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Inspection: situation in juvenile psychiatry untenable

Care for young people with serious psychological problems has come to a standstill. Children from twelve to thirteen years of age with syndromes such as eating disorders, depression and suicidality do not receive the help they need. Thousands of children are on waiting lists of up to one year. “It is obvious that something must be done.”

Chief Inspector of the Health and Youth Care Inspectorate Korrie Louwes investigated the situation in twenty institutions. “Corona has further enlarged, deepened and sharpened the problems that already existed for youth mental health care,” says Louwes.

She calls the situation very serious. “We see a war of attrition. Employees who become exhausted because they want to provide care and are no longer able to do so because they have too little manpower. We see care institutions that have to say ‘no’ while they see that help really should be provided. We also see the helplessness of parents. It is imperative that something happens now. “

Te complex

Anne Fleur is just sixteen when she develops a serious eating disorder. She has to be acutely admitted to a juvenile psychiatric clinic but is put on a waiting list. “I was on a waiting list for two months and because I also developed depression and auto-mutilated, I received a five-line letter that I was too complex and could start all over again with a search for help,” says Van Haren.

Anne Fleur’s condition is deteriorating rapidly. She makes a suicide attempt and then there is room. “I ended up in the emergency room and then three days later I was suddenly able to go to the same organization, which initially said that they had no place.”

Anne Fleur’s experiences are not unique. Thousands of children in the Netherlands with serious psychological complaints cannot be helped immediately and are on waiting lists.

Ruth is the mother of four children. When her youngest son of thirteen went to seventh grade for the first time, she felt he was upset. One day when he goes to work on his bike in the shed, she thinks he will be away for a long time.

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‘Fortunately we found him in time’

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Pety So, a doctor at Youtz’s crisis service, experiences every week that young people have nowhere to turn, even after a suicide attempt. “Last week there were fourteen young people who registered with crisis reasons that we could not offer a place.”

Mental health care shortages have existed since 2015, when youth care services were decentralized. The country is divided into 42 regions and within those regions the municipalities are financially responsible for youth psychiatry.

“If a child is suicidal or has an eating disorder, and lives in a village, then the municipality must choose: am I going to keep my swimming pool open or am I going to provide this child with proper care,” says Marco Bottelier. He is a child psychiatrist and director of Accare, a large institution in the north-east of the country.

“The waiting time for a child who is registered with eating problems is currently thirteen weeks. The waiting time for treatment is six weeks. And we find that unacceptable”, says Bottelier.

Ascending waiting lists

Chief Inspector Louwes expects waiting lists throughout the Netherlands to increase further. “We know that many vulnerable families have joined. The crisis has also affected families that were not already in the picture. We expect that this problem will still take place in a dormant way in many families.”

Louwes has already drawn attention to the problems several times. “It is not up to us to tell you how it should be done, but that something must be done is obvious.”

Anne Fleur is now doing better. She wrote two books about her experiences and founded a peer support group. Her recovery is a process of trial and error. “But partly because of my psychosocial service dog Kodo, who ensures that I do not become disrupted, through panic, fear or re-experiences, I will never fall so deeply again.”

The Rotterdam alderman for youth, mobility and language Judith Bokhove calls for more support for young people on the waiting lists.

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Reaction of councilor Judith Bokhove to waiting lists

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