CCITP Conference Rotterdam 2018

CONFERENCE PROGRAM

Wednesday, October 17 / 2018 (Pre-conference)

Time/Location Program Content

5.00 - 5.45 pm    Registration with Coffee/Tea

5.45 - 6.15 pm Introduction: Zero strategies in mental health: delusion or reality?
Steve Miccio - Chief Executive Officer for PEOPLe Inc (USA)

6.15 - 7.15 pm Buffet

7.15 - 7.35 pm Presentation: Zero Coercion: fairy taill or truth?
Yolande Voskes, Phd - Assistant professor at VU University medical centre and senior researcher at mental health institute GGZ Breburg, The Netherlands

7.40 - 8.00 pm Presentation: The suicide prevention action networks: optimizing support and care so that no one in our communities dies by suicide
Dr. Gerdien Franx - Program manager National Agenda Suicide prevention, 113 Suicide Prevention, Supranet, The Netherlands

8.05 - 8.25 pm Presentation: Zero beds in Utopia
Marijke van Putten, MD - Psychiatrist and CEO of Mental Health Institute (MHI) Noord Holland Noord (NHN), The Netherlands

8.30 - 9.00 pm Discussion

9.00 - 9.15 pm Closing Pre-conference
Prof. Niels Mulder, MD, PhD - President of the EAOF, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands

Thursday, October 18 / 2018

Time/Location Program Content

7.30 - 9.00 am    Registration

9.00 - 9.15 am    Welcome by the chair of the program committee
prof. Niels Mulder, MD, PhD

9.15 - 9.30 am   Official opening of the First International Conference on Crisis, Coercion and Intensive Treatment in Psychiatry
Drs. Marjan ter Avest   Director MIND

9.30 - 10.00 am
chair: Niels Mulder Key Note Session- Expertise by experience, peer support in crisis situations
Steve Miccio   Chief Executive Officer for PEOPLe Inc (USA)
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Peer Services Exploding the Myth about Crises

The discussion will focus on the efficacy of peer operated services in the crisis world. I will discuss the formula that has made addressing crisis care more trauma informed, safe, engaging and driven to assist people in changing their perceptions concerning crisis. The discussion will be a story of how personal crisis has lent to the design of crisis respites and peer driven mobile crisis services as well as the partnered development of a crisis stabilization service that incorporates peers, traditional providers and local law enforcement. Innovative services that support and promote a healing approach to moving beyond crisis toward wellness will be shared from the perspective of the emergency hospital visit and stay to safe transition back to community.

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10.00 - 10.30 am
chair: Niels Mulder Key Note Session- Towards human rights compliant alternatives to coercion - a European perspective
Claudia Marinetti, PhD   Director Mental Health Europe
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Towards Human Rights compliant alternatives to coercion - a European perspective

This presentation will give an overview of the European and International legal framework in relation to coercion in psychiatric care and the possibilities to implement alternatives to it. Specific forms of substituted decision-making are disproportionately applied to persons with mental health problems across Europe. Those include forced placement in psychiatric units and hospitals, and forced treatment. The United Nations Convention on the Rights of Persons with Disabilities, adopted in 2006 and ratified by all EU Member States and by the EU itself, includes the right to legal capacity and to supported decision-making. From a human rights perspective, legal capacity - the right to make choices and be recognised before the law - is the key to ensuring autonomy and inclusion for a person and is a necessity for moving from coercion towards human rights compliant alternatives.

Desite this, mental health laws, as well as other public health laws, across Europe also contain forms of substituted decision-making which are applied to persons with mental ill health in order to allow them to be placed in psychiatric care and to be treated against their explicit will. Also, the prevalence of the biomedical approach to mental health has led to a situation where it is the norm, rather than the exception, in many psychiatric care settings to compel persons with mental ull heakth to take a treatment and in some countries they can also be required to take treatment while living in the community. However, forced treatments and placements in hospitals should be avoided unless absolutely necessary. There are effective alternatives (Open Dialogue, Soteria, Trieste Model and more) which can help to reduce the use of hospitalisation, both forced and voluntary, and forced treatment by helping to maintain the right of persons with psychosocial disabilities to make their own choices with the help of therapeutic support networks.

Alternatives to coercion exist, and in this presentation a few of those will be presented and discussed.

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10.30 - 11.00 am Coffee break

11.00 - 12.30 pm Parallel sessions (with parallel session in Dutch)

11.00 - 12.30 pm Room 1 - Symposium

Title: You will get better at home

Overview of the developments in finance and organisation of the Dutch acute mental health services
Jeroen Traas, Policy Maker, Dimence, Netherlands

Intensive Home Treatment in the Netherlands
Elnathan Prinsen, Psychiatrist & manager of the division of crisis mental health services, Dimence, Netherlands

General use of theoretical models of family therapy in the organisation of emergency psychiatry
Guido Ruijgrok, Psychiatrist & teamleader of the Intensive Home Treatment team in Almelo, Dimence, Netherlands

11.00 - 12.30 pm Room 2 - Symposium

Title: A view on the organization of emergency, crisis and intensive care psychiatry in Belgian contexts

Emergency psychiatry in a Belgian context: historical, organizational and medical perspectives.
Jurgen De Fruyt, Psychiatrist, AZ Sint-Jan Brugge-Oostende AV, Belgium
Koen Titeca, Ronny Bruffaerts, Co-authors

Evolution of involuntary admission from the emergency room from an academic hospital in Belgium, 1998-2017
Ronny Bruffaerts, Details will follow
Jeroen Decoster, Joris Vandenberghe, Marc Sabbe, Koen Demyttenaere, Co-authors

Medical clearance of psychiatric patients presenting to the emergency service
Sylvie Vanstechelman, Psychiatrist, AZ Sint-Jan Brugge
Jurgen De Fruyt, Koen Titeca, Gilbert Lemmens, Co-authors

From the psychiatric emergency service to the psychiatric intensive care unit.
Hella Demunter, Psychiatrist, UPC KU Leuven, Belgium
Chris Bervoets, Ronny Bruffaerts, Joris Vandenberghe, Ruud van Winkel, Co-authors

11.00 - 12.30 pm Room 3 - Symposium

Title: Coercion in psychiatry: legal and clinical developments and current ethical challenges

The Bochum SALUS project - The ethics of coercion: Striking a balance between autonomy, well-being and security in psychiatric practice
Jakov Gather, Researcher, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany

A conceptual framework for evaluating informal coercion in psychiatry
Matthe Scholten, Scientist, Ruhr University Bochum, Germany

Effects of open-door policies in acute psychiatry on coercion, absconding and serious incidents
Simone Efkemann, Researcher, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany

Aggressive incidents by legally committed patients in acute psychiatric hospitals with open door policies. A mixed methods study
Janice Kalagi, Researcher, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany

11.00 - 12.30 pm Room 4 - Workshop

The art of enduring: a non-judging, systemic approach to suicidal behaviour
F.J. van Oenen MD PhD, family therapist, Arkin Jeugd en Gezin, Netherlands
J. Cornelis MD, Psychiatrist, Spoedeisende Psychiatrie Amsterdam, Arkin, Netherlands

11.00 - 12.30 pm Room 5 - Workshop

Interventions to improve clinical outcomes of involuntary hospital treatment
Domenico Giacco, Psychiatrist, Unit for Social and Community Psychiatry - Queen Mary University of London, United Kingdom
Stefan Priebe, Maev Conneely, Erin Burn, Co-speakers

11.00 - 12.30 pm Room 6 - Workshop

Non-violence resistance (NVR) on an acute psychiatric ward for children and adolescents
E. Miedema, Psychiatrist, GGZ Noord Holland Noord, Netherlands

11.00 - 12.30 pm Room 7 - Workshop

Preventing crisis in Trieste (Italy) and Utrecht (The Netherlands):what can we learn from each other?
Christien Muusse, Scientist, Trimbos-instituut , Netherlands
Sanne Wullems, Co-speakers

11.00 - 11.30 am Room 8 - Oral presentation Chair: Jan Berndsen

Course of dangerousness after court ordered compulsory psychiatric admissions: a prospective observational cohort study
Mark H. de Jong, Psychiatrist, Yulius Mental Health, Netherlands
Andre L. Wiedsma, Arthur E, Van Gool, Cornelis L. Mulder, Co-authors

11.00 - 11.30 am Room 9 - Oral presentation Chair: Niels Mulder

Psychiatric Ambulance: A New Feature in Psychiatric Emergency Care. 7 years on the road
Frode Bremseth, Nurse, Stavanger University Hospital, Norway
Kjetil Hustoft, Co-author

11.30 - 12.00 am Room 8 - Oral presentation Chair: Jan Berndsen

Involuntary hospital admission from the street - does it do any good?
Dr Philip Timms, Psychiatrist, South London & Maudsley NHS Foundation Trust, United Kingdom
Dr Jennifer Perry, Co-author

11.30 - 12.00 am Room 9 - Oral presentation Chair: Niels Mulder

Development of smart inpatient rooms using automation and preventing using restraints in suicidal patients
Remco F.P. de Winter, Psychiatrist, Parnassia Psychiatric institute, Netherlands
Wouter S. van Maanen, Arlette S. van Amerongen, Co-authors

