The Netherlands is generous to its citizens and inhabitants with a welfare system I myself have benefited from. I ask that you not misinterpret this as ingratitude nor dismiss me as yet another expat bitching about the healthcare system when I say this: in my experience, psychiatric care in the Netherlands is to a great extent unavailable and when available often counterproductive. This country can and should do better.
*This article was sent by an anonymous reader.
My personal story with a mental illness in the Netherlands
I was diagnosed with mental illness when I was 16 (I’m twice that age now). I have learned that this is a chronic disease that you need to learn to deal with. Throughout the years and with professional support I have managed to acquire essential coping mechanisms. In particular, I have learned to determine when it is critical that I ask for professional help. This has already saved my life a few times.
I know this might sound trivial but when you have a mental illness it is usually very hard to ask for help: you may wonder whether you’re just being weak, or if your peers or family will perceive you as crazy or a crybaby. Unfortunately, the system here reinforces those fears as it makes it hard to ask for help. The patient must be very persistent and sometimes endure contact with unprepared and/or not at all compassionate personnel.
I have a job in Amsterdam. The company doctor determined a month ago that due to the acute state of my depression I was unable to work and should go home and concentrate on my recovery. Yet, I am failing to find the professional help I need. I am fortunate to be followed by a very caring psychiatrist who saw me struggle at the beginning of the year and recommend additional psychological help. Getting an appointment took nine months, despite several calls and recurrent intervention of my also very caring GP.
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Inadequately-trained professionals
In the meantime due to my mental illness, I had ups and downs. Once I had an acute episode of anxiety and tried to get a hold of my psychiatrist. Since he wasn’t at the office I talked to his psychiatric assistant. In order to do such a job, it is not required to have a medical degree, and the person I was in contact with proved to have not even Wikipedia-level knowledge of my disease.
Well-meaning as they may be, this lack of knowledge is dangerous! I called this person when my symptoms were starting. They told me they would talk to a psychiatrist at the practice to see what could be done. Throughout the afternoon my symptoms worsened (as expected). Eventually, the assistant called me to say that the other doctor had decided not to interfere with my doctor’s treatment. They recommended I try to breathe into a bag to calm down. Luckily my GP was able to see me almost immediately and prescribed a sedative on the spot.
I was finally very fortunate to find a psychologist who is caring but my symptoms have worsened. She determined I now need daily care instead of weekly appointments. Turns out day hospital spots are scarce and I might be able to get one only in a few months… It seems not even doctors are themselves able to navigate the healthcare system in order to get appropriate urgent care for their patients! Bottom line: the professional help I need now is not available for months, and the medical support I do have has been paused for holidays.
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Why write about it now?
I’m writing this because I think the availability and quality of psychiatric care in the Netherlands needs discussing. I wish mine were simply a terrible isolated example but I am sorry to say I have heard about other cases and witnessed yet another. I once took a friend in deep anguish to an emergency service where they were told by the doctor that they would love to help but their hands were tied. My friend would have to see a psychiatrist.
You see, we’d tried that before, but the psychiatrist we found had told my friend they were simply overwhelmed and should “try harder”‘ (this friend had been diagnosed in another country with a mental illness for which they were taking medication). Months before arriving at the emergency room we had tried to get an appointment with a psychologist but this was over the summer. The doctors who weren’t on holiday discussed intakes only during an hour on Fridays and they were swamped. Maybe next year will be the lucky year they call back with an appointment?
My question is then, try WHAT harder? I guess you’re left with helpful advice.
Have you had experience with the mental healthcare system in the Netherlands? We welcome you to share about it in the comments below.
Editor’s note: This article was originally published in January 2018 but was fully updated in October 2020 for your reading pleasure.
