title: Evaluation of the signalling and referral system for households at risk of eviction in Amsterdam.
abstract: In Amsterdam, over 1400 households are evicted each year. We describe the results of an evaluation of the functioning of the signalling and referral system, set up for households at risk of eviction, through a qualitative and quantitative study. Interviews and questionnaires completed by employees of 12 housing associations (for rent arrears) and by employees of 13 nuisance control care networks (for nuisance), were used. Data on households with rent arrears, for which a court eviction order was requested, were collected prospectively in September and October 2003, and retrospectively on households causing nuisance and/or who were known to be evicted due to nuisance in 2001-2003. Functioning of signalling, of the 'alarm' of problems underlying rent arrears and/or nuisance, was evaluated by the extent of problems that were identified by the employees. Functioning of referral was evaluated by comparing the identified problems with the assistance contacts. For 275 households with rent arrears, housing associations reported social problems in 196 (71%), of whom 94 (48%) were in contact with social assistance, and medical problems in 62 (23%) of whom 18 (29%) were in contact with medical assistance. House visits resulted in a much higher identification of problems, and were associated with a reduced eviction risk [relative risk 0.57 (95% confidence interval: 0.43-0.75)]. For 190 nuisance households, nuisance control care networks reported social problems in 103 (54%), of which 13 (13%) were in contact with social assistance, and medical problems in 155 (82%), of which 142 (92%) were in contact with medical assistance. To prevent evictions in Amsterdam, housing associations should improve their signalling role by conducting more house visits, and they should refer more households to medical assistance. Nuisance control care networks should refer more households to social assistance. Only a systematic and integrated approach can keep more households at home.
authors.affiliation: GGD Municipal Public Health Service, Amsterdam, The Netherlands.
authors.forename: Igor
authors.initials: I
authors.lastname: van Laere
authors.forename: Matty
authors.initials: M
authors.lastname: de Wit
authors.forename: Niek
authors.initials: N
authors.lastname: Klazinga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005191:Family Characteristics; D005260:Female; D006798:Housing / Q000191:economics* / Q000331:legislation & jurisprudence; D006801:Humans; D007407:Interviews as Topic; D035846:Law Enforcement; D007860:Leasing, Property / Q000191:economics / Q000331:legislation & jurisprudence; D008297:Male; D008483:Medical Assistance / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands; D011632:Public Assistance / Q000706:statistics & numerical data*; D011635:Public Health Administration; D012017:Referral and Consultation / Q000592:standards*; D018570:Risk Assessment / Q000592:standards*; D012307:Risk Factors; D012940:Social Problems; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult