Page 126 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

Clinical Implications Detection of conduct problems at an early age
In the Netherlands, the GGD (Municipal Health Service) protects, monitors and promotes the health of all residents. It identifies and prevents health risks, provides assistance in the event of an incident, e.g., after an outbreak of food poisoning or infectious diseases, and also provides rapid assistance in case of disasters. In addition to tasks such as advising municipalities on health policy, the GGD also conducts health investigations, gives vaccinations and supports schools, among other things, with their care for a healthy learning environment for children. In the context of health research that takes place as standard among all children, children are seen at regular times by Youth Health Care (YHC) professionals of the GGD. At specific times, teachers are also asked information about how the children function at school. When youngsters are in high school, they are approached by the GGD for health screening with the aim of detecting problems early. Not only physical health is considered, but also lifestyle themes such as alcohol, smoking, nutrition and exercise. Besides, the emotional development, for example resilience, independence, mood swings and social problems such as bullying, are also considered. In the extension of this health research, results of the present thesis (chapter 2) indicated that YHC professionals and teachers already observed signs of disruptive behavior as early as the age of five in half of the children that would eventually be treated in the orthopsychiatric residential setting.
Since 2015, in The Netherlands, district teams (i.e., wijkteams) have been set up. These teams are organized by the municipality and, among other things, have the task of timely identifying and guiding vulnerable families. District teams aim to activate and support residents in their social functioning. Often these teams have a broad preventive task, and there is common ground with activity of the GGD and district teams. This task could be better utilized in practice, by stimulating collaboration between GGD and the district teams. YHC professionals for instance could involve the district teams when they receive signals of psychosocial problems. District teams on the other had could benefit from regular screening of children by the YHC, which offers a picture of the children from birth up to 18 years. District teams could improve insights about individual children by using that knowledge. Children showing signs of disruptive behavior at an early age can be identified by the YHC and be referred to
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