Mental Health Care in the Netherlands
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- Norman Robinson
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1 Mental Health Care in the Netherlands Key Figures 2012 GGZ Nederland Amersfoort, May
2 Incidence of mental health disorders in the population of the Netherlands % and number of Dutch in the age of years with a newly developed psychological disorder on DSM IV Axis 1 in the last 12 months* 1,8% 191,400 Top 5 most common disorders* Depression 1,3% 135,600 Specific phobia 0,7% 75,700 Generalized anxiety disorder 0,6% 64,400 Alcohol abuse 0,6% 66,000 Panic disorder 0,5% 53,500 * These numbers are computed for the total population of years in the Netherlands on (10,557,188) Source: de Graaf, R., M. ten Have and S. van Dorsselaer (2010), De psychische gezondheid van de Nederlandse bevolking. Nemesis-2: Opzet en eerste resultaten. [The mental health of the Dutch population. Nemsis-2: design and preliminary results]. Trimbos Instituut 2
3 Prevalence of mental health disorders in the population of the Netherlands Some form of psychological disorder 18,0% Top 5 most common disorders*: Depression 5,2% Specific phobia 5,0% Social phobia 3,8% Alcohol abuse 3,7% ADHD 2,1% * prevalence in the past 12 months, residents aged years Source: de Graaf, R., M. ten Have and S. van Dorsselaer (2010), De psychische gezondheid van de Nederlandse bevolking. Nemesis-2: Opzet en eerste resultaten. [The mental health of the Dutch population. Nemsis-2: design and preliminary results]. Trimbos Instituut 3
4 Use of mental health services per age group (2010) 2,0 1,5 1,0 0,5 0,0 male female population (average) Source: GGZ Nederland (2013), GGZ in de Zorgverzekeringswet, tabellen over de jaren [Mental health care in the Health Insurance Act, tables over the years ], GGZ Nederland
5 Mental health budget 2012 In the Netherlands, mental health problems are the major cause of burden of disease. However, mental health providers only use 6.1 % of total health and social care budgets in the Netherlands. 31% 26% hospitals, medical specialists providers of long term care for elderly providers of care for the disabled primary care practices 6% 8% 10% 19% mental health care other care providers Source: CBS Statline (2013) 5
6 Funding of specialist mental health care (2012) The Health Insurance Act (ZVW) covers curative care. This includes almost all outpatient mental health treatment as well as the first year of inpatient mental health care. Longterm mental health care is funded under the Exceptional Medical Expenses Act (AWBZ). In order to be eligible for care under the AWBZ, a person has to pass an objective assessment by the National Care Assessement Centre (CIZ). The total budget in 2012 for mental health care was 5,82 billion. 10% 2% Health Insurance Act (ZVw) 23% 65% Exceptional Medical Expenses Act (AWBZ) Forensic Care (Ministry of Safety and Justice) Social Support Act (WMO) Sources: State Budget Ministry of Health, 2012; Ministry of Safety and Justice, 2012; NZa,
7 Number of patients and treatments under the Health Insurance Act * 2012** number of patients 827, , , , ,900 number of treatments 884, , , , ,900 * preliminary data, excluding December 2012 ** estimation for total of 2012, bases on the period November 2011 to October Source: number of patients number of treatments ** GGZ Nederland (2014), Sectorrapport 2012: feiten en cijfers over een sector in beweging [Mental health industry report 2012, facts and figures on an industry in transition]. 7
8 Number of treatments per sector of mental health care * Children and youth 179, , , ,500 Adults 520, , , ,200 Elderly 93,100 90,100 87,000 74,800 Addiction care 75,200 76,200 75,300 66,600 Forensic care 16,500 17,800 18,500 16,200 TOTAL 884, , , ,300 * preliminary data, excluding December 2012 Source: GGZ Nederland (2014), Sectorrapport 2012: feiten en cijfers over een sector in beweging [Mental health industry report 2012, facts and figures on an industry in transition]. 8
9 Distribution of treatments per sector of mental health care % 90% 80% 70% 60% 50% 40% 30% 20% Forensic Addiction care Elderly Adults Children and youth 10% 0% * * preliminary data, excluding December 2012 Source: GGZ Nederland (2014), Sectorrapport 2012: feiten en cijfers over een sector in beweging [Mental health industry report 2012, facts and figures on an industry in transition]. 9
10 Long term treatment for people with severe mental illness clinical admission for more than 1 year sheltered housing other (outpatient care, day occupation, none) Source: CIZ (National Care Assessment Centre),
11 Placements at the disposal of the government (Ministry of Security and Justice) Placement at the disposal of the government (TBS) can be imposed by a court when someone with a mental disorder has committed a severe offence and is found to be (partially or fully) irresponsible for his/her criminal behaviour Number of new placements at the disposal of the government 2500 Number of people at the disposal of the government in that year women men Compulsory confinement Conditional Placement Total number of impositions Source: DJI (2013). Forensische zorg in getal [Forensic care in numbers ]. Ministerie van Veiligheid en Justitie. 11
12 Number of primary and specialist mental health care providers between This is an estimate of all health care providers in primary and specialist mental health care. The 181 service providers in specialist mental health are eligible for membership of GGZ Nederland, 113 were actually members of GGZ Nederland. Primary mental health care providers Health care psychologists 3,956 4,031 N/A N/A Other (such as psychiatrists, educational counsellors) TOTAL 4,153 4, N/A N/A Specialist mental health care providers Mental health organisations within budget parameter system Mental health organisations outside budget parameter system N/A N/A Self employed psychologists 1,220 1,518 N/A N/A Self employed psychiatrists N/A N/A TOTAL 1,873 2, Source: NZa (2012) 12
13 Number of jobs and employees between ** (%) growth Number of employees 81,350 84,930 85,780 85, Number of jobs (FTE)* 65,700 66,830 67,480 67, * only for members GGZ Nederland ** estimation based on numbers PGGM for year 2012 Sources: Number of people working: AZWinfo.nl (2013); Number of jobs in fulltime equivalents: Jaarverantwoording Zorginstellingen (2013) 13
14 GGZ Nederland is the sector organisation of specialist mental health and addiction care providers in the Netherlands. The aim of GGZ Nederland and its members is to ensure the availability of high quality, accessible, affordable and sustainable mental health care. In 2013, its 113 members were responsible for a market share of 80.6% in the health insurance market and more than 90% in child and youth care, sheltered housing, addiction care and forensic care Seated in Amersfoort, its 66 employees represent the interests of its members in an on-going and constructive dialogue with client organisations, health insurers, national and local governments, professional associations and trade unions. 14
15 Membership of GGZ Nederland by type of service providers Despite the increase in membership between 2010 and 2013, the market share decreased from 90.3% in 2009 to 80.6% in 2011 for common mental disorders. For other types of services, the market share is still more than 90% in Members with mental health care output Integrated mental health care organisation Forensic care Child and youth psychiatry Outpatient mental health care (RIAGG) Sheltered Housing (RIBW) Addiction care TOTAL Source: GGZ Nederland (2014), Sectorrapport 2012: feiten en cijfers over een sector in beweging [Industry report 2012, facts and figures on an industry in transition]. 15
16 These data were supplied by member organisations of GGZ Nederland. In some cases, other sources have been used. For more information, please refer to the full report at: Nederland_Sectorrapport_2012-web.pdf Published by: Website: GGZ Nederland PO Box 830, 3800 AV Amersfoort 16
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