Director of the Pfalzklinikum facility “Care-Foster-Live”, Birgit Fuchs, underlines the vital mental health services of the company and how they improve tolerance and acceptance

The requirements and services in community-based services are as individual as their users – however, they all have the same goal: to accept impaired people in the community, to organise their daily lives and to promote tolerance and understanding over and over again. For almost 20 years, Pfalzklinikum has worked towards turning patients into residents. An important step in this respect is the decentralisation of the services offered in many communities in the Palatinate.

Out of the long-time care sector of clinics into the communities: with this goal in mind the community-based services with the name “Care-Foster-Live” was founded at the end of the 1990s. The work of the facility is based on a resource-oriented attitude. This means that the focus is not on the clients‘ deficiencies, but on their strengths and abilities and how to use and foster them. Trying to distinguish itself from the clinical departments, the facility developed new structures and services in the communities – a first step towards decentralisation. Initially, two living groups were built up in Palatinate communities during this period.

At home in the Palatinate

In 2007, a process started which was intensely characterised by moving services into the communities and by enhancing the portfolio: in the meantime, Care-Foster-Live has become an integral part in eleven communities in the Palatinate, partially offering several services. The product range comprises outpatient outreach care services (in four larger areas), miscellaneous residential offers (in eight communities), day centres for persons with mental impairments (in one community) and for the elderly (in three communities), a contact point as well as services for integration into the world of work (in two communities).

The concepts of the diverse services mainly focus on the basic idea of centring on persons and on the requirements in various care areas. The wide range of offers often produces creative solutions for the benefit of clients. An example is the participation Centre in Bellheim: On the one hand, this service ensures that the residents get the intense support they need. On the other hand, they have the opportunity to largely organise their daily life independently since they live in their own apartments or shared flats.

Challenges of decentralised services

The areas have a mainly rural structure and show great differences in their infrastructure and prosperity, the financial resources of the communal funding organization’s and in demographic development.

Therefore, they have diverse requirements concerning the organisation of the services. For example, the organisation of outpatient services with long travel times is a major challenge which is not reflected in the financing logic of the systems existing in the various communities.

Additionally, most regions neither have a wide range of service providers nor community mental health groups. Self-help for persons with mental diseases or impairments as an important cooperation partner does virtually not exist. Therefore, the work in networks is impeded, especially regarding creative solutions. Consequently, important quarrelling partners for the development of concepts and cooperation partners for the tailoring of regional solutions are missing. So, one possibility of counteracting is to work together with the Regional Association of (Ex-) Users of Mental Health Services.

In a close cooperation the training course “Experience Involved“ (ExIn) is offered, enabling (ex-) users of mental health services to be trained as “recovery companions” and participate actively in the services of the facility as members of staff. With their personal experience, they function as mediators between persons treating and persons affected. Moreover, such cooperation strengthens the regional self-help.

Individual services for individual people

Through the years, Care-Foster-Live has specialised in persons with challenging behaviour patterns, thanks to the proximity to the acute psychiatric services offered by Pfalzklinikum. After their clinical treatment, many of these persons do not find a service provider that develops possible solutions with them. With a view to the Federal Act of Participation, the staff members of the facility develop, on the one hand, decentralised, lasting solutions in the miscellaneous regions. On the other hand, in cooperation with clinical services, they establish specialised services where the length of the clients’ stay is limited.

Care-Foster-Live plans, for instance, the care service for young adults (BJE). With their challenging behaviour practices, some young adults switching from youth welfare services to integration aid reach their limits when they are confronted with the existing services. For this reason, Care-Foster-Live has developed a concept for intense out-patient care in Speyer. This service offers the right balance between care and retreat possibilities and thus, makes it easier for young adults to switch to integration aid. Such specialised time-limited intermediate solutions between treatment and assistance in the community should be the starting point for creative solutions, as well as enabling a self-determined life.

All these developments could be launched thanks to the facilities of employees and executives who, for a long time, reflected, discussed and questioned their attitudes, underwent training and enhanced their perspectives by participating in country-wide events. In particular, the intense dialogue with the persons concerned led to a change in professional self-understanding. An integral part of this process is to adopt an attitude of trust in other people. By a close conceptual and organisational linking to the clinical services, a provider of a complex array of psycho-social care services has been established which is distinguished not by exclusion, but by cooperation and the willingness to dare creative social innovations outside the regulations of the German Social Act.


Birgit Fuchs

Director of Care-Foster-Live


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