[External referrals within the Wvggz at a mental health institution in the Rijnmond region]

Since 2020, the Compulsory Mental Healthcare Act (Wvggz) has been in effect in the Netherlands. This law provides the option for ‘compulsory care’ for individuals experiencing severe harm as a result of a mental disorder. A new element introduced by this law is the ‘external referral’ (externe aanwijzing). This allows anyone to raise concerns about a citizen’s mental condition and report it. This can lead to an external referral of a medical director (GD), initiated by the public prosecutor. The GD is responsible for determining whether care is needed in the context of a care authorization or ‘zorgmachtiging’ (ZM).

To analyse the process of the ‘externe aanwijzing’ within Antes.

This observational study is conducted at Antes, an institution for mental healthcare, where 128 externe aanwijzingen were analyzed during the period of 2020-2021.

The majority (60%) of the analyzed externe aanwijzingen resulted in a positive recommendation for a ZM by the GD. Externe aanwijzingen through a forensic route more frequently led to a ZM (68%) compared to those through the municipality (39%). Nearly all patients with a ZM received active treatment.

Individuals with a forensic externe aanwijzing more commonly receive a ZM directly as a result of this process. The externe aanwijzing proves to be a valuable means of engaging individuals averse to care, including voluntarily. This study provides insights into the process of externe aanwijzingen and care authorizations within Antes.