12.00 - 12.30 pm Room 8 - Oral presentation Chair: Jan Berndsen

Voluntary or involuntary acute psychiatric hospitalization in Norway: A 24 hours follow up study
Kjetil Hustoft, Psychiatrist, Stavanger University Hospital, Depertmanet of adult psychiatry, Norway

12.00 - 12.30 pm Room 9 - Oral presentation Chair: Niels Mulder

Crisis lines and treatment at 113
Judith de Heus, Psychologist, 113 Suicide Prevention, Netherlands

11.00 - 12.30 pm Room 10 - mini-symposium, Nederlandse Track

Terug dringen van dwang en drang, zowel in klinische setting als ambulant
Harry Gras, Policy maker, Lister, Netherlands

11.00 - 12.30 pm Room 11 - mini-symposium, Nederlandse Track

Forensische High & Intensive Care: Hoe implementeer je dit model in de praktijk
Angelique Moonen, projectmanager FHIC de Rooyse Wissel
Lianne Toonen, afdelingsmanager, de Rooyse Wissel

12.30 - 1.30 pm Lunch with poster presentations

1.30 - 3.00 pm Parallel sessions (with parallel session in Dutch)

1.30 - 3.00 pm Room 1 - Symposium

Title: Suicide Prevention Action Networks in the Netherlands

Implementation and evaluation of the Suicide Prevention Action Network (SUPRANET) Community in six Dutch regions.
Meike Baretta, PhD student, Netherlands
Renske Gilissen, Co-author

Effectiveness of the SUPRANET community program on general practitioners
Elke Elzinga, PhD student, 113 Suicide Prevention, Netherlands
Renske Gilissen, Co-author

Feasibility and impact of data-driven learning within the Dutch suicide prevention action network (SUPRANET Care).
Kim Setkowski, PhD student, 113 Suicide Prevention, Netherlands
Renske Gilissen, Co-author

1.30 - 3.00 pm Room 2 - Symposium

Title: Crisis management in adults with autisme spectrum disorders

When a crisis is no crisis; the many faces of autism spectrum disorders (ASD)
Bram Sizoo, Psychiatrist, Dimence, Center for Devenlopmental Disorders, Netherlands

Intensive Specialized Autism Care Study (ISAC study): precipitating and recovery processes; preliminary results
Hendrikje Bloemert, Dimence, Netherlands
Prof. B. van Meijel, Dr. B.B. Sizoo & Dr. E.W.M. Verhoeven, Co-authors

Treatment of trauma in individuals with autism spectrum disorders (ASD) in crisis
Ella Lobregt-van Buuren, Dimence, Netherlands
Bram Sizoo, Liesbeth Mevissen and Ad De Jongh, Co-authors

1.30 - 3.00 pm Room 3 - Symposium

Title: Child and adolescent mental health and crisis intervention reform in Belgium

Child and adolescent mental health reform in Belgium: the general phramework
Veerle Umans, networkcoördinator, Ligant, Belgium /i>
Ann Van der Speeten, Co-author

Organization of crisis intervention programs
Eric Schoentjes, Psychiatrist, Ghent University Hospital, Belgium

Home based crisis intervention in child and adolescent mental health care
Cedric Kemseke, Networkcoördinator, WINGG Youth Mental Health Network, Belgium
Annelies Kog, Co-author

Implementation of innovative strategies in Belgian child and adolescent crisis intervention programs
Marina Danckaerts, Psychiatrist, UPC KU Leuven, Belgium
Toon Langeraert, Co-author

1.30 - 3.00 pm Room 4 - Workshop

Case discussion making use of the Agression signal guide and the Safewards model
Saskia van Duin, Nurse, GGZ Noord Holland Noord, Netherlands
Shuna Vanner, Co-speaker

1.30 - 3.00 pm Room 5 - Workshop

Intensive Treatment Centre for youth: rationale and development
Pierre C.M. Herpers, Psychiatrist, Karakter, Netherlands

1.30 - 2.00 pm Room 7 - Oral presentation Chair: Margret Overdijk

Can we constraint somebody to health? Coercion and meaning
Jacques Quintin, Scientist, University of Sherbrooke, Canada

1.30 - 2.00 pm Room 8 - Oral presentation Chair: Marijke van Putten

Exclusion by seclusion - Influence of nurses on aggression and the decision to use seclusion
Paul Doedens, Nurse, Academic Medical Center, Netherlands
Corine Latour, Lindy-Lou Boyette, Lieuwe de Haan, Co-authors

1.30 - 2.00 pm Room 9 - Oral presentation Chair: Jan Berndsen

An unusual chapter Images of living at a forensic psychiatric ward, based on relational care
Petra Schaftenaar, Scientist, Inforsa, Netherlands

1.30 - 2.00 pm Room 11 - Oral presentation Chair: Berno van Meijel

Exploring construct validity of clinical staging in schizophrenia spectrum disorders in an acute psychiatric ward
Steven Berendsen, doctor in training to be a psychiatrist, Arkin, Netherlands
Hans J. Nusselder, Psychiatrist, Arkin, Netherlands
J. van der Paardt, Psychiatrist, Arkin, Co-author

2.00 - 2.30 pm Room 7 - Oral presentation Chair: Margret Overdijk

Taking a risk; searching for a dignified form of living for people with complex problems
Harry Gras, Policy maker, Lister, Netherlands
Gerry Cornelissen, Co-author

2.00 - 2.30 pm Room 8 - Oral presentation Chair: Marijke van Putten

The personal in the professional in Mental Health Care - ethical and methodological considerations
Kjetil Moen, Scientist, Stavanger University Hospital, Norway

2.00 - 2.30 pm Room 9 - Oral presentation Chair: Jan Berndsen

International Comparison of the Opinion regarding Forensic Mental Health between the US, UK and Japan
Akihiro Shiina, Psychiatrist, Chiba University Center for Forensic Mental Health, Japan

2.00 - 2.30 pm Room 11 - Oral presentation Chair: Berno van Meijel

Dutch development of intensive care - current and past findings in an international context
Eric Noorthoorn, Researcher, GGNet, Netherlands

2.30 - 3.00 pm Room 7 - Oral presentation Chair: Margret Overdijk

Active Recovery Triad: zero permanent residents in long term mental health care
Lieke Zomer, Scientist, VUmc, Netherlands
Yolande Voskes, Lisette van der Meer, Jaap van Weeghel, Co-authors

2.30 - 3.00 pm Room 8 - Oral presentation Chair: Marijke van Putten

Patients reflections on their experience of power and coercion in psychiatry: a qualitative study
Evi Verbeke, Psychologist, Ghent University, Belgium
Stijn Vanheule, Joachim Cauwe, Femke Truijens, Co-authors

2.30 - 3.00 pm Room 9 - Oral presentation Chair: Jan Berndsen

Forensic High & Intensive Care; a model to intensify forensic psychiatric care in crisis
Sylvia Gerritsen, Scientist, VU Medical Center, Netherlands
Petra de Leede, Yolande Voskes, Guy Widdershoven, Co-authors

1.30 - 3.00 pm Room 10 - mini symposium, Nederlandse Track

Verandert een brede blik de kijk op de client en zijn omgeving?
Justine Theunissen, CCE (Centrum voor Consultatie en Expertise)
Tom van Son, CCE (Centrum voor Consultatie en Expertise)

3.00 - 3.30 pm Tea break

3.30 - 4.00 pm
Chair: Marijke van Putten
Key Note Session- Coercive measures and prevention of seclusion and restraint in Europe
Andrew Molodynski, MBChB   Consultant Psychiatrist, Oxford Health NHS Foundation Trust. Honorary Senior Clinical Lecturer, Oxford University
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Coercion in Mental Health Care- International Perspectives

The balance between individual choice and provision of treatment and care without consent has been at the heart of mental health care from the very beginning of facilities and treatments being available. In some ways the issues have not changed, but the way in which we think about them and in which they affect people undoubtedly have. The issue has never had a higher profile, as evidenced by reviews of mental health law in many countries, the service user movement, and the UN CRPD. The issues are undoubtedly complex and there are significant variations in coercive practices around the world, and even within regions and countries. Even within contained health systems there can be substantial variations.
This presentation draws on information gathered over several years by Andrew and colleagues while researching in the field and will provide an overview of coercive practices in different regions of the world, the evidence for effectiveness or ineffectiveness, and some of the key themes we can draw out. It will finish by looking to the future for coercive interventions, and where we might be going.

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4.00 - 4.30 pm
Chair: Marijke van Putten
Key Note Session- Intensive treatment in clinical settings, prevention of seclusion and restraint
Yolande Voskes, Phd   Assistant professor at VU University medical centre and senior researcher at mental health institute GGZ Breburg
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Intensive treatment in clinical settings, prevention of seclusion and restraint

Locking a psychiatric patient in a seclusion room is a controversial practice in the Netherlands, as well as in other countries in and outside of Europe. Seclusion is a traumatic and emotional experience that has a major impact on patients with psychiatric symptoms. In recent years, mental healthcare institutions in the Netherlands started projects to reduce seclusion. These projects have resulted in improvements in mental health care and a decline in number and duration of seclusions. However, psychiatric patients are still secluded. To achieve a further reduction of seclusion and to reduce also the number of beds in mental health care institutions, a group of professionals started the development of High and Intensive Care (HIC) in mental health care. Previous research on the reduction of seclusion in the Netherlands, evidence based practices, experience based practices and consensus meetings with all stakeholders (patients, peer providers, family, nurses, psychiatrists, managers and researchers) were the basis of this new model on mental health care in the Netherlands. The HIC-model focusses on restoring and maintaining contact, crisis prevention and stepped care. It requires close collaboration with relatives and with the ambulatory teams. In order to measure the implementation of the HIC-model, the HIC-monitor has been developed. The HIC monitor is a model fidelity scale and contains of 65 items on eleven subscales to be rated using a 5-point Likert scale, in ascending order of "not implemented" to "fully implemented" At the moment all large mental health care institutions are implementing this model. A national study is done to get more insight into the implementations and the effects of HIC on coercive measures and quality of care. This keynote presents the High and Intensive Care model and will pay attention to the results of the national study on HIC.

