Phrenos Center of Expertise for severe mental illness aims to promote personal, clinical and societal recovery for people with severe mental health problems. Phrenos Center of Expertise does this by developing, gathering, disseminating, sharing and implementing knowledge. Phrenos Center of Expertise uses this knowledge to influence the policy for the care of people with severe mental problems. Phrenos Center of Expertise does not offer individual help, treatment or diagnosis.
In our vision the pursuit is for a society in which people with severe mental problems are accepted, and one in which they can take part on an equal footing, and receive the care to support their recovery. Their recovery entails building a meaningful life, as defined by the person in question, with or without ongoing or recurrent symptoms or issues. This is the area in which we want the care of and support for this group to be improved. It requires optimal (and the most accessible) choice of treatment, rehabilitation, other types of rehabilitation support, and improved acceptance in the community. This does not only involve professionals, but also activities which involve (guided) self-help and using the patients’ own potential, input and energy.
Working closely with partners in this field, Phrenos Center of Expertise aims to raise awareness of personal and societal recovery (support) for people with severe mental problems by:
1. Developing, gathering, disseminating, sharing and implementing the knowledge of treatment, rehabilitation, recovery (support), and acceptance in the community.
2. Using this knowledge to influence the policy for the care of people with severe mental problems.
Phrenos Center of Expertise focuses on the following knowledge areas:
• Early signalling, diagnosis and treatment
• Rehabilitation and community involvement
• Recovery and recovery support
These areas are closely connected with one another, and also overlap. However, in light of Phrenos Center of Expertise’s objective, they are nevertheless differentiated.
The knowledge cycle constitutes the following components:
• Knowledge development and synthesis: developing, gathering and evaluating knowledge and best practices.
• Knowledge translation and dissemination: making the available knowledge suitable for practical usage, and disseminating it in the professional field.
• The use of knowledge in practice: implementation and structural application of (new) knowledge in practice.
• Knowledge evaluation and policy: evaluation of knowledge cycle performance, and the use of available knowledge in practice, and using this to formulate new knowledge policy.
The annual reports outline further details about our organisation and activities. (The annual reports are only available in Dutch)
Phrenos Center of Expertise has made a multi-annual plan: The Phrenos Center of Expertise 2016 – 2020 multi-annual programme.
This multi-annual plan (only available in Dutch) outlines five objectives which the Phrenos Center of Expertise has formulated based on its plan of action entitled Crossing the Bridge. Phrenos wishes to use this to reach its goal of a one third recovery increase for people with severe mental health problems.
The name Phrenos
The name Phrenos originates from classic Greek and is the second declension of the word “phren”, which first and foremost means “mind”. The original root meaning of phren(os) is midriff, i.e. enclosing the heart. Figuratively speaking, phren(os) has multiple meanings: around the breast, starting point for spiritual impulses, feeling, covetousness, intent, thoughts, desire, heart and intellect. The word phren(os) thus encompasses both the head and the heart.
Severe mental health problems
Policy makers and researchers in the Mental Health Care Services primarily use the term severe mental health problems to identify a specific group of patients. They are patients who have been in long term care, and who experience issues in different areas of life (for example besides psychotic symptoms, also issues such as housekeeping difficulties, problems with neighbours, unopened mail, and debt accumulation).
The recovery experiences of people with severe mental health problems have led to experiential expertise. They discovered that they were able to bring about changes in their recovery in ways in which the care they were receiving couldn’t. During exchanges about their disorder and recovery experiences, people also discovered that they were able to support each other, in a way which was different to that provided by regular care provision.
Recovery and recovery support
Recovery is a relatively new concept in the Mental Health Care Services, and refers to something other than the cure of disease alone. During a recovery process a personal balance is rediscovered, following the experience of (serious) mental problems. One gets over the miserable consequences of having mental health problems, and rediscovers the (lost) potential to lead a fulfilled life, with or without the mental health vulnerability.
A psychosis is a mental problem in which people lose the normal contact with reality. Somebody experiencing psychosis can be confused, have hallucinations and hear voices. The term “psychosis” is very broad and is often mixed up with schizophrenia. A psychosis can also appear once in a life time or as an expression of bipolar type 1 disorder or major depression. Schizophrenia and other psychotic disorders are some of the most disruptive mental health conditions. Furthermore the term ‘schizophrenia’ carries a lot of stigma.
Rehabilitation and participation
People with severe mental health problems feel that they are ‘participating’ when they take part in society, and fulfil roles in the community. Participating can occur in different areas, such as work (paid or voluntary), following a course, joining a club, doing a sport, having social relations, domestic and family life. Rehabilitation is firmly linked to notions such as hope, outlook and advancement (Dröes & Van Weeghel, 1994).
