Recent Developments Regarding Psychiatry in The Netherlands
Arjan Dokelaar, July 9, 2011

Dear editor,

I would hereby like to inform you about recent developments regarding psychiatry in The Netherlands. The Dutch government has approved a proposal by Minister Edith Schippers of Health, Welfare and Sport to cut psychiatric care by 593 million euros. The minister presented the package of measures at a press conference in Nieuwspoort on june 10th during which she stated the following:

"should you not figure out sertain things that belong to life in your own social circle and should you not call on healthcare if you really have a disease?"


It is clear that the measure is not meant purely financial and that the validity of psychiatric diagnosis is being questioned.

The industry associations of psychiatry, including mental health care Netherlands , the Dutch Association of Psychiatry (NVvP) and National Forum for Mental Health (LPGGz) scream bloody murder. They try to whip patients into protest against the government by stating that the measure is discriminating them and calling them victims of "inhuman" and "stigmatizing" government measures.



"These proposed cuts discriminatory shoot us down the wrong way here and we will therefore vigorously protest. Why do patients with severe or chronic mental illness or a personal contribution and patients with severe chronic medical condition or not? Furthermore, and have savings in mental health care at the expense of the patient, the alternative is for structural interventions that more savings potential profits, such as the removal of barriers and streamline the financing of care, "said Rutger Jan van der Gaag, chairman of the Dutch Association of Psychiatry (NVvP).

The measure will however only target exceeded allowed growth and will actually improving care.

There is a Dutch saying "who pays decides". The own contribution that is now demanded for psychiatric care ensures that, in general, (serious) psychiatric abuse will automaticly be prevented and it wil possibly cause innovation that leads to effective alternatives for psychiatry which are now not able to get a foothold because they are being supressed by the autority of the psychiatric medical dogma. The patient becomes partly Mr. bread, giving them a greater say in their treatment.

Already in 2009, the then Minister of Health Ab Klink called for a cut of 120 million euros and also then came the psychiatric profession in revolt. They filed suit to the then Minister which they lost.

In the lawsuit the professional groups claimed that the measure would reduce the quality of care for patients and that "it was not their fault" that demand for psychiatric care was rising.


"Demand [for psychiatric care] has increased and therefore more on care. But that's not our fault? We also believe that the Minister have nothing to do. This is between us, the care authority and the health insurers, "said Marleen Barth, president of GGZ Netherlands. "We follow the announced measure critical of the minister. It has no effect on its own budget, "confirms a spokesman for the Dutch Health Care Authority.


"It is not possible to quantify the excess. The settings are currently working on the accounts to make, "said an indignant Barth. "Moreover, people will only help us if they have been referred by a GP for example. It's not that we are creating demand."

Less than three months after the trial mental health care Netherlands (GGZ Nederland) started a million dollar national propaganda campaign called "1 in 4" to lower the threshold for psychiatric care ( ) This campaign was a shortly later banned by the Advertising Code Commission because it was misleading and proclaimed falsehoods.

Page size advertisements in major newspapers

The psychiatrists had clearly different interests than those of patients. They tried to escalate the problems in order to safeguard their future. How can you justify that you claim in a lawsuit that a announced cut results in lower quality care for patients while you soon after invest milions of dollars in propaganda by company "Maximum Recruitment Advertising" (see domain owner to recruit more patients?

In reality, it were the politicians who handled in the best interests of patients. It were they who for years have fought to constrain serious psychiatric human rights abuses - such as consecutive years imprisonment in solitary confinement. It were they who publicly spoke disgrace of it and it were they who sought solutions and also, if necessary, forced them with the profession.

Minister Klink has also repeatedly expressed his displeasure over the course of events in psychiatry and announced that measures would come.

The financial measures should be seen in the right context and it is important to realize that politicians have for years struggled against malpractice in psychiatry based on their own ideological foundations.

Below are some references:

I hope this information is valuable for you.

Best Regards,
Arjan Dokelaar
The Netherlands