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5.00 pm
Reception at the City Town Hall / meeting Rotterdam City Council

Friday, October 19 /2018

Timings Event

9.00 - 9.15 am    Introduction to the program of day 2

9.15 - 10.00 am
Chair: Margret Overdijk Key Note Session- Research, evidence, and practice of coercive treatment - what is the link?
Prof. Stefan Priebe   Professor of Social and Community Psychiatry at Queen Mary University of London, UK
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Research, evidence, and practice of coercive treatment - what is the link?

Coercive treatment has practically always been part of practice in mental health care, although the societal context, legal basis, and forms of coercion have changed fundamentally over the last 250 years. During the same period, psychiatry has become an academic discipline involving medicine and other sciences. Scientific disciplines commonly have the aspiration to advance through research and be evidence-based in their practice.

The presentation will show the main research methods that have been applied to understand coercive treatments and their effects, summarise the existing evidence that the research has produced and explore in which way, if any, the evidence has influenced practice.

It will be argued that the wide spread practice and importance of coercive treatment has hardly driven an extensive research agenda in psychiatry, and only a few aspects of coercive treatments have been studied with rigorous methods. When the studies yielded negative findings, in particular about the benefits of coercive treatment in the community, there has been a limited impact on practice.

Whilst the direct links between research, evidence, and practice of coercion in psychiatry may be seen as weak, there might be more indirect links that help to maintain and shape current practice of coercion. Direct and indirect links - also considering so-called informal forms of coercion - and potential future scenarios for how coercive practice might be guided by evidence (or not) will be discussed.

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10.00 - 10.30 am
Chair: Margret Overdijk Key Note Session- The Zero Suicide Journey
Dr. Gerdien Franx   Program manager National Agenda Suicide prevention, 113 Suicide Prevention, Supranet, Netherlands
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The Zero Suicide Journey

Suicide prevention is a major health care responsibility in desperate need of new perspectives. Despite decades of research and considerable investments in health care services little progress has been made in reducing morbidity and mortality due to suicidal behavior. US suicide rates show a 24% rise between 1999 and 2014.4 In the Netherlands the suicide rate has risen with 38% in eight years, returning in 2012-2015 to peak numbers of the 1980's.5 Over 40% of Dutch inhabitants who died by suicide received specialist mental health care. From successive major systematic reviews on suicide prevention strategies6,7 it becomes clear that progress is slow. The uptake by the field of guideline best practices and recommendations seems to be even slower8 with many workers lacking specific training to work with suicidal patients.9,10 Accepting this state of affairs implies that suicide will keep killing several hundreds of thousands humans every year worldwide in the next decades.

This keynote presents Zero Suicide, a new approach to suicide prevention that is gaining momentum worldwide and aims for the pursuit of zero suicides in healthcare. Zero Suicide starts from the core value that no one should die alone and in despair by suicide, and from the conviction that suicide can be prevented. It is an integral, transformative approach that applies Safety and Quality Improvement principles developed in technological sectors (e.g. aviation, automotive, energy) and in somatic healthcare on the scale of entire (mental) health care systems or institutions. Core components are: 1) a safety culture with commitment to the goal of zero suicides, 2) continuous (data driven) improvement of care processes and routines, and 3) structural and reliable use of suicide specific interventions. These components are translated into well-defined organizational behaviors (to lead; to train; to identify, engage and treat; to transition and to improve) that all contribute to patient and staff safety. Zero Suicide's optimistic and ambitious approach contrasts with the attenuated and reserved stance commonly encountered among health care staff towards the preventability of suicides, and with a current reality of losing many patients to suicide. It is a B-HAG: a Big Hairy, Audacious Goal that may evoke anxiety among frontline workers. Therefore, the first steps on the journey towards Zero Suicide are the abandonment of blame after suicide and the creation a Just Culture in which professionals feel secure to learn and improve every day.

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10.30 - 11.00 am Coffee break

11.00 - 12.30 pm Parallel sessions (with parallel session in Dutch)

11.00 - 12.30 pm Room 1 - Symposium

Title: Trauma Informed Teamwork in Clinical Psychiatry

An introduction into Trauma Informed Teamwork: the Neurosequential Model of Therapeutics
Tony Bloemendaal, Psychologist, Fivoor, Netherlands

Implementing Trauma Informed Teamwork in a locked psychiatric ward
Lucas Schalk, Psychiatrist, Fivoor, Netherlands
Pascal Visser, Lotte Newbold, Taco Coenders, Co-authors

Preliminary results of Trauma Informed Teamwork on critical incidents and coercive measures
Lucas Schalk, Psychiatrist, Fivoor, Netherlands

11.00 - 12.30 pm Room 2 - Symposium

Title: Peer support and its influence on coercion in different settings in the Netherlands and Germany

Can Peer Support Workers reduce coercion in psychiatry?
Jakov Gather, Researcher, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany

Trying to mediate between patient and team during a month long seperation
Russel Cummins, peer expert, GGZ inGeest, Netherlands

Don't fight the status, fight the consequences
Niek Regelink, Details will follow, Netherlands

11.00 - 12.30 pm Room 3 - Symposium

Title: Aggression towards oneself and others: crisis from an outpatient forensic perspective

The Dexamethasone Suppression Test as Biomarker for Suicidality: A Meta-Analysis
Drs. Pascalle Spaan, Student, Erasmus University - Rotterdam
Drs. Tessa Verrijp, Dr. Sabine J. Roza, Co-authors

Treating trauma in forensic youth with disruptive, impulse control and conduct disorders
Drs. A.J. Stierum, MD, child and adolescent psychiatrist, forensic FACT, Fivoor Rotterdam

A case-study on philosophical interviewing in addition to treatment of a severely revengeful ASD-patient
Dr. Rosalind van der Lem, Psychiatrist, Fivoor Rotterdam & Dordrecht Outpatient Center, Netherlands
Drs. Jan Flameling, Co-author

Risk assessment and management in threatening persons with confused behaviour
Dr. Sabine J. Roza, Details will follow
Drs. Teun van den Brink, drs. Tanya van Neerbos, dr. Frank van Riet, Co-authors

11.00 - 12.30 pm Room 4 - Workshop

Effective interactions with patients and familymembers
J. Boogaarts, Nurse, Bureau de Mat, Netherlands

11.00 - 12.30 pm Room 5 - Workshop

Dialectical behavioral therapy (DBT), an effectively proven treatment method adapted program for youth
Jacomijn Jacobs, Psychologist, Karakter centre for child psychiatry, Netherlands
Ursula Witteveen, Co-speaker

11.00 - 12.30 pm Room 11 - Workshop

Blind Spot
Jeanet Nieuwenhuis, Psychiatrist VGGNet, Netherlands

11.00 - 11.30 am Room 7 - Oral presentation Chair: Margret Overdijk

A state-wide case register for coercive measures in a federal state of Germany
Erich Flammer, Psychologist, Ulm University, Department of Psychiatry and Psychotherapy I, Center for Psychiatry Suedwuerttemberg, Germany
Tilman Steinert, Co-author

11.00 - 11.30 am Room 8 - Oral presentation Chair: L. van Melle

Youth in Psychiatric Emergency Services in the Netherlands: Factors associated with (in)voluntary admission
Pety So, Psychiatrist, Lucertis, Netherlands

11.30 - 12.00 pm Room 7 - Oral presentation Chair: Margret Overdijk

Is the attempted suicide short intervention program (ASSIP) justified and applicable in an IHT setting
Olivier Bollen, Psychiatrist, Reling, Belgium
An Minnart, Co-author

11.30 - 12.00 pm Room 8 - Oral presentation Chair: L. van Melle

The clinical utility of evidence based risk evaluation combined with de-escalation interventions in emergency psychiatry
Dr. Roland van de Sande, HU University of Applied Sciences, Utrecht

12.00 - 12.30 pm Room 7 - Oral presentation Chair: Margret Overdijk

Great inspiration from Near-Death Experiences (NDE's) for quality of Life
Sabine van den Bulk, Social Worker, Practice Sabine van den Bulk, Netherlands
Bob Coppes, Co-author

12.00 - 12.30 pm Room 8 - Oral presentation Chair: L. van Melle

How to handle extremely violent patients on a psychiatric ward
Farah Hussain, Psychiatrist, Parnassiagroep, Netherlands
N. Mulder, Co-author

11.00 - 12.30 pm Room 6 - mini-symposium, Nederlandse Track

Netwerkpsychiatrie HIC en IHT
Yolande Voskes, Phd, Assistant professor at VU University medical centre - Netherlands
Prof. Niels Mulder, MD, PhD, President of the EAOF, Department of Psychiatry, Erasmus MC, Rotterdam - The Netherlands

