Advertisement

Community Mental Health Journal

, Volume 51, Issue 2, pp 175–184 | Cite as

Outsourcing Mental Health Care Services? The Practice and Potential of Community-Based Farms in Psychiatric Rehabilitation

  • Sorana C. IancuEmail author
  • Marjolein B. M. Zweekhorst
  • Dick J. Veltman
  • Anton J. L. M. van Balkom
  • Joske F. G. Bunders
Original Paper

Abstract

Psychiatric rehabilitation supports individuals with mental disorders to acquire the skills needed for independent lives in communities. This article assesses the potential of outsourcing psychiatric rehabilitation by analysing care farm services in the Netherlands. Service characteristics were analysed across 214 care farms retrieved from a national database. Qualitative insights were provided by five case descriptions, selected from 34 interviews. Institutional care farms were significantly larger and older than private care farms (comprising 88.8 % of all care farms). Private, independent care farms provide real-life work conditions to users who are relatively less impaired. Private, contracted care farms tailor the work activities to their capacities and employ professional supervisors. Institutional care farms accommodate for the most vulnerable users. We conclude that collaborations with independent, contracted and institutional care farms would provide mental health care organizations with a diversity in services, enhanced community integration and a better match with users’ rehabilitation needs.

Keywords

Farms Rehabilitation Community integration Outsourcing professionalization Logistic regression 

Notes

Acknowledgments

The authors would like to thank to Bart Jan Krouwel, chairman of the Federation for Agriculture and Care, for granting permission to use the data published online by the Federation.

Conflict of interest

This study was funded by TransForum Netherlands, a temporary collaborative programme between research institutes, Dutch government, non-governmental organisations and private sector, which conducted research on agriculture in a metropolitan context. TransForum Netherlands had no involvement in the design, data collection, analysis and interpretation, in the writing of the report or in the decision to submit the paper for publication. The authors report no conflicts of interest.

