To react to young people in a vulnerable situation

In the governmental coalition agreement, it is stated that special emphasis will be placed on strengthening mental health services and supporting diverse operational forms. These promises are empty, because the first major action in mental health affairs by the new government is to close Janus rehabilitation – a remedy that has for 25 years served one of the most vulnerable groups in society; young people with severe mental and social issues.

These are young people who have dropped out of school and work. Many of them have diagnoses on the autism spectrum, depression, anxiety, a history of trauma and social isolation. They have searched widely in the system – and received responses that solutions tailored to their needs are not available. At Janus rehabilitation, they have found shelter, found hope and achieved success. Over 56% (average) of those who have completed the service in the last 3 years have gone into education, work or active job seeking. The service that Janus provides to its clients is delivered by a specialist team with specific knowledge under the leadership of a psychiatrist with decades of experience. Janus is a unique, interdisciplinary and coordinated service, which cannot be found anywhere else in the system.

The remedy is closed – nothing comparable takes over

Now this service is to be discontinued. Staff has been let go. No comparable solution is ready. Many young people – as well as those waiting for a place – are left in an absolute void, their guardians also burdened by the uncertainty about the future.

In an inquiry in the Althingi recently, I asked the Minister of Health about what would take over for these young people. No clear answers were received. Not where, not when, not how! Not even an acknowledgment of how serious the situation is when it is clear that no remedy will receive this vulnerable and marginalised group in the same manner.

What is also serious is that neither the Minister of Health nor members of the governing parliament have shown the decency to acquaint themselves with Janus rehabilitation's work on the ground. Representatives of Janus rehabilitation have invited the ministers to come and see the facilities, to familiarize themselves with the operation. But no visit has materialized. The silence is deafening. The irresponsibility is evident.

Professionals warn

The Psychiatric Association, Píeta association, Þroskahjálp, Einhverfusamtökin and others have warned that remedies within VIRK occupational rehabilitation fund – which are now to take over some of the service – do not have the professional knowledge required. The young people that Janus rehabilitation serves are not ready for traditional employment-oriented solutions – they first need mental rehabilitation, in a secure and integrated environment provided by specialists with specific knowledge, experience and guaranteed access to a psychiatrist.

It is difficult to see this decision as anything other than an ideological attack on private enterprise. It arouses a suspicion – which is not unfounded – that if Janus rehabilitation had been a state-run solution, this would not be happening. But here it is not the system that needs to be defended – but the young people.

In service surveys and interviews, participants describe how Janus rehabilitation has saved their lives, given them purpose, confidence and a new start. Parents of young people say that there they have finally found a place that understands the needs of their children.  What kind of society overlooks this experience?

It is morally wrong – and professionally irresponsible – to close an active remedy without another equally good one being ready. It is not acceptable to transfer such a service to a more general system without evaluation, adaptation or real dialogue with those who know the service best.

The window is still open

But there is still time to act. The Minister of Health can backtrack from this decision. She can make a temporary agreement, secure continued operations while working on a future vision in collaboration with professionals, users and guardians.

We should not sacrifice the future of young people for system rules. We should not remain silent when a service that works is taken down – because it is not part of the big public picture. We must make ourselves heard. For those who have no voice – and for what is at stake.

If Janus rehabilitation is closed – then it is by the grace of the government majority. The authorities bear that responsibility – both politically and morally.

Our young people have started a petition to protest against this attack on their life-saving remedy. Show support in action;

https://island.is/undirskriftalistar/ace3bde9-f921-4833-b2ff-21e966be072d

The author is a parliamentary group leader of Framsókn.