to signals and who come into contact with young people or adult clients more easily,” they advise.

The two providers of this type of closed youth care are “shocked” and “touched” by Bhugwandass’ report. After the unannounced visit from the IGJ, the institution in Zetten decided not to admit new children into the ZIKOS department as of February 15. “Because we believe we are currently insufficiently able to offer these young people the safe and expert environment they need,” the institution said.

The other provider in Harreveld also says it will not continue “with ZIKOS in its current form.” It will seek customization for new children. Both institutions say they take the report “extremely seriously” and are currently investigating the signals from the report or launching an investigation.