Original state of the art abstract, full audio and slide presentation by Robert Vermeiren (Leiden University Medical Center, chair of the child and adolescent faculty of the Dutch Association of Psychiatry – NVvP) on Social revolution in (Dutch) child psychiatry: redefining the role of the psychiatrist (ESCAP 2017 Congress in Geneva, Switzerland).
Demedicalistion, normalisation, … firm talk is used to force changes In the Dutch child mental health system. Drastic action has been taken to coerce a transition. Since January 2015, child psychiatry in the Netherlands is no longer part of health insurance. Instead, each of the individual 388 communities has obtained full responsibility, organisational and financial, for all care for youth, including all child psychiatry.
Since then, the field is in turmoil. While several changes are being embraced, the overall evaluation is far from positive. Positive aspects include the emphasis on family empowerment and rehabilitation, integrated care together with community (youth) teams and youth care partners. The downside is the neglect of specialised care and the fragmentation. At present, there is substantial discussion what is best for the future. It must be acknowledged that being under privatized health care insurers was far from ideal as well.
At present, the Netherlands receives attention from many different countries, who are interested in our decentralized system. Therefore, the Dutch revolution could set a trend in other countries, who similarly struggle with increasing costs and a large number of children who remain to receive inadequate care. Fundamentally, this revolution forces us to pro-actively address the role of the child psychiatrist in the social-medical domain. We should not leave this to politicians.
View Robert Vermeiren's slide presentation (pdf, 43 pages).