I totally agree. I moved here from the United States and am *shocked* by the lack of support for mental health here. Having people in the middle of mental health crises jump through hoops, just to find roadblock after roadblock, is unconscionable. They definitely need to discuss this publicly. I have struggled with clinical depression for years and was treated in the United States with medication, but when I got here a little over a year ago, and had a severe depressive episode 6 months ago, I got no help, and have gotten no substantive help to date. I went to the huisarts, who basically told me to get more sunshine and take walks (for my crippling depression that caused me to miss several days of work.) He refused to refer me to a psychiatrist or prescribe medication. I went back and he did refer me to a therapist, but she was terrible and had no understanding of clinical depression, and she and I agreed we were a terrible match. I got a 250 euro bill for that visit (to be fully paid by me for my deductible.) Since then, I have searched to no avail for a good psychotherapist who takes insurance. I am in another depressive crisis, and called the huisarts again, who has no appointments until next week. It has been 6 months with no meds and no therapy, and nobody sees any urgency in helping me. I am turned away, find minimal insurance/institutional support for mental healthcare, and attitudes are surprisingly ignorant for medical professionals. It’s like they don’t believe that mental illness really exists, and that it is just a bad attitude. Shocking, and unfortunate. I don’t know what to do. I’m in a deep pit, and this country is not the place to be to pull me out of it.
I like to raise awareness about Mental Health and care in different countries.
I’m Bipolar ..or I have Bipolar(manic depression) do not know how to classify it. It began years ago, not much as a up and downs and some very difficult depression periods ..As I lived in the Netherlands , where is the top health care in Europe I was confused about :very easy: way they treated Mental health. 2 years in a row I was visiting doctors and specialist, even the head of Haarlem psychiatry had me as a patient ..He looked at me with confidence and told me ..Just take those pills and you will be fit and ready to work in no time.. Little I knew , that pills began to killing me ..I slept 16 hours a day..i wasn’t able to socialize I was so dizzy and full of anxiety. I got no diagnosis just a little symptoms of depression , that Alexander stated that will go away .. I should be more active. Easy to say when tasks as shower, cooking and cleaning was so hard it became a trigger, not to mention going to the supermarket – it took me 2 days to get ready for going outside and do grocery for a week, as I didn’t wanted to leave my house.
I moved , I run away..i was medicated for a non existing disease ..I was a drug tester for the dutch government …they even let me pay it, cause insurance you pay didn’t covered it fully ..So on top of the 112euro insurance another 80eur a month was such a fun
In 2015 I find specialist in Slovakia , that diagnosed me after 3 sittings and put me on the right medication. Been stable since and finally I’m able to be myself again and have the knowledge what is on with me . It was a long run and it will be , as this kind of disease are not curable ..I got my life sentence … Now again back in Amsterdam, I will not look up for help here..i have my Doc for 3 years and will take the risk and fly every 3 months for check and medication back to Slovakia as after that experience, I have no trust at all..
I’m writing it for you as a awareness, please get help if you struggle, don’t mind to admit , anxiety, stress or depression …Mental disease is as any other, it’s invisible and that make it even more tricky Every 3rd person you know is having depression ..Sometimes people don’t get it, and also I very dislike people taking it as advantage ..No its not an excuse to be an asshole..
I also face the same issues. The doctors in Holland couldn’t understand my symptoms. I had to discover on my own. I have 4 years in this country and I had to see so many doctors with no interest to help you, just as a robot typical medicine that for 2 years I wasn’t able to work. I am great full cause I was pushed to learn life coach skills and on the end I could diagnosed my self with bipolar disorder, adhd, thyroid issues and the doctors send me then to the specialist. But, even the specialists are working as robots because they follow a plan and that it. Still the daily headaches are not gone even if I take the medicine and even if I use so many strategies from life coaching. I want to find a doctor that can understand and want to help his patients, like the example I sow with the doctor from Slovakia. Is anyone here that can recommend a doctor that can help a bipolar disorder with mania and hyper maniac episodes, with adhd symptoms and with daily headaches? Thank you
I’ve been trying HARDER for a year and I’m exhausted. The GGZ is under enormous pressure, waiting lists easily extend into six months, and I keep being referred on.
There was a suicide recently at a local company that imports a great number of expat workers. I keep wondering how hard they should have tried for their life to be saved. I keep thinking about the fact that they probably did try. How many people suffering from depression must feel a compounded sense of hopelessness in the face of the system here? It’s not something commonly discussed, but it should be.
I’ll be going overseas for treatment and then coming back. It shouldn’t be necessary, it will be expensive, but I cannot emotionally afford another year spent trying to find someone willing to work with me.
I’m well past exhausted with the dutch medical system as a whole. I have serious mental health needs ever since I was randomly stabbed almost to death in the street watching fireworks on NYE. That was over a year ago. I am shocked, appalled, disgusted…so many other words..at how I’ve been treated..from the GP to the psychiatrists and all in-between. Absolutely useless people with no lateral thinking skills and absolutely no empathy. In fact that is one thing that affects the dutch as a whole – no empathy. It’s so very strange to live in a country full of people who lack empathy. During several periods when I became suicidal due to chronic PTSD, I told the GP, Victim’s help, my psychologist and my psychiatrist that I wanted to die. What do you think they did? Nothing. I’m still paying for a random gangster-try-hard did to me but rest assured he’s being looked after in prison – getting all the help he needs whether he likes it or not. Me? Stuck in limbo. Victim’s Help, the GPs, the so-called professionals are devoid of sense. It’s all procedure, no thinking out of the box and no tailoring treatment for specific needs. They hear your problem, pick a procedure for you and that’s it – you’re screwed because it’s a one-size fits all and you won’t even get close to getting what you need. My short-term memory is badly damaged. What do you think happens when I miss appointments simply because I can’t remember them? I get a bill, because I didn’t give 24 hours notice. After several times Victim’s Help finally decides they should try to call the GP for me to discuss it. All the GP/receptionists say is it’s not their policy to do anything about that – if you miss an appointment you have to pay. I live directly across the street – it literally would take them 30 seconds to call to let me know it’s about time to come. That’s even if you can get an appointment in less than 3 days time – you’re screwed if it’s urgent. Oh and then you’re in trouble for getting Victim’s Help to speak for you on top of that because it ‘makes them feel backed in to a corner’. This country is hellish and I am desperately trying to leave before it kills me. What a backwards hell-hole.
I’m glad atleast I’m not alone in this situation. I already accepted that the health care system is bad but it’s manageable. That is until I started suffering with mental health. I had to wait 3 months for my first appointment that lasted 1 hour and one more month for the second one that lasted less than 30 minutes. My therapist told me she is not an actual psychologist but a gp for psychologist whatever that means. She is one of the most useless “doctors” I’ve ever encountered. I find it more useful to talk with a friend in a pub. Her level of advice is if I tell her that I’m over thinking cannot sleep, she would tell me to stop overthinking and try sleeping. When talking about suicide she almost does it with a smile on her face like it’s a casual talk about the weather. Don’t rely on these doctors here if you can find help online or get treated abroad.
I think also for mental health the general Dutch Darwinism is at work. Either you suck it up and deal with it and continue to live, or you don’t and maybe you die, but then it’s still your problem, not theirs. I have been on waiting lists for treatment since April 2019 now, and have yet to hear back from them. Even when they say that they would update you every 3 months about your status – they don’t. My GP has tried her best to help me, and at some point I had weekly checkins with her, because she wanted to make sure I would not run in front of a bus, but the GPs are not qualified to provide much mental healthcare, so while that is nice, it did not change my situation much.
I did try to find someone outside of the system and just pay cash for a therapist. Even there, the waiting lists are horrendous, and many places do not take new clients. The experience I had with the therapist I eventually found was very bad, she did not even bother to show up to half of the appointments, and forgot which language I spoke every single time. So after a few times I gave up on that.
I might try to find a therapist online, but I still feel bad about paying into a healthcare system which does nothing for me, as mental healthcare would be the one I need, and nothing else.
7years. That’s how long it took me to get the care my illness needs. In Italy and Hungary (famously bad health care systems) I got help in 3 days to a week- just for comparison…
Severe anxiety episodes and panic disorder- I collapsed in public many times and had to go to ambulance with hyperventilation and muscle spasms. And they kicked me out with zero follow up after I was walking again…
Trying harder all I did, and 7 years later now I am with a caring psychiatrist and a cognitive therapist payed by insurance. As it should be from the beginning. I pay every year about 1500 euros for insurance. So 7 yeras times 1500 – for what exactly? Where that money of mine went?
In this country you are not expected to be a human being with empathy but an efficient machine for the system.
In a simple language, here is how it works:
1. everyone has a full booked agenda and that means they do not have time you and your human pain (you have to have thick skin)
2. life is about competition: go out there and fight for your peace of cake.
3. Who cares how you feel – you have to supress your emotions like the Dutch people are raised from early age.
4. just be an observer from your window and watch people here in constant hectic movements, chaos, pushing each others in rush and having very little regard for another person. It is all about ME, ME, ME first attitude.
None of you did anything wrong – you are just human beings who could not cope with this dehumanized, machine running society deeply disconnected from the Source and nature. Here is my advice for you: Or conform and kill your soul and human side and live meaninglesly like robot doing things planned in advance (agenda), or leave (which I strongly recommend you). Dutch are raised this way -you can not blame them, their humans side has been deprogrammed from early age. How can you expect empathy from humans that are devoided of it?
I’ve never had a problem with getting an appointment (and treatment) with a dermatologist, gynecologist etc. however, to get to a psychologist/psychiatrist is a whole different story.
TLDR: I’ve been trying to get medication since 2016 without success and, because of this issue, I’m planning to move out from here ASAP.
I used to take medication for ADHD in my home country. When I got here, I talked to my huisarts about the situation and she prescribed me the generic version of my medication available here in the Netherlands. The medication didn’t worked out, so my huisarts said I should see a specialist to get the right medication. I’ve found a place; waited 3 months for an intake; went to a couple of appointments and then I was told they couldn’t prescribe medication.
Sometime after, got another referral from my huisarts. Waited 3 to 4 months to get help. I went to some appointments with a different person at each time. One psychiatrist said I had plenty of options of medications to try and, after trying two different medications, another psychiatrist said I had no more options. Follow-up consultations were 3 to 4 weeks apart. After 6 months of getting nowhere, I gave up going to this place as I was facing symptoms of IBS (very likely due to the stress of managing my ADHD without help/medication).
On the second half of 2019 I decided to take a break from all of this and decided to try get help again in 2020. That’s when I was diagnosed with ulcerative colitis (a chronic bowel disease), which gets worse if I’m stressed out. After I healed from my first crisis, I decided (on January 2012) once again to get help, but instead of waiting “JUST” 3 months for an appointment, I’ll have to wait 5.
When it comes to mental health care in The Netherlands it seems that I live in a very remote and out-dated island with only two psychiatrists. The whole process is excruciatingly slow, burocratic and apathetic and I’m sure it took a lot of people to their limit.
Mental healthcare in the Netherlands is disappointing. I had to go through months of insomnia and anxiety episodes every single day, I was about to collapse and struggling to keep functioning – and I got absolutely no medication. All I heard was “try to go for a walk” or “try to calm down”, “try to make friends that can help you”, which of course can help if you are having a bad day, but not if you had anxiety as a chronic problem for years, and you are going through a moment where this has become more intense and if affecting your life through bad sleep and nervous breakdowns every day.
Moreover the GP would keep saying “I had the right to talk to the her only for 15 minutes”, like if I was getting a privilege, while she seemed to take no responsibility in actually making me feel better. Then she referred me to a psychologist which would come with the same silly advice, and kept on telling me that the treatment could not exceed 6 sessions and that I should know exactly what I wanted. Rather than making me feel better, she did nothing but putting me more pressure to leave their practice as soon as possible.
The solution was to come back to my home country, pay a private psychiatrist and get the medication. The GP did not even check my Vitamin D and hormones, which were obviously very very defficient. Basically it is shameless, I dont understand why the Netherlands is known for having a good healthcare system – at least for mental healthcare, my was experience was very bad.