Mental Health Issues and Treatment in The Netherlands

As 40% of Dutch residents struggle with mental health issues at least once in their lives and these issues often reoccur, it’s of great importance that they receive appropriate and high-quality mental health care. The accuracy and effectiveness of mental health care is predominantly dependent on the mental healthcare system in a country. The mental healthcare system in the Netherlands is divided into different levels of care; psychologist at the GP office, base level of mental health care, specialised level of mental health care and the long term level of mental health care. The level of care is dependent on the severity and complexity of the mental health issue that someone is experiencing. An individual would always first consult their GP when they are experiencing psychological problems. From there on, further treatment or referral to a different level of care will be provided. 

Psychologist at GP office

When someone is experiencing psychological complaints, the first step will be to consult their GP. The GP will try to gain insight into the nature and severity of the psychological complaints. If it concerns mild psychological complaints, these can most likely be treated by the psychologist within the general practice. For example, in the case of excessive worrying, gloominess, or work related stress complaints. This type of treatment is accessible to every Dutch resident and is free of charge. Treatment provided by the psychologist within the general practice is predominantly focused on preventing the further development of mental illnesses. Treatment on this level of care consists of dialogue with the psychologist, self-help modules, psychoeducation or (if necessary) medication prescribed by the GP. 

When the psychological complaints are more severe and need further treatment, the GP will refer the patient to a base level or specialised level of mental health care. Several different criteria are of importance when deciding which health care provider should be consulted: 

• The diagnosed or suspected DSM disorder. 
• The seriousness and severity of the disorder or complaints. 
• The complexity of the disorder or complaints. 
• The course of the disorder or complaints and whether the person has had mental health issues in the past. 

Based on these criteria the GP will refer you to either a base level or a specialised level of mental health care.

Base level mental healthcare

The base level mental health care treats moderate and less complex psychological disorders. For example, moderate anxiety disorders, depression or personality disorders. On this level of mental health care, the patient’s requests and wishes with regard to the treatment program are taken into account. Maintaining autonomy during treatment is of great importance at this level. The type of treatment can consist of dialogue with a psychologist or psychiatrist, psychotherapy, or in some cases medication can be prescribed by the psychiatrist.

Specialised level of mental healthcare

When the base level of treatment is not effective enough, one can be referred to the specialised level of mental health care. This level of care treats more severe and complex psychological disorders. When the GP suspects that the psychological complaints are severe or complex, he or she can also refer the patient straight to this specialised level of care, instead of starting at the base level treatment. These psychological problems often need intensive treatment. The treatment on this level consists of different types of psychotherapy and in some cases medication is prescribed by the psychiatrist. 

Long term mental healthcare

Long term mental health care consists of patients that have been treated for a psychological disorder for a duration of three years or longer, and/or have been admitted to a mental health clinic for at least three years. The psychological disorders one suffers from at this level of mental health care, are often very severe and complex disorders with a chronic character.