People seeking psychological support in the Netherlands are waiting too long for treatment, creating financial constraints and worsening mental health.

Queues for intake appointments with mental healthcare professionals can be as long as half a year, while those with the most serious conditions are waiting the longest according to the Netherlands Court of Audit. 

Amidst a pandemic and resulting lockdowns that have exacerbated mental health conditions, the Dutch Healthcare Authority reports that more than 77,000 people in the Netherlands are waiting for psychological support. 

One in three of those in line are waiting longer than the maximum acceptable time. These Treeknormen standards, which were established by healthcare providers and insurers in 2005, stipulate patients should wait no longer than four weeks for an intake appointment and a following ten weeks to start therapy.

Among this group is Adam Emara, a student in The Hague, whose GP referred him for specialist treatment for PTSD in August 2020. “If a door would close, all of a sudden, I felt trapped,” Emara recalls, “I formed my own island and I was freaking out.”

Despite needing immediate support, Emara found that all nearby mental healthcare providers covered by his insurance had a minimum waiting time of six months. Emara was lonely and frustrated, “people know I need help, my doctor says I need help but you just don’t get it,” he told 9to5.

The mental healthcare system is “broken,” according to Harry de Graaf, a GP in Groningen who regularly refers people for similar care and then watches their conditions worsen while they wait. “It feels like we’re leaving them on the street,” De Graaf says of his patients, “they feel helpless.”

These waiting times are not only caused by a growth in people seeking mental healthcare. The Netherlands Court of Audit reported last year that there was a shortage of beds and staff in mental health institutions and that care providers are financially incentivised to treat patients with milder disorders. 

For those waiting for care, this brings psychological and financial burdens. Emara was forced to find a psychologist that his insurance didn’t cover, incurring further stress and anxiety about how he would pay.

Balancing money and support can be difficult. After spending €1180 on three months of therapy, the costs were getting too high for Emara. As his trauma had become more manageable, he ended his therapy prematurely.

De Graaf tries to help his patients who are waiting for specialist psychological support. Although he is not a mental health expert, as a GP he feels obliged to monitor these patients every two weeks. This gives De Graaf extra work and he points out that he is not the right person to be offering them psychological support.

There was one psychological silver lining for Emara though. Although having to pay for therapy “still hurt,” he knew he was doing the right thing. “I’m choosing myself,” Emara thought, “and that’s way more important than the money.” 

For those without sufficient disposable income, however, this choice is not theirs to make.