References

  1. Anthony, W., Cohen, M., Farkas, M., et al. (2002). Psychiatric rehabilitation (2nd ed.). Boston: Center for Psychiatric Rehabilitation.Google Scholar
  2. Bond, G., Drake, R., & Becker, D. (2008). An update on randomized controlled trials of evidence-based supported employment. Psychiatric Rehabilitation Journal, 31(4), 280–290.PubMedCrossRefGoogle Scholar
  3. Corrigan, P. W., Kuwabara, S. A., & O’Shaughnessy, J. (2009). The public stigma of mental illness and drug addiction findings from a stratified random sample. Journal of Social Work, 9(2), 139–147.CrossRefGoogle Scholar
  4. Di Iacovo, F., & O’Connor, D. (2009). Supporting policies for social farming in Europe. Firenze: Arsia.Google Scholar
  5. Elings, M., & Hassink, J. (2008). Green care farms, a safe community between illness or addiction and the wider society. International Journal of Therapeutic Communities, 29, 310–321.Google Scholar
  6. Farkas, M., & Anthony, W. A. (2010). Psychiatric rehabilitation interventions: A review. International Review of Psychiatry, 22, 114–129.PubMedCrossRefGoogle Scholar
  7. Federatie Landbouw en Zorg. (2011). Zorgboerderijen in Nederland. Retrieved May 31, 2011 from http://www.zorgboeren.nl/zorgboerderijen.php.
  8. Frumkin, H. (2001). Beyond toxicity: Human health and the natural environment. American Journal of Preventive Medicine, 20(3), 234–240. doi: 10.1016/s0749-3797(00)00317-2.PubMedCrossRefGoogle Scholar
  9. Hassink, J., Elings, M., Zweekhorst, M., van den Nieuwenhuizen, N., & Smit, A. (2010). Care farms in the Netherlands: Attractive empowerment-oriented and strengths-based practices in the community. Health & Place, 16, 423–430.CrossRefGoogle Scholar
  10. Hassink, J., & Van Dijk, M. (2006). Farming for health. Green-care farming across Europe and the United States of America. Wageningen: Springer.Google Scholar
  11. Hassink, J., Zwartbol, C., Agricola, H. J., Elings, M., & Thissen, J. T. N. M. (2007). Current status and potential of care farms in the Netherlands. NJAS-Wageningen Journal of Life Sciences, 55(1), 21–36.CrossRefGoogle Scholar
  12. Haubenhofer, D. K., Elings, M., Hassink, J., & Hine, R. E. (2010). The development of green care in western European countries. Explore-The Journal of Science and Healing, 6(2), 106–111.CrossRefGoogle Scholar
  13. Hickman, C. (2005). Therapeutic gardens: An overview of the history of hospital gardens in England from 1800. In Forum UNESCO University and Heritage, 10th International Seminar “Cultural Landscapes in the 21st Century”, Newcastle upon Tyne.Google Scholar
  14. Hine, R., Peacock, J., & Pretty, J. (2008). Care framing in the UK: Contexts, benefits and links with therapeutic communities. Therapeutic Communities, 29(3), 245–260.Google Scholar
  15. Iancu, S. C. (2013). New dynamics in mental health recovery and rehabilitation. The case of care farms. 's-Hertogenbosch: BOXPress.Google Scholar
  16. Kremer, M. (2006). Consumers in charge of care: The Dutch personal budget and its impact on the market, professionals and the family. European Societies, 8(3), 385–401.CrossRefGoogle Scholar
  17. Le Boutillier, C., Leamy, M., Bird, V. J., Davidson, L., Williams, J., & Slade, M. (2011). What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance. Psychiatric Services, 62(12), 1470–1476.PubMedCrossRefGoogle Scholar
  18. Meerburg, B. G., Korevaar, H., Haubenhofer, D. K., Blom-Zandstra, M., & Van Keulen, H. (2009). The changing role of agriculture in Dutch society. Journal of Agricultural Science, 147, 511–521.CrossRefGoogle Scholar
  19. Michon, H. W. C., Ketelaars, D., van Weeghel, J., & Smit, F. (1998). Accessibility of government-run sheltered workshops to people with psychiatric histories. Social Psychiatry and Psychiatric Epidemiology, 33, 252–257.PubMedCrossRefGoogle Scholar
  20. Patel, V., Weiss, H. A., Chowdhary, N., Naik, S., Pednekar, S., Chatterjee, S., et al. (2010). Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): A cluster randomised controlled trial. The Lancet, 376(9758), 2086–2095.CrossRefGoogle Scholar
  21. Pedersen, I., Ihlebaek, C., & Kirkevold, M. (2012). Important elements in farm animal-assisted interventions for persons with clinical depression: A qualitative interview study. Disability and Rehabilitation, 34(18), 1526–1534.PubMedCrossRefGoogle Scholar
  22. Rössler, W. (2006). Psychiatric rehabilitation today: An overview. World Psychiatry, 5(3), 151–157.PubMedCentralPubMedGoogle Scholar
  23. Slade, M. (2012). Everyday solutions for everyday problems: How mental health systems can support recovery. Psychiatric Services, 63(7), 702–704. doi: 10.1176/appi.ps.201100521.PubMedCrossRefGoogle Scholar
  24. van Oostenbrugge, L., & Hutink, H. (2014). Keurmerken, certificaten en kwaliteitsverklaringen in de zorg. Een praktisch overzicht. Den Haag: Nictiz.Google Scholar
  25. Ware, N. C., Hopper, K., Tugenberg, T., Dickey, B., & Fisher, D. (2007). Connectedness and citizenship: Redefining social integration. Psychiatric Services, 58(4), 469–474.PubMedCrossRefGoogle Scholar
  26. Young, S. (2008). Outsourcing in public health: A case study of contract failure and its aftermath. Journal of Health Organization and Management, 22(5), 446–464. doi: 10.1108/14777260810898688.PubMedCrossRefGoogle Scholar
  27. Young, S., & Macinati, M. S. (2012). Health outsourcing/backsourcing. Case studies in the Australian and Italian health sector. Public Management Review, 14(6), 771–794.CrossRefGoogle Scholar
  28. ZonMW. (2010). Kennisagenda Zorg voor Zorglandbouw met innovatie, effectiviteit en doelmatigheid. Een verkenning naar mogelijkheden en draagvlak voor een kennisagenda Landbouw en Zorg. Den Haag: ZonMW.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Sorana C. Iancu
    • 1
    Email author
  • Marjolein B. M. Zweekhorst
    • 1
  • Dick J. Veltman
    • 2
  • Anton J. L. M. van Balkom
    • 2
  • Joske F. G. Bunders
    • 1
  1. 1.Department of Innovation in the Health and Life Sciences, ATHENA InstituteVU University AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Psychiatry, EMGO+ Institute for Health and Care ResearchVU University Medical Center, GGZ InGeestAmsterdamThe Netherlands

Personalised recommendations