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.
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.
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.