11.00 - 11.30 pm Room 9 - Oral Presentation, Nederlandse Track Chair: M. Scholten

Suicidepreventie project NS
Laura Boelsma , Programmamedewerker suicidepreventie & afhandeling at Nederlandse Spoorwegen - Netherlands
Alexander Scholz, programmamanager suïcidepreventie, afhandeling en nazorg bij ProRail

11.30 - 12.00 pm Room 9 - Oral presentation, Nederlandse Track Chair: M. Scholten

Dwang in de inrichting in de eerste helft van de twintigste eeuw
Prof. dr. Joost Vijselaar, Netherlands

11.00 - 12.30 pm Room 10 - mini-symposium, Nederlandse Track

Zero Suicide: Lunacy or lift-off?
Dr. Gerdien Franx , Program manager National Agenda Suicide prevention, 113 Suicide Prevention, Supranet, Netherlands
Anke Wammes, Manager communication at 113 Suicide Prevention, Netherlands

12.30 - 1.30 pm Lunch with poster presentations

1.30 - 3.00 pm Parallel sessions (with parallel session in Dutch)

1.30 - 3.00 pm Room 1 - Symposium

Title: Emergency psychiatry: a place for innovation

It's him again! Pilot psychiatric evaluation of disturbed suspects in Amsterdam.
E.P.K. Sikkens, MD, Psychiatrist, Spoedeisende Psychiatrie Amsterdam, Arkin, Netherlands
J. Zoeteman, S. van Luik, M. van Oudenaerden, Co-authors

The initiative of psychiatric emergency ambulance transportation in Amsterdam
Hans van de Moosdijk, Community Psychiatric Nurse

Handling dilemmas that come with conducting a Randomised Controlled Trail within an emergency psychiatry setting
Ansam Barakat, MSc., PhD Candidate, Arkin, Netherlands
Jurgen Cornelis, Dr. Matthijs Blankers, Prof. dr. Aartjan Beekman, Prof. dr. Jack Dekker, Co-authors

Intensive Home Treatment: The first baseline results of a multicentre randomised controlled trial
Jurgen Cornelis, MD, Psychiatrist, Spoedeisende Psychiatrie Amsterdam, Arkin, Netherlands
Ansam Barakat, Dr. Matthijs Blankers, Prof. dr. Aartjan Beekman, Prof. dr. Jack Dekker, Co-authors

1.30 - 3.00 pm Room 2 - Symposium

Title: Community Treatment Orders; their use and attitudes in the UK, The Netherlands, and Norway

Community Compulsion in the UK- evidence, current situation, and ongoing controversies
Andrew Molodynski, Psychiatrist, Oxford Health NHSFT and Oxford University, United Kingdom

Community Treatment Orders in Norway: What we know and what we need to know
Jorun Rugkasa, Scientist, Akershus University Hospital, Norway

Compulsory Treatment in the Community: what do Dutch mental healthcare workers think?
Dieuwertje de Waardt, Psychiatrist, Vincent van Gogh
F.M.M.A. van der Heijden, Co-author

1.30 - 3.00 pm Room 3 - Workshop

De-Escaltion is more than an intervention!
Minco Ruiter, Social Worker, Inforsa, Arkin, Netherlands
Petra Schaftenaar, Scientist, Inforsa, Netherlands

1.30 - 3.00 pm Room 4 - Workshop

How to optimize patient influence during involuntary admission
Martijn Kemper, Social Worker, GGZ inGeest, Netherlands
Niek Regelink, Co-speaker

1.30 - 3.00 pm Room 5 - Workshop

A missing link in aggression prevention: joining the level of emotional development
B. Stringer, Nurse, Centre for Consultation and Expertise, Netherlands
A. Lens-van Rijn, Co-speaker

1.30 - 3.00 pm Room 6 - Workshop

Crisis prevention and treatment in personality disorder
Ellen Willemsen, Psychiatrist, Dutch Centre of Expertise on Personality Disorders , Netherlands
Joost Hutsebaut, Co-speaker

1.30 - 3.00 pm Room 9 - Workshop

Ethical dilemma's in nursing: self harm and chronic suicidality
Shuna Vanner, Nurse, GGZ Noord Holland Noord , Netherlands
Denise Rigters, Anouk de Jonge, Co-speakers

1.30 - 2.00 pm Room 7 - Oral presentation Chair: Berno van Meijel

Boundaries in the treatment relation during home based crisis intervention
Pieter Goedeme, Nurse, Ziekenhuis Netwerk Antwerpen, Mobiel Crisisteam Antwerpen, Belgium
Jan Van Hecke, Co-author

2.00 - 2.30 pm Room 7 - Oral presentation Chair: Berno van Meijel

The relationship between ethnicity, trauma, coping and prognosis in patients with a psychotic disorder
Ayuk Bakia, Scientist, Erasmus MC Rotterdam, Netherlands
Bernice van Aken, Co-author

1.30 - 2.00 pm Room 8 - Oral presentation Chair: Yolande Voskes

Outpatient Commitment in spite of Community Treatment Orders (CTO) Controversy
Neels Ehlers, Scientist, Addictions and Mental Health, Alberta Health Services, Canada

2.00 - 2.30 pm Room 8 - Oral presentation Chair: Yolande Voskes

Ambulatory coercion: a step forwards or backwards in reducing coercion?
Laura van Melle, Scientist, VU University Medical Center, Netherlands
Yolande Voskes, Guy Widdershoven, Co-authors

2.30 - 3.00 pm Room 7 - Oral presentation Chair: Berno van Meijel

Clinical implementation of the High and Intensive Care model reduces seclusion to almost zero (-99.98%)
Astrid Dirks, Psychiatrist, GGZ Breburg, Netherlands

2.30 - 3.00 pm Room 8 - Oral presentation Chair: Yolande Voskes

"I want to get out!": My experiences with coercion, psychosis and depression
May-May Meijer, Consumer, Netherlands

1.30 - 3.00 pm Room 10 - mini-Symposium, Nederlandse Track

Wet Verplichte GGZ
Heleen Schaffels, Psychiater GGZ inGeest - Netherlands

3.00 - 3.30 pm Tea break

3.30 - 4.00 pm
Chair: Berno van Meijel
Key Note Session- Prevention of crisis in youth mental health care
Prof. Robert Vermeiren, MD, PhD   Professor of child and adolescent psychiatry, Leiden University Medical Center
Medical managing director of the child psychiatric clinic Curium-LUMC
Professor of Forensic Child and Adolescent Psychiatry, Section of Child Psychiatry, VU University medical center, Amsterdam
Member to the board of the dutch knowledge center of Child and Adolescent Psychiatry
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Prevention of crisis in youth mental health care

During adolescence, major mental disorders often have their onset. Because adolescence is characterised by developmental immaturity, individual characteristics complicate interaction when they need professional help. As a result, the likelihood of acting out as well as self-destructive behaviour is substantially higher. This poses particular challenges for professionals dealing with these kids. Professionals who, only because they are adults, are more likely to be seen as stupid and thus unfit to help them. For those and many other reasons, handling adolescents in crisis is a challenge. In this lecture, it will be explained how a collaboration between child psychiatric institutes in the Netherlands work together for optimizing how to reach out to adolescents in crisis, in order to reduce restriction, in particular separation, to an absolute minimum.

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4.00 - 4.30 pm
Chair: Berno van Meijel
Key Note Session-Trauma informed treatment
Brian Sims, MD   Senior Director, Medical and Behavioral Health, National Association of State Mental Health Program Directors Consultant, NASMHPD Center for Innovation in Trauma Informed Approaches
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Influencing Outcomes with Trauma Informed Treatment - A Baltimore Experience - Healing IN Communities

This session entitled 'Influencing Outcomes through Trauma Informed Treatment - A Baltimore Experience' -' Healing IN Communities', will focus on strategies utilized by SAMHSA's National Center for Trauma Informed Care in cooperation with the city of Baltimore, Maryland with resultant healing in communities and agencies there intended to promote healing and recovery. At the time of our initial entry into Baltimore, there was significant violence with Baltimore reaching in one year the highest number of homicides in its history. Our goal upon entry was to assist the city in its healing process; a process involving the understanding and addressing of the high prevalence of trauma interwoven in the communities. Add to this extensive Historical trauma, and the city was suffering, with no significant channel to relieve the agony or processes to address the pervasive traumas. In implementing trauma informed strategies, the attempt was to assist a city in crisis, stressing healing and subsequent beginnings of recovery. As the city sought emotional healing, it as well sought physical healing. The Adverse Childhood Experiences study will be discussed, to show the correlations of adverse experiences, many of which occurred in childhood and some even before the child had formed language to express, and how these experiences have profound emotional and physiological consequences, stressing the need for early intervention in treatment. This led to a broad range of trainings in the city, totaling to date some 78 agencies and over 2600 people.

With this collaborative, people all over Baltimore have been receiving assistance and education on strategies to not only help others but to help themselves. The key to successful and sustained effects, is to embrace prevention. This discussion promotes the addressing of trauma on both ends of the spectrum. Examples from the efforts within the city, with creation of unique, community- oriented programs will be discussed with the goals there of producing long- lasting outcomes. Concepts that promote healing; communicating effectively; embracing the premise of 'It's not what's wrong with you, but what happened to you' have become the mantra. With active collaboration, we have attempted to help individuals of all levels of expertise to understand that 'you do not have to be a therapist to be therapeutic'. Many communities and agencies have begun to emerge with strength, healing and resilience. While still a work in progress, the response from the City has displayed an overwhelming desire to heal.

