Workable and affordable mental health care also requires limiting our care needs

Hospital staff of Maastricht University Hospital will go on strike in September 2021 for a better collective labor agreement.Statue Marcel van den Bergh/Volkskrant

At the end of May, this newspaper contained a striking article about pain points in healthcare as a result of bureaucratization and far-reaching protocolling caused by market forces. In May, the National Health Care Institute also sounded the alarm; they state that healthcare in the Netherlands is running up against financial and personnel limits. The Zorginstituut wants to have a social debate about this. A welcome call, but more is needed than an awareness campaign.

We have to organize healthcare differently, because the effectiveness of the current system is wearing out. During the intake we also have to take a more critical look at whether treatment is necessary and desirable. Only in this way can we prevent full waiting rooms at the GP, endless waiting lists for relevant treatments and sky-high healthcare costs.

Typical is the state of mental health care (GGZ) and, more specifically, the way in which the concept of ‘trauma’ is dealt with. This term is highly subject to inflation, largely due to the supply-oriented nature of mental health care. Healthcare organizations must be commercially successful, which means that they sell ‘yes’ far too quickly. There seems to be a treatment ready for every discomfort or problem: there is a great temptation to call in assistance unnecessarily quickly. But a care provider must also be able and dare to say ‘no’.

talk about trauma

This unhealthy tendency leads to people being talked into trauma too quickly. A fierce battle of words in the private sphere or an employment relationship that is not perfect is increasingly unjustifiably leading to a demand for care. In addition, there is a trend that we should ‘be vulnerable’, ‘stand in our strength’ and ‘become the best version of ourselves’.

Self-improvement is now mandatory if you want to count. Acknowledging that you can’t or won’t do something equals failure. Then you need to see a psychologist or a coach. In the longer term, this aroused need for care affects the resilience of people and of society.

The mental health care system is overloaded. From general practitioners and mental health practice nurses to mental health psychologists: everyone struggles with capacity problems. Meanwhile, the long waiting lists are at the expense of urgent cases, such as for people with PTSD (Post-Traumatic Stress Disorder). This increase in unnecessary treatments makes care more inefficient. At the same time, costs are skyrocketing. Not only in the health care, but also in the social domain, as a result of the dropout or other undesirable social effects associated with untreated PTSD.

In addition to the social discussion about limits to healthcare, also focus on a more workable division of healthcare, with simpler legislation and regulations. For example, have every psychologist start a relevant treatment, instead of just the coordinating practitioner. In addition, stop organizing all care according to strict protocols and as a one size fits all model. Give the professional and people with a care demand more space to come up with a solution themselves. That sometimes requires extra services and other times not. Health is personal, so is effective treatment.

Leen Pakvis has more than twenty years of experience in the field of trauma counseling and is director of Traumaloket Nederland. The organization offers relief, aftercare and guidance after shocking incidents or events.

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