Stigma is a sociology concept, and the literal meaning is: a mark which distinguishes people from one another and attributes unpleasant characteristics to them, such as dangerous, untrustworthy, or unpredictable behaviour. When certain people or groups have a stigma attached to them, they are rejected, ignored or avoided by others.
On 9 januari 2015 there was the Masterclass Research Antistigma interventions bij Tranzo (Tilburg University). Prof. dr. Graham Thornicroft gave the lecture ‘What we know from research concerning anti-stigma interventions’. Prof. dr. Graham Thornicroft, King’s College, UK, is an important reseacher on stigma and psychiatry and one of the initiators of the campaign Time to Change in Great-Britain.
Watch the lecture:
By ‘early psychosis’ we mean the period leading up to the first psychotic symptoms, when a variety of symptoms and issues can usually already be identified, up until the first five years of a psychotic disorder. When people suffer from a psychotic episode, this usually influences their daily lives.
Work and severe mental health problems
People with a severe mental disorder find that in many areas in society and the community they get left behind, including work. There is a wide gap between what they would like, and the actual reality. In the Netherlands, prospects in the workplace for people with severe mental disorders are extremely limited.
Individual Placement and Support (IPS) is an employment service that helps more people with mental illness obtain employment than any other type of vocational program. Phrenos delivers training and consultation services helping implementing IPS in Dutch Mental Health Care Services.
Watch an interview with Gary Bond about IPS:
Here are some book titles (only in Dutch) which have been published with the involvement of Phrenos Center of Expertise, along with short descriptions, and order details.
Here are some publications (only in Dutch) which were realised by, or in collaboration with, Phrenos Center of Expertise. They can be downloaded free of charge.
Phrenos Center of Expertise arranges for international literature data bank searches to be carried out on a regular basis. The searches are grouped together by topic. The articles all have a summary in Dutch at the end.
Phrenos Center of Expertise has a good reputation for organising successful conferences. The conferences are aimed at the exchange, rendition and connection of (evidence-based) knowledge and opinions in the area of care provision for people with severe mental health problems, and the exchange of experiences with colleagues in or outside the Mental health Care Services. Besides one-off conferences, there is the annual Phrenos Psychosis conference, and the biennial Rehabilitation Conference.
Phrenos Center of Expertise offers courses which enable professionals to update their knowledge and skills. The courses are designed to reflect the relevant professional guidelines as closely as possible. Besides these courses, combined educational courses with implementation support are available. Several courses are offered in-company. Phrenos Center of Expertise also offers tailor-made courses.
Phrenos Center of Expertise offers tailor-made support for the implementation of a range of programmes, guidelines or methods:
• Individual Placement and Support (IPS)
• Wellness Recovery Action Plan (WRAP)
• Multi-Disciplinary Schizophrenia Guideline (MDSG)
• Early Detection and Intervention Evaluation (EDIE)
Dutch Network for Early Psychosis
The multidisciplinary Dutch Network for Early Psychosis allows professionals who have an expertise in the area of early psychosis to share knowledge, encourage scientific research, and further the development of treatment programmes. Treatment teams can meet up and exchange experiences. The network is the engine behind the Early Psychosis Manual, the Early Psychosis Standard, the annual Masterclass, and the Networking conference.
Phrenos Center of Expertise plays an important part in the inventory, gathering, and dissemination of research knowledge for the treatment, recovery and rehabilitation of people with severe mental health problems. Furthermore, Phrenos Center of Expertise aims to be involved in setting up a multi-annual research or knowledge agenda for the aforementioned areas. The following services make a significant contribution hereto:
• Expert Committee Routine Outcome Monitoring (ROM) on severe mental health problems
• Group of reseachers working together on stigma and destigmatisation
• Quality Assessment of Regional Treatment System for Schizophrenia (QUARTS)
Phrenos Center of Expertise has a range of different platforms offering experience experts, family members, and professionals the opportunity to share knowledge and exchange experiences relating to the care of people with severe mental health problems:
• Individual Placement and Support (IPS)
• Family experience expertise
• Rehabilitation and the elderly
• (Flexible) Assertive Community Treatment (F-)ACT experience expertise
Phrenos Knowledge Center also collaborates with others on certain projects. For example we are collaborating on two projects: Innovations for cooperation of Mental Health Care Services and Sheltering Services for homeless people and the Breakthrough method in Early Psychosis, in which the standard for treating Early Psychosis is implemented in the Mental Health Care Services.
Phrenos had previously carried out the Building Blocks Project, and the LIVE Project.
Recovery Support Workshop
Since April 2012 the Recovery Support Workshop has been striving to obtain an answer to the question: how can our organisations offer recovery support, and what are the necessary requirements? The Workshop was set up so that the recovery and autonomy of mentally vulnerable people could become a reality by the year 2020.