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4.30 - 5.00 pm
Closing ceremony

5.00 pm
Drinks

Time/Location	Program Content
5.00 - 5.45 pm	Registration with Coffee/Tea
5.45 - 6.15 pm	Introduction: Zero strategies in mental health: delusion or reality? Steve Miccio - Chief Executive Officer for PEOPLe Inc (USA)
6.15 - 7.15 pm	Buffet
7.15 - 7.35 pm	Presentation: Zero Coercion: fairy taill or truth? Yolande Voskes, Phd - Assistant professor at VU University medical centre and senior researcher at mental health institute GGZ Breburg, The Netherlands
7.40 - 8.00 pm	Presentation: The suicide prevention action networks: optimizing support and care so that no one in our communities dies by suicide Dr. Gerdien Franx - Program manager National Agenda Suicide prevention, 113 Suicide Prevention, Supranet, The Netherlands
8.05 - 8.25 pm	Presentation: Zero beds in Utopia Marijke van Putten, MD - Psychiatrist and CEO of Mental Health Institute (MHI) Noord Holland Noord (NHN), The Netherlands
8.30 - 9.00 pm	Discussion
9.00 - 9.15 pm	Closing Pre-conference Prof. Niels Mulder, MD, PhD - President of the EAOF, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands

Time/Location	Program Content
7.30 - 9.00 am	Registration
9.00 - 9.15 am	Welcome by the chair of the program committee prof. Niels Mulder, MD, PhD
9.15 - 9.30 am	Official opening of the First International Conference on Crisis, Coercion and Intensive Treatment in Psychiatry Drs. Marjan ter Avest Director MIND
9.30 - 10.00 am chair: Niels Mulder	Key Note Session- Expertise by experience, peer support in crisis situations Steve Miccio Chief Executive Officer for PEOPLe Inc (USA) read more Peer Services Exploding the Myth about Crises The discussion will focus on the efficacy of peer operated services in the crisis world. I will discuss the formula that has made addressing crisis care more trauma informed, safe, engaging and driven to assist people in changing their perceptions concerning crisis. The discussion will be a story of how personal crisis has lent to the design of crisis respites and peer driven mobile crisis services as well as the partnered development of a crisis stabilization service that incorporates peers, traditional providers and local law enforcement. Innovative services that support and promote a healing approach to moving beyond crisis toward wellness will be shared from the perspective of the emergency hospital visit and stay to safe transition back to community. Close
10.00 - 10.30 am chair: Niels Mulder	Key Note Session- Towards human rights compliant alternatives to coercion - a European perspective Claudia Marinetti, PhD Director Mental Health Europe read more Towards Human Rights compliant alternatives to coercion - a European perspective This presentation will give an overview of the European and International legal framework in relation to coercion in psychiatric care and the possibilities to implement alternatives to it. Specific forms of substituted decision-making are disproportionately applied to persons with mental health problems across Europe. Those include forced placement in psychiatric units and hospitals, and forced treatment. The United Nations Convention on the Rights of Persons with Disabilities, adopted in 2006 and ratified by all EU Member States and by the EU itself, includes the right to legal capacity and to supported decision-making. From a human rights perspective, legal capacity - the right to make choices and be recognised before the law - is the key to ensuring autonomy and inclusion for a person and is a necessity for moving from coercion towards human rights compliant alternatives. Desite this, mental health laws, as well as other public health laws, across Europe also contain forms of substituted decision-making which are applied to persons with mental ill health in order to allow them to be placed in psychiatric care and to be treated against their explicit will. Also, the prevalence of the biomedical approach to mental health has led to a situation where it is the norm, rather than the exception, in many psychiatric care settings to compel persons with mental ull heakth to take a treatment and in some countries they can also be required to take treatment while living in the community. However, forced treatments and placements in hospitals should be avoided unless absolutely necessary. There are effective alternatives (Open Dialogue, Soteria, Trieste Model and more) which can help to reduce the use of hospitalisation, both forced and voluntary, and forced treatment by helping to maintain the right of persons with psychosocial disabilities to make their own choices with the help of therapeutic support networks. Alternatives to coercion exist, and in this presentation a few of those will be presented and discussed. Close
10.30 - 11.00 am	Coffee break
11.00 - 12.30 pm	Parallel sessions (with parallel session in Dutch)
	11.00 - 12.30 pm Room 1 - Symposium Title: You will get better at home Overview of the developments in finance and organisation of the Dutch acute mental health services Jeroen Traas, Policy Maker, Dimence, Netherlands Intensive Home Treatment in the Netherlands Elnathan Prinsen, Psychiatrist & manager of the division of crisis mental health services, Dimence, Netherlands General use of theoretical models of family therapy in the organisation of emergency psychiatry Guido Ruijgrok, Psychiatrist & teamleader of the Intensive Home Treatment team in Almelo, Dimence, Netherlands 11.00 - 12.30 pm Room 2 - Symposium Title: A view on the organization of emergency, crisis and intensive care psychiatry in Belgian contexts Emergency psychiatry in a Belgian context: historical, organizational and medical perspectives. Jurgen De Fruyt, Psychiatrist, AZ Sint-Jan Brugge-Oostende AV, Belgium Koen Titeca, Ronny Bruffaerts, Co-authors Evolution of involuntary admission from the emergency room from an academic hospital in Belgium, 1998-2017 Ronny Bruffaerts, Details will follow Jeroen Decoster, Joris Vandenberghe, Marc Sabbe, Koen Demyttenaere, Co-authors Medical clearance of psychiatric patients presenting to the emergency service Sylvie Vanstechelman, Psychiatrist, AZ Sint-Jan Brugge Jurgen De Fruyt, Koen Titeca, Gilbert Lemmens, Co-authors From the psychiatric emergency service to the psychiatric intensive care unit. Hella Demunter, Psychiatrist, UPC KU Leuven, Belgium Chris Bervoets, Ronny Bruffaerts, Joris Vandenberghe, Ruud van Winkel, Co-authors 11.00 - 12.30 pm Room 3 - Symposium Title: Coercion in psychiatry: legal and clinical developments and current ethical challenges The Bochum SALUS project - The ethics of coercion: Striking a balance between autonomy, well-being and security in psychiatric practice Jakov Gather, Researcher, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany A conceptual framework for evaluating informal coercion in psychiatry Matthe Scholten, Scientist, Ruhr University Bochum, Germany Effects of open-door policies in acute psychiatry on coercion, absconding and serious incidents Simone Efkemann, Researcher, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany Aggressive incidents by legally committed patients in acute psychiatric hospitals with open door policies. A mixed methods study Janice Kalagi, Researcher, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany
	11.00 - 12.30 pm Room 4 - Workshop The art of enduring: a non-judging, systemic approach to suicidal behaviour F.J. van Oenen MD PhD, family therapist, Arkin Jeugd en Gezin, Netherlands J. Cornelis MD, Psychiatrist, Spoedeisende Psychiatrie Amsterdam, Arkin, Netherlands 11.00 - 12.30 pm Room 5 - Workshop Interventions to improve clinical outcomes of involuntary hospital treatment Domenico Giacco, Psychiatrist, Unit for Social and Community Psychiatry - Queen Mary University of London, United Kingdom Stefan Priebe, Maev Conneely, Erin Burn, Co-speakers 11.00 - 12.30 pm Room 6 - Workshop Non-violence resistance (NVR) on an acute psychiatric ward for children and adolescents E. Miedema, Psychiatrist, GGZ Noord Holland Noord, Netherlands 11.00 - 12.30 pm Room 7 - Workshop Preventing crisis in Trieste (Italy) and Utrecht (The Netherlands):what can we learn from each other? Christien Muusse, Scientist, Trimbos-instituut , Netherlands Sanne Wullems, Co-speakers
	11.00 - 11.30 am Room 8 - Oral presentation Chair: Jan Berndsen Course of dangerousness after court ordered compulsory psychiatric admissions: a prospective observational cohort study Mark H. de Jong, Psychiatrist, Yulius Mental Health, Netherlands Andre L. Wiedsma, Arthur E, Van Gool, Cornelis L. Mulder, Co-authors 11.00 - 11.30 am Room 9 - Oral presentation Chair: Niels Mulder Psychiatric Ambulance: A New Feature in Psychiatric Emergency Care. 7 years on the road Frode Bremseth, Nurse, Stavanger University Hospital, Norway Kjetil Hustoft, Co-author 11.30 - 12.00 am Room 8 - Oral presentation Chair: Jan Berndsen Involuntary hospital admission from the street - does it do any good? Dr Philip Timms, Psychiatrist, South London & Maudsley NHS Foundation Trust, United Kingdom Dr Jennifer Perry, Co-author 11.30 - 12.00 am Room 9 - Oral presentation Chair: Niels Mulder Development of smart inpatient rooms using automation and preventing using restraints in suicidal patients Remco F.P. de Winter, Psychiatrist, Parnassia Psychiatric institute, Netherlands Wouter S. van Maanen, Arlette S. van Amerongen, Co-authors 12.00 - 12.30 pm Room 8 - Oral presentation Chair: Jan Berndsen Voluntary or involuntary acute psychiatric hospitalization in Norway: A 24 hours follow up study Kjetil Hustoft, Psychiatrist, Stavanger University Hospital, Depertmanet of adult psychiatry, Norway 12.00 - 12.30 pm Room 9 - Oral presentation Chair: Niels Mulder Crisis lines and treatment at 113 Judith de Heus, Psychologist, 113 Suicide Prevention, Netherlands
