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Mental Health Treatment in The Netherlands

7 Minutes

Edited & medically reviewed by THE BALANCE Team

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CONTENTS

At least four out of ten people in the Netherlands have to deal with psychological complaints at least once in their lifetime. The number of people with mental health problems has increased in recent years. There is a clear increase visible in the prevalence of mental health problems, therefore accessible and adequate treatment is of great importance.

In the Netherlands, mental disorders are divided into three main categories, namely mood disorders, anxiety disorders, and substance disorders.

It’s known that 4 out of 10 people in the Netherlands suffer from some kind of mental health issue at least once in their lives. Besides, the rating people give their mental health has never been this low.

In the Netherlands psychological disorders are categorised into three main categories, namely mood disorders, anxiety disorders and substance abuse disorders. As a category, anxiety disorders are the most common mental health disorders in the Netherlands. Anxiety disorders include, for example, panic disorders, social phobia and agoraphobia. The category ‘mood disorders’ includes, for example, bipolar disorder or depression. The group of substance disorders includes, for example, alcohol and drug abuse.

When looking at the prevalence of individual mental health disorders, depression is the most common in the Netherlands.

When someone suffers from such psychological disorders, the degree of severity and impact on daily life should also be considered. Research shows that overall 60% of patients suffering from a mood disorder indicate that they are extremely affected by the disorder. On the other hand, 31% of patients suffering from an anxiety disorder, and only 25% of patients suffering from substance disorders, rate that they are extremely affected by it. This may explain the use of healthcare among people in these categories.

People suffering from mood disorders are more likely to utilise health care services in the Netherlands. On the other hand, people suffering from substance disorders are less likely to utilise mental health services.

Every year, more than four percent of people develop a new or reoccuring mental illness. Half of these are new cases, in which the disorder appears for the first time. The other half are recurrent cases; for these people, the mental illness in question returns after at least a year of absence.

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.

The Dutch mental healthcare system provides several different types of mental health treatment programmes, mental health facilities and mental health clinics. Overall, treatment can be divided into ambulatory care and acute care. Ambulatory care refers to all medical services performed on an outpatient basis and without admission to a mental health clinic. On the other hand, acute care refers to inpatient care, which means that someone is admitted to a mental health clinic. During hospitalisation the patient remains under constant care. Admission to a mental health clinic in the Netherlands can either be voluntary or forced. Forced admission can take place when one poses a threat to themselves or those around them. Inpatient care is often a more intensive treatment programme.

Types of therapy in the Netherlands

There are different types of therapy in the Netherlands. Depending on the nature and severity of the psychological disorder, the type of therapy will be determined. They can be performed during ambulatory care and acute care.

The most common types of therapy in the Netherlands are:

Cognitive behavioural therapy
EMDR therapy
Systemic therapy
Schema therapy

Types of care workers in the Netherlands

The therapy mentioned above will always be performed by a psychologist or psychiatrist. However, during the treatment of mental health issues, several different care workers can be involved. Bear in mind, not all care workers are always involved in the treatment of psychological disorders.

Types of care workers in the Netherlands:

General practitioner (GP): When someone is experiencing psychological complaints, the first step will be to consult their GP. The GP can refer a patient to a specialist for further treatment if necessary. Besides, the GP will be informed on the progress throughout treatment.
Psychologist at the GP office (in Dutch POH-GGZ): At the request of the GP, the psychologist at the GP office can see a patient with psychological problems to get a better understanding of the symptoms, determine whether treatment is necessary, and possibly provide further guidance.
Psychologist: A psychologist treats someone through therapy such as dialogue and by performing exercises and assignments. A psychologist cannot prescribe medication.
Psychiatrist: Psychiatrists are medical specialists. Therefore, unlike psychologists, they are allowed to prescribe medication in addition to therapy. Serious psychological problems requiring medication are generally treated by a psychiatrist.
Psychotherapist: A psychotherapist is a psychologist or psychiatrist who is specialised in performing psychotherapy (such as EMDR or Cognitive behavioural therapy).
Psychiatric nurse: A psychiatric nurse aims to improve the quality of life. A patient will usually come across this type of care worker while being hospitalised.
Social worker: A social worker can help you with practical problems, for example with finances, work, housing or administrative matters. A social worker does not offer treatment for psychological problems, but does offer advice and practical support.
Case manager: A case manager monitors that the client receives accurate care and support. Case managers coordinate the care. They ensure that the various care providers keep each other properly informed.

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