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Deinstitutionalisation in the Netherlands.

Y J Pijl1, H Kluiter, D Wiersma

  • 1Department of Social Psychiatry, P. 0. Box 30.001 9700 RB Groningen, The Netherlands. Y.J.Pijl@med.rug.nl

European Archives of Psychiatry and Clinical Neuroscience
|November 8, 2001
PubMed
Summary
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Community mental health services in the Netherlands, including day treatment and home treatment, expanded significantly. These alternatives to inpatient care did not attract new patients but increased overall engagement with mental health services.

Area of Science:

  • Psychiatry
  • Health Services Research
  • Public Health

Background:

  • Mental health care in the Netherlands saw a shift towards community-based services.
  • Initiatives were led by mental hospitals and general hospital psychiatric departments.

Purpose of the Study:

  • To evaluate the effectiveness of community-based mental health services as alternatives to inpatient care.
  • To determine if day treatment, sheltered residences, and assertive home treatment supplemented or replaced inpatient services.

Main Methods:

  • Utilized the Groningen case register to track adult users and service utilization (1989-1997).
  • Analyzed changes in community- and hospital-based service use, adjusting for population size and age.
  • Examined treated incidence and prevalence rates.

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Main Results:

  • Significant growth observed in day treatment, sheltered residences, and assertive home treatment utilization.
  • Average length of inpatient hospital stay decreased by 33% during the study period.
  • Implementation of alternatives did not increase the overall number of new patients but extended the duration of care for existing patients.

Conclusions:

  • Community-based mental health services in the Netherlands effectively expanded without attracting new patient populations.
  • These services appear to have maintained patients within the mental health care system for longer periods.
  • The study highlights the role of these alternatives in modifying service utilization patterns rather than solely reducing inpatient numbers.