	11.00 - 12.30 pm Room 10 - mini-symposium, Nederlandse Track Terug dringen van dwang en drang, zowel in klinische setting als ambulant Harry Gras, Policy maker, Lister, Netherlands 11.00 - 12.30 pm Room 11 - mini-symposium, Nederlandse Track Forensische High & Intensive Care: Hoe implementeer je dit model in de praktijk Angelique Moonen, projectmanager FHIC de Rooyse Wissel Lianne Toonen, afdelingsmanager, de Rooyse Wissel
12.30 - 1.30 pm	Lunch with poster presentations
1.30 - 3.00 pm	Parallel sessions (with parallel session in Dutch)
	1.30 - 3.00 pm Room 1 - Symposium Title: Suicide Prevention Action Networks in the Netherlands Implementation and evaluation of the Suicide Prevention Action Network (SUPRANET) Community in six Dutch regions. Meike Baretta, PhD student, Netherlands Renske Gilissen, Co-author Effectiveness of the SUPRANET community program on general practitioners Elke Elzinga, PhD student, 113 Suicide Prevention, Netherlands Renske Gilissen, Co-author Feasibility and impact of data-driven learning within the Dutch suicide prevention action network (SUPRANET Care). Kim Setkowski, PhD student, 113 Suicide Prevention, Netherlands Renske Gilissen, Co-author 1.30 - 3.00 pm Room 2 - Symposium Title: Crisis management in adults with autisme spectrum disorders When a crisis is no crisis; the many faces of autism spectrum disorders (ASD) Bram Sizoo, Psychiatrist, Dimence, Center for Devenlopmental Disorders, Netherlands Intensive Specialized Autism Care Study (ISAC study): precipitating and recovery processes; preliminary results Hendrikje Bloemert, Dimence, Netherlands Prof. B. van Meijel, Dr. B.B. Sizoo & Dr. E.W.M. Verhoeven, Co-authors Treatment of trauma in individuals with autism spectrum disorders (ASD) in crisis Ella Lobregt-van Buuren, Dimence, Netherlands Bram Sizoo, Liesbeth Mevissen and Ad De Jongh, Co-authors 1.30 - 3.00 pm Room 3 - Symposium Title: Child and adolescent mental health and crisis intervention reform in Belgium Child and adolescent mental health reform in Belgium: the general phramework Veerle Umans, networkcoördinator, Ligant, Belgium /i> Ann Van der Speeten, Co-author Organization of crisis intervention programs Eric Schoentjes, Psychiatrist, Ghent University Hospital, Belgium Home based crisis intervention in child and adolescent mental health care Cedric Kemseke, Networkcoördinator, WINGG Youth Mental Health Network, Belgium Annelies Kog, Co-author Implementation of innovative strategies in Belgian child and adolescent crisis intervention programs Marina Danckaerts, Psychiatrist, UPC KU Leuven, Belgium Toon Langeraert, Co-author
	1.30 - 3.00 pm Room 4 - Workshop Case discussion making use of the Agression signal guide and the Safewards model Saskia van Duin, Nurse, GGZ Noord Holland Noord, Netherlands Shuna Vanner, Co-speaker 1.30 - 3.00 pm Room 5 - Workshop Intensive Treatment Centre for youth: rationale and development Pierre C.M. Herpers, Psychiatrist, Karakter, Netherlands
	1.30 - 2.00 pm Room 7 - Oral presentation Chair: Margret Overdijk Can we constraint somebody to health? Coercion and meaning Jacques Quintin, Scientist, University of Sherbrooke, Canada 1.30 - 2.00 pm Room 8 - Oral presentation Chair: Marijke van Putten Exclusion by seclusion - Influence of nurses on aggression and the decision to use seclusion Paul Doedens, Nurse, Academic Medical Center, Netherlands Corine Latour, Lindy-Lou Boyette, Lieuwe de Haan, Co-authors 1.30 - 2.00 pm Room 9 - Oral presentation Chair: Jan Berndsen An unusual chapter Images of living at a forensic psychiatric ward, based on relational care Petra Schaftenaar, Scientist, Inforsa, Netherlands 1.30 - 2.00 pm Room 11 - Oral presentation Chair: Berno van Meijel Exploring construct validity of clinical staging in schizophrenia spectrum disorders in an acute psychiatric ward Steven Berendsen, doctor in training to be a psychiatrist, Arkin, Netherlands Hans J. Nusselder, Psychiatrist, Arkin, Netherlands J. van der Paardt, Psychiatrist, Arkin, Co-author 2.00 - 2.30 pm Room 7 - Oral presentation Chair: Margret Overdijk Taking a risk; searching for a dignified form of living for people with complex problems Harry Gras, Policy maker, Lister, Netherlands Gerry Cornelissen, Co-author 2.00 - 2.30 pm Room 8 - Oral presentation Chair: Marijke van Putten The personal in the professional in Mental Health Care - ethical and methodological considerations Kjetil Moen, Scientist, Stavanger University Hospital, Norway 2.00 - 2.30 pm Room 9 - Oral presentation Chair: Jan Berndsen International Comparison of the Opinion regarding Forensic Mental Health between the US, UK and Japan Akihiro Shiina, Psychiatrist, Chiba University Center for Forensic Mental Health, Japan 2.00 - 2.30 pm Room 11 - Oral presentation Chair: Berno van Meijel Dutch development of intensive care - current and past findings in an international context Eric Noorthoorn, Researcher, GGNet, Netherlands 2.30 - 3.00 pm Room 7 - Oral presentation Chair: Margret Overdijk Active Recovery Triad: zero permanent residents in long term mental health care Lieke Zomer, Scientist, VUmc, Netherlands Yolande Voskes, Lisette van der Meer, Jaap van Weeghel, Co-authors 2.30 - 3.00 pm Room 8 - Oral presentation Chair: Marijke van Putten Patients reflections on their experience of power and coercion in psychiatry: a qualitative study Evi Verbeke, Psychologist, Ghent University, Belgium Stijn Vanheule, Joachim Cauwe, Femke Truijens, Co-authors 2.30 - 3.00 pm Room 9 - Oral presentation Chair: Jan Berndsen Forensic High & Intensive Care; a model to intensify forensic psychiatric care in crisis Sylvia Gerritsen, Scientist, VU Medical Center, Netherlands Petra de Leede, Yolande Voskes, Guy Widdershoven, Co-authors
	1.30 - 3.00 pm Room 10 - mini symposium, Nederlandse Track Verandert een brede blik de kijk op de client en zijn omgeving? Justine Theunissen, CCE (Centrum voor Consultatie en Expertise) Tom van Son, CCE (Centrum voor Consultatie en Expertise)
3.00 - 3.30 pm	Tea break
3.30 - 4.00 pm Chair: Marijke van Putten	Key Note Session- Coercive measures and prevention of seclusion and restraint in Europe Andrew Molodynski, MBChB Consultant Psychiatrist, Oxford Health NHS Foundation Trust. Honorary Senior Clinical Lecturer, Oxford University read more Coercion in Mental Health Care- International Perspectives The balance between individual choice and provision of treatment and care without consent has been at the heart of mental health care from the very beginning of facilities and treatments being available. In some ways the issues have not changed, but the way in which we think about them and in which they affect people undoubtedly have. The issue has never had a higher profile, as evidenced by reviews of mental health law in many countries, the service user movement, and the UN CRPD. The issues are undoubtedly complex and there are significant variations in coercive practices around the world, and even within regions and countries. Even within contained health systems there can be substantial variations. This presentation draws on information gathered over several years by Andrew and colleagues while researching in the field and will provide an overview of coercive practices in different regions of the world, the evidence for effectiveness or ineffectiveness, and some of the key themes we can draw out. It will finish by looking to the future for coercive interventions, and where we might be going. Close
4.00 - 4.30 pm Chair: Marijke van Putten	Key Note Session- Intensive treatment in clinical settings, prevention of seclusion and restraint Yolande Voskes, Phd Assistant professor at VU University medical centre and senior researcher at mental health institute GGZ Breburg read more Intensive treatment in clinical settings, prevention of seclusion and restraint Locking a psychiatric patient in a seclusion room is a controversial practice in the Netherlands, as well as in other countries in and outside of Europe. Seclusion is a traumatic and emotional experience that has a major impact on patients with psychiatric symptoms. In recent years, mental healthcare institutions in the Netherlands started projects to reduce seclusion. These projects have resulted in improvements in mental health care and a decline in number and duration of seclusions. However, psychiatric patients are still secluded. To achieve a further reduction of seclusion and to reduce also the number of beds in mental health care institutions, a group of professionals started the development of High and Intensive Care (HIC) in mental health care. Previous research on the reduction of seclusion in the Netherlands, evidence based practices, experience based practices and consensus meetings with all stakeholders (patients, peer providers, family, nurses, psychiatrists, managers and researchers) were the basis of this new model on mental health care in the Netherlands. The HIC-model focusses on restoring and maintaining contact, crisis prevention and stepped care. It requires close collaboration with relatives and with the ambulatory teams. In order to measure the implementation of the HIC-model, the HIC-monitor has been developed. The HIC monitor is a model fidelity scale and contains of 65 items on eleven subscales to be rated using a 5-point Likert scale, in ascending order of "not implemented" to "fully implemented" At the moment all large mental health care institutions are implementing this model. A national study is done to get more insight into the implementations and the effects of HIC on coercive measures and quality of care. This keynote presents the High and Intensive Care model and will pay attention to the results of the national study on HIC. Close
5.00 pm	Reception at the City Town Hall / meeting Rotterdam City Council

