Along with the rapid multiplication of drug users and the rise of AIDS, there was another development going on in the 1980s: the anti-psychiatry movement. Kees Onderwater worked as a psychiatric nurse at the time and helped establish several activation projects for people with mental disabilities.
Counting candy
Onderwater: "In the 1970s I was a psychiatric nurse at the Sint Joris Gasthuis in Delft, in a pavilion with forty-three elderly men. Their sandwiches were cut into small pieces for them and a few times a day they were handed cigarettes. Their occupational therapy was counting candies and putting them in bags. What medication there was gave a lot of side effects. We as nurses-in-training felt that the psychiatric patients were being treated inhumanely and rebelled against it along with clients. We contacted the Gekkenkrant, a magazine for psychiatric patients, published by critical clients, students and family members of psychiatric patients. They came to make reports and of course we were not thanked."
Inspiring example
In 1983 came a plan for an Amsterdam mental health care new style. It was a time when the development of democratic psychiatry in Italy was an inspiring example. There, small clinics were established in neighborhoods and cooperative organizations were set up, in which clients lived and worked together and were jointly responsible. Based on the Italian model, the large psychiatric clinic in Santpoort was dismantled in the 1980s and 1990s. The first transfer to Amsterdam took place in 1986. Onderwater: "People went from Santpoort to Kempering in the Bijlmer and four of them went to live independently in a flat. Initially this was done without preparation and was a huge change for clients and staff. It worked out well for most clients, but not for a large group. Now, after thirty years in psychiatry, I know that you have to take your time with everything. But back then, in the 1980s, we were mostly in a hurry."
" We felt that psychiatric patients were being treated inhumanely and, together with clients, rebelled against it."
Protected places
With the dismantling of Santpoort, more and more people with mental disabilities came to live in the city. The urban clinics themselves did not have employment and day care facilities like those on the Santpoort site. The existing social work facilities offered hardly any opportunities for people with mental disabilities. This created a need for day care and sheltered employment. Onderwater: "Since 1987 I worked as a prevention worker for Riagg Centrum/Oud West, later Mentrum (now part of Arkin, ed.). In that period I helped set up many activation projects. For example, in 1988 we set up the Stichting Nieuwe Werkvormen Amsterdam (SNWA), one of the first projects in Amsterdam aimed at labor integration of people with psychiatric problems. At the same time, the first day activity center was opened, of which more were gradually added. They were protected places, a kind of walk-in centres, where people could spend their day meaningfully, especially in a creative way. Later, small businesses were also created, for example for woodwork, chores, garden maintenance. They were still strongly inward-looking: many service things were done for one's own organization or for people who knew each other."
Involvement through client councils
After the phase of rebellion against the established psychiatric order, came the phase of organized participation with client councils. A new trend in this regard is that clients do not want to be tied to the activation offerings of their own organization, but want to be able to go anywhere in the city. The emphasis is now more on possibilities and less on limitations. Onderwater: "This is sometimes difficult for social workers because they are expected to care less and facilitate more. Clients want to take more control over their own lives. They want to choose what they are going to do."
