Appeal to the Dutch Parliament has been in vain

Controversial Youth Law now ratified

The Board of ESCAP has expressed its concern about the new Dutch youth law by sending an Appeal to the Upper Chamber of the Dutch Parliament. The appeal turned out to be in vain: the new law was ratified on February 18th 2014 by the Upper Chamber of the Dutch parliament.

Apart from ESCAP, also the Royal Academy of Sciences and the Flemish Association for Child Psychiatry and the European Union of Medical Specialists (EUMS) had expressed their concerns. The EUMS represents more than 1.4 million medical specialists. The main problem is that health care for children and adolescents with psychiatric disorders will no longer be insured and will be transferred to the responsability of local governments. This will put an end to the right of Dutch youth to access insured mental health care. More than 93,000 parents, healthcare professionals, general practitioners, pediatricians, teachers and professors had already signed a petition trying to abandon these plans.

The full text of the ESCAP Appeal, dated 6 February 2014, reads as follows:

Appeal to the Chair of the Committee for Health, Welfare and Sports and all Members of the Upper Chamber of the Dutch Parliament, from the President and the Board of the European Society for Child and Adolescent Psychiatry (ESCAP).



In the interest of all children with severe mental problems I should like to bring an important matter to your attention.
Your Chamber is about to ratify a new Youth Law which will place Child and Adolescent Psychiatry outside the Health system and moreover outside the achievement of Insured Care. On top of these measures your Minister announces budget cuts concerning the mental health care for a next generation of adults that will have to carry responsibility for an ageing society in the near future. These children are the ones You and I will be dependent of in a few years time.

1)   The new law places Child and Adolescent Psychiatry outside the national Health system . This is a measure dictated by an ideology of ‘demedicalization’ and ignores medical knowledge and European standards that were so hard-won through the European cooperation between child and adolescent research, diagnostic and treatment experts in the past decades. ESCAP represents this cooperation and its standards and strongly pleads for the children’s rights to receive appropriate mental health care when they need it.
This measure will put Youth Mental Health Care on a distance from Adult Psychiatry (while our treatments always involve adults – the parents and family of our patients) and it creates boundaries between minors and adults and it discriminates mental diseases against somatic diseases.

2)   By withdrawing the right of Insured Care from Child and Adolescent Psychiatry, the new law creates a legal inequality concerning the access to professional Youth Mental Health Care and concerning the quality of care that youth mental health professionals offer to children and adolescents.

3)   Together with the Youth Law, budget cuts were announced. Although a similar transition in Denmark has shown that decentralization of Youth Care has only driven the cost of care higher than ever, your Government seems to still believe that the new law will economize care. We expect that not the demolition of Care structures, but a cross border exchange and application of knowledge will be profitable to child and adolescent psychiatry.

Within ESCAP the national societies for Child and Adolescent Psychiatry of all European countries work together to raise the standards of professional care for children with severe mental disorders, and until today The Netherlands have always been an honoured member. A recent scientific review by Dr Albayrak (University of Duisburg-Essen) showed that the Netherlands appears to be the world's number one research country in the field of child psychiatry (ECAP Journal, 21, 327-37. DOI: 10.1007/s00787-012-0265-x). Please Mylady, do not tear down this precious building by removing a corner stone. Executing this law will place The Netherlands behind many other European countries, where children’s access to the best possible care is sacred and where investments in Child and Adolescent Psychiatry are being increased, not cut.
This is why I appeal to your Chamber to not pass the paragraphs in the Youth Law that concern Child and Adolescent Psychiatry and to leave Youth Mental Health Care in The Netherlands inside the system of Insured Health and to refrain from cutting youth mental health budgets.

I have the honour to be, Mylady, yours faithfully,

Dr Ruud Minderaa, MD PhD,
President of ESCAP.

Dr Brendan Doody (Dublin), Dr Stephan Eliez (Geneva), Dr Johannes Hebebrand (Duisburg-Essen), Dr Tuula Tamminen (Tampere), Dr Dimitris Anagnostopoulos (Athens), Dr Claude Bursztejn (Strassbourg), Dr Sofie Crommen (Zutendaal), Dr Füsun Çuhadaroglu Çetin (Ankara),  Dr Beate Herpertz-Dahlmann (Aachen),  Dr Óscar Herreros (Madrid), Dr Carl-Göran Svedin (Linköping), Dr Agnes Vetro (Szeged),
Members of the Board of ESCAP.