Timings	Event
9.00 - 9.15 am	Introduction to the program of day 2
9.15 - 10.00 am Chair: Margret Overdijk	Key Note Session- Research, evidence, and practice of coercive treatment - what is the link? Prof. Stefan Priebe Professor of Social and Community Psychiatry at Queen Mary University of London, UK read more Research, evidence, and practice of coercive treatment - what is the link? Coercive treatment has practically always been part of practice in mental health care, although the societal context, legal basis, and forms of coercion have changed fundamentally over the last 250 years. During the same period, psychiatry has become an academic discipline involving medicine and other sciences. Scientific disciplines commonly have the aspiration to advance through research and be evidence-based in their practice. The presentation will show the main research methods that have been applied to understand coercive treatments and their effects, summarise the existing evidence that the research has produced and explore in which way, if any, the evidence has influenced practice. It will be argued that the wide spread practice and importance of coercive treatment has hardly driven an extensive research agenda in psychiatry, and only a few aspects of coercive treatments have been studied with rigorous methods. When the studies yielded negative findings, in particular about the benefits of coercive treatment in the community, there has been a limited impact on practice. Whilst the direct links between research, evidence, and practice of coercion in psychiatry may be seen as weak, there might be more indirect links that help to maintain and shape current practice of coercion. Direct and indirect links - also considering so-called informal forms of coercion - and potential future scenarios for how coercive practice might be guided by evidence (or not) will be discussed. Close
10.00 - 10.30 am Chair: Margret Overdijk	Key Note Session- The Zero Suicide Journey Dr. Gerdien Franx Program manager National Agenda Suicide prevention, 113 Suicide Prevention, Supranet, Netherlands read more The Zero Suicide Journey Suicide prevention is a major health care responsibility in desperate need of new perspectives. Despite decades of research and considerable investments in health care services little progress has been made in reducing morbidity and mortality due to suicidal behavior. US suicide rates show a 24% rise between 1999 and 2014.4 In the Netherlands the suicide rate has risen with 38% in eight years, returning in 2012-2015 to peak numbers of the 1980's.5 Over 40% of Dutch inhabitants who died by suicide received specialist mental health care. From successive major systematic reviews on suicide prevention strategies6,7 it becomes clear that progress is slow. The uptake by the field of guideline best practices and recommendations seems to be even slower8 with many workers lacking specific training to work with suicidal patients.9,10 Accepting this state of affairs implies that suicide will keep killing several hundreds of thousands humans every year worldwide in the next decades. This keynote presents Zero Suicide, a new approach to suicide prevention that is gaining momentum worldwide and aims for the pursuit of zero suicides in healthcare. Zero Suicide starts from the core value that no one should die alone and in despair by suicide, and from the conviction that suicide can be prevented. It is an integral, transformative approach that applies Safety and Quality Improvement principles developed in technological sectors (e.g. aviation, automotive, energy) and in somatic healthcare on the scale of entire (mental) health care systems or institutions. Core components are: 1) a safety culture with commitment to the goal of zero suicides, 2) continuous (data driven) improvement of care processes and routines, and 3) structural and reliable use of suicide specific interventions. These components are translated into well-defined organizational behaviors (to lead; to train; to identify, engage and treat; to transition and to improve) that all contribute to patient and staff safety. Zero Suicide's optimistic and ambitious approach contrasts with the attenuated and reserved stance commonly encountered among health care staff towards the preventability of suicides, and with a current reality of losing many patients to suicide. It is a B-HAG: a Big Hairy, Audacious Goal that may evoke anxiety among frontline workers. Therefore, the first steps on the journey towards Zero Suicide are the abandonment of blame after suicide and the creation a Just Culture in which professionals feel secure to learn and improve every day. Close
10.30 - 11.00 am	Coffee break
11.00 - 12.30 pm	Parallel sessions (with parallel session in Dutch)
	11.00 - 12.30 pm Room 1 - Symposium Title: Trauma Informed Teamwork in Clinical Psychiatry An introduction into Trauma Informed Teamwork: the Neurosequential Model of Therapeutics Tony Bloemendaal, Psychologist, Fivoor, Netherlands Implementing Trauma Informed Teamwork in a locked psychiatric ward Lucas Schalk, Psychiatrist, Fivoor, Netherlands Pascal Visser, Lotte Newbold, Taco Coenders, Co-authors Preliminary results of Trauma Informed Teamwork on critical incidents and coercive measures Lucas Schalk, Psychiatrist, Fivoor, Netherlands 11.00 - 12.30 pm Room 2 - Symposium Title: Peer support and its influence on coercion in different settings in the Netherlands and Germany Can Peer Support Workers reduce coercion in psychiatry? Jakov Gather, Researcher, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany Trying to mediate between patient and team during a month long seperation Russel Cummins, peer expert, GGZ inGeest, Netherlands Don't fight the status, fight the consequences Niek Regelink, Details will follow, Netherlands 11.00 - 12.30 pm Room 3 - Symposium Title: Aggression towards oneself and others: crisis from an outpatient forensic perspective The Dexamethasone Suppression Test as Biomarker for Suicidality: A Meta-Analysis Drs. Pascalle Spaan, Student, Erasmus University - Rotterdam Drs. Tessa Verrijp, Dr. Sabine J. Roza, Co-authors Treating trauma in forensic youth with disruptive, impulse control and conduct disorders Drs. A.J. Stierum, MD, child and adolescent psychiatrist, forensic FACT, Fivoor Rotterdam A case-study on philosophical interviewing in addition to treatment of a severely revengeful ASD-patient Dr. Rosalind van der Lem, Psychiatrist, Fivoor Rotterdam & Dordrecht Outpatient Center, Netherlands Drs. Jan Flameling, Co-author Risk assessment and management in threatening persons with confused behaviour Dr. Sabine J. Roza, Details will follow Drs. Teun van den Brink, drs. Tanya van Neerbos, dr. Frank van Riet, Co-authors
	11.00 - 12.30 pm Room 4 - Workshop Effective interactions with patients and familymembers J. Boogaarts, Nurse, Bureau de Mat, Netherlands 11.00 - 12.30 pm Room 5 - Workshop Dialectical behavioral therapy (DBT), an effectively proven treatment method adapted program for youth Jacomijn Jacobs, Psychologist, Karakter centre for child psychiatry, Netherlands Ursula Witteveen, Co-speaker 11.00 - 12.30 pm Room 11 - Workshop Blind Spot Jeanet Nieuwenhuis, Psychiatrist VGGNet, Netherlands
	11.00 - 11.30 am Room 7 - Oral presentation Chair: Margret Overdijk A state-wide case register for coercive measures in a federal state of Germany Erich Flammer, Psychologist, Ulm University, Department of Psychiatry and Psychotherapy I, Center for Psychiatry Suedwuerttemberg, Germany Tilman Steinert, Co-author 11.00 - 11.30 am Room 8 - Oral presentation Chair: L. van Melle Youth in Psychiatric Emergency Services in the Netherlands: Factors associated with (in)voluntary admission Pety So, Psychiatrist, Lucertis, Netherlands 11.30 - 12.00 pm Room 7 - Oral presentation Chair: Margret Overdijk Is the attempted suicide short intervention program (ASSIP) justified and applicable in an IHT setting Olivier Bollen, Psychiatrist, Reling, Belgium An Minnart, Co-author 11.30 - 12.00 pm Room 8 - Oral presentation Chair: L. van Melle The clinical utility of evidence based risk evaluation combined with de-escalation interventions in emergency psychiatry Dr. Roland van de Sande, HU University of Applied Sciences, Utrecht 12.00 - 12.30 pm Room 7 - Oral presentation Chair: Margret Overdijk Great inspiration from Near-Death Experiences (NDE's) for quality of Life Sabine van den Bulk, Social Worker, Practice Sabine van den Bulk, Netherlands Bob Coppes, Co-author 12.00 - 12.30 pm Room 8 - Oral presentation Chair: L. van Melle How to handle extremely violent patients on a psychiatric ward Farah Hussain, Psychiatrist, Parnassiagroep, Netherlands N. Mulder, Co-author
	11.00 - 12.30 pm Room 6 - mini-symposium, Nederlandse Track Netwerkpsychiatrie HIC en IHT Yolande Voskes, Phd, Assistant professor at VU University medical centre - Netherlands Prof. Niels Mulder, MD, PhD, President of the EAOF, Department of Psychiatry, Erasmus MC, Rotterdam - The Netherlands 11.00 - 11.30 pm Room 9 - Oral Presentation, Nederlandse Track Chair: M. Scholten Suicidepreventie project NS Laura Boelsma , Programmamedewerker suicidepreventie & afhandeling at Nederlandse Spoorwegen - Netherlands Alexander Scholz, programmamanager suïcidepreventie, afhandeling en nazorg bij ProRail 11.30 - 12.00 pm Room 9 - Oral presentation, Nederlandse Track Chair: M. Scholten Dwang in de inrichting in de eerste helft van de twintigste eeuw Prof. dr. Joost Vijselaar, Netherlands 11.00 - 12.30 pm Room 10 - mini-symposium, Nederlandse Track Zero Suicide: Lunacy or lift-off? Dr. Gerdien Franx , Program manager National Agenda Suicide prevention, 113 Suicide Prevention, Supranet, Netherlands Anke Wammes, Manager communication at 113 Suicide Prevention, Netherlands
12.30 - 1.30 pm	Lunch with poster presentations
1.30 - 3.00 pm	Parallel sessions (with parallel session in Dutch)
	1.30 - 3.00 pm Room 1 - Symposium Title: Emergency psychiatry: a place for innovation It's him again! Pilot psychiatric evaluation of disturbed suspects in Amsterdam. E.P.K. Sikkens, MD, Psychiatrist, Spoedeisende Psychiatrie Amsterdam, Arkin, Netherlands J. Zoeteman, S. van Luik, M. van Oudenaerden, Co-authors The initiative of psychiatric emergency ambulance transportation in Amsterdam Hans van de Moosdijk, Community Psychiatric Nurse Handling dilemmas that come with conducting a Randomised Controlled Trail within an emergency psychiatry setting Ansam Barakat, MSc., PhD Candidate, Arkin, Netherlands Jurgen Cornelis, Dr. Matthijs Blankers, Prof. dr. Aartjan Beekman, Prof. dr. Jack Dekker, Co-authors Intensive Home Treatment: The first baseline results of a multicentre randomised controlled trial Jurgen Cornelis, MD, Psychiatrist, Spoedeisende Psychiatrie Amsterdam, Arkin, Netherlands Ansam Barakat, Dr. Matthijs Blankers, Prof. dr. Aartjan Beekman, Prof. dr. Jack Dekker, Co-authors 1.30 - 3.00 pm Room 2 - Symposium Title: Community Treatment Orders; their use and attitudes in the UK, The Netherlands, and Norway Community Compulsion in the UK- evidence, current situation, and ongoing controversies Andrew Molodynski, Psychiatrist, Oxford Health NHSFT and Oxford University, United Kingdom Community Treatment Orders in Norway: What we know and what we need to know Jorun Rugkasa, Scientist, Akershus University Hospital, Norway Compulsory Treatment in the Community: what do Dutch mental healthcare workers think? Dieuwertje de Waardt, Psychiatrist, Vincent van Gogh F.M.M.A. van der Heijden, Co-author
	1.30 - 3.00 pm Room 3 - Workshop De-Escaltion is more than an intervention! Minco Ruiter, Social Worker, Inforsa, Arkin, Netherlands Petra Schaftenaar, Scientist, Inforsa, Netherlands 1.30 - 3.00 pm Room 4 - Workshop How to optimize patient influence during involuntary admission Martijn Kemper, Social Worker, GGZ inGeest, Netherlands Niek Regelink, Co-speaker 1.30 - 3.00 pm Room 5 - Workshop A missing link in aggression prevention: joining the level of emotional development B. Stringer, Nurse, Centre for Consultation and Expertise, Netherlands A. Lens-van Rijn, Co-speaker 1.30 - 3.00 pm Room 6 - Workshop Crisis prevention and treatment in personality disorder Ellen Willemsen, Psychiatrist, Dutch Centre of Expertise on Personality Disorders , Netherlands Joost Hutsebaut, Co-speaker 1.30 - 3.00 pm Room 9 - Workshop Ethical dilemma's in nursing: self harm and chronic suicidality Shuna Vanner, Nurse, GGZ Noord Holland Noord , Netherlands Denise Rigters, Anouk de Jonge, Co-speakers
	1.30 - 2.00 pm Room 7 - Oral presentation Chair: Berno van Meijel Boundaries in the treatment relation during home based crisis intervention Pieter Goedeme, Nurse, Ziekenhuis Netwerk Antwerpen, Mobiel Crisisteam Antwerpen, Belgium Jan Van Hecke, Co-author 2.00 - 2.30 pm Room 7 - Oral presentation Chair: Berno van Meijel The relationship between ethnicity, trauma, coping and prognosis in patients with a psychotic disorder Ayuk Bakia, Scientist, Erasmus MC Rotterdam, Netherlands Bernice van Aken, Co-author 1.30 - 2.00 pm Room 8 - Oral presentation Chair: Yolande Voskes Outpatient Commitment in spite of Community Treatment Orders (CTO) Controversy Neels Ehlers, Scientist, Addictions and Mental Health, Alberta Health Services, Canada 2.00 - 2.30 pm Room 8 - Oral presentation Chair: Yolande Voskes Ambulatory coercion: a step forwards or backwards in reducing coercion? Laura van Melle, Scientist, VU University Medical Center, Netherlands Yolande Voskes, Guy Widdershoven, Co-authors 2.30 - 3.00 pm Room 7 - Oral presentation Chair: Berno van Meijel Clinical implementation of the High and Intensive Care model reduces seclusion to almost zero (-99.98%) Astrid Dirks, Psychiatrist, GGZ Breburg, Netherlands 2.30 - 3.00 pm Room 8 - Oral presentation Chair: Yolande Voskes "I want to get out!": My experiences with coercion, psychosis and depression May-May Meijer, Consumer, Netherlands
	1.30 - 3.00 pm Room 10 - mini-Symposium, Nederlandse Track Wet Verplichte GGZ Heleen Schaffels, Psychiater GGZ inGeest - Netherlands
3.00 - 3.30 pm	Tea break
3.30 - 4.00 pm Chair: Berno van Meijel	Key Note Session- Prevention of crisis in youth mental health care Prof. Robert Vermeiren, MD, PhD Professor of child and adolescent psychiatry, Leiden University Medical Center Medical managing director of the child psychiatric clinic Curium-LUMC Professor of Forensic Child and Adolescent Psychiatry, Section of Child Psychiatry, VU University medical center, Amsterdam Member to the board of the dutch knowledge center of Child and Adolescent Psychiatry read more Prevention of crisis in youth mental health care During adolescence, major mental disorders often have their onset. Because adolescence is characterised by developmental immaturity, individual characteristics complicate interaction when they need professional help. As a result, the likelihood of acting out as well as self-destructive behaviour is substantially higher. This poses particular challenges for professionals dealing with these kids. Professionals who, only because they are adults, are more likely to be seen as stupid and thus unfit to help them. For those and many other reasons, handling adolescents in crisis is a challenge. In this lecture, it will be explained how a collaboration between child psychiatric institutes in the Netherlands work together for optimizing how to reach out to adolescents in crisis, in order to reduce restriction, in particular separation, to an absolute minimum. Close
4.00 - 4.30 pm Chair: Berno van Meijel	Key Note Session-Trauma informed treatment Brian Sims, MD Senior Director, Medical and Behavioral Health, National Association of State Mental Health Program Directors Consultant, NASMHPD Center for Innovation in Trauma Informed Approaches read more Influencing Outcomes with Trauma Informed Treatment - A Baltimore Experience - Healing IN Communities This session entitled 'Influencing Outcomes through Trauma Informed Treatment - A Baltimore Experience' -' Healing IN Communities', will focus on strategies utilized by SAMHSA's National Center for Trauma Informed Care in cooperation with the city of Baltimore, Maryland with resultant healing in communities and agencies there intended to promote healing and recovery. At the time of our initial entry into Baltimore, there was significant violence with Baltimore reaching in one year the highest number of homicides in its history. Our goal upon entry was to assist the city in its healing process; a process involving the understanding and addressing of the high prevalence of trauma interwoven in the communities. Add to this extensive Historical trauma, and the city was suffering, with no significant channel to relieve the agony or processes to address the pervasive traumas. In implementing trauma informed strategies, the attempt was to assist a city in crisis, stressing healing and subsequent beginnings of recovery. As the city sought emotional healing, it as well sought physical healing. The Adverse Childhood Experiences study will be discussed, to show the correlations of adverse experiences, many of which occurred in childhood and some even before the child had formed language to express, and how these experiences have profound emotional and physiological consequences, stressing the need for early intervention in treatment. This led to a broad range of trainings in the city, totaling to date some 78 agencies and over 2600 people. With this collaborative, people all over Baltimore have been receiving assistance and education on strategies to not only help others but to help themselves. The key to successful and sustained effects, is to embrace prevention. This discussion promotes the addressing of trauma on both ends of the spectrum. Examples from the efforts within the city, with creation of unique, community- oriented programs will be discussed with the goals there of producing long- lasting outcomes. Concepts that promote healing; communicating effectively; embracing the premise of 'It's not what's wrong with you, but what happened to you' have become the mantra. With active collaboration, we have attempted to help individuals of all levels of expertise to understand that 'you do not have to be a therapist to be therapeutic'. Many communities and agencies have begun to emerge with strength, healing and resilience. While still a work in progress, the response from the City has displayed an overwhelming desire to heal. Close
4.30 - 5.00 pm	Closing ceremony
5.00 pm	Drinks