May 27, 2026 · 6 min read
For an expat, finding therapy in the Netherlands is a lottery, not a referral
For an internationally-mobile patient in the Netherlands, getting into therapy is structured less like a referral than like a lottery. Three draws stack up before care begins: which huisarts you register with, since reimbursed GGZ care needs a written GP referral (Rijksoverheid); whether your language is ever treated as a matching field, which it usually is not; and whether you can read a credential system where the generic title psycholoog has not been protected since 1993, while gezondheidszorgpsycholoog and psychotherapeut are protected and registered under the Wet BIG (Psychologen Amsterdam; BIG-register, 350,000+ professionals). On 1 January 2025, 16.8% of the population, more than 3 million people, were born abroad (CBS). The lived expat wait runs anywhere from about six weeks to over a year, as expats report it, never a measured national average. And the evidence that documents the barrier comes from English-language forums and expat press, which over-represent higher-resource expats, so the people hit hardest are the least visible in it. "We offer English" is the most misleading promise in the system, because offering English at intake and providing continuous English-language care are two different things.
May 27, 2026 · 5 min read
The first contact that never happens
The unanswered phone, the email that goes nowhere, "van het kastje naar de muur." That layer is real, but there is no Dutch figure for it; it lives as testimony, not statistic. The hard number sits one notch up, at the first conversation that never gets booked. The NZa shows 67% of intake-appointment waits breach the four-week norm, and 72,443 of 108,878 ggz waiting positions are people still waiting to be seen for the first time (NZa, 2025). The regulator has said plainly that during that wait no one owns the patient (IGJ, 2023), and the GP becomes the holding pen, with 93% reporting few or no options to refer (LHV, 2025). For someone who took weeks to work up the courage to ask, an unanswered first contact is not a delay. It is the door closing at the moment of most need.
May 27, 2026 · 6 min read
Every room belongs to someone. The space between them belongs to no one.
Van het kastje naar de muur is not a service failure. It is the predictable output of a system where nobody is assigned to own the person between rooms. The Inspectorate found providers made insufficient agreements about who is responsible while a client is on a waiting list. The State 2025 IBO calls the system onhoudbaar and names versnippering across four separate laws as a core cause. And the GP, the one fixed point, has become an involuntary holding pen: 93% of GPs say they can barely refer to specialist GGZ, and they spend around 3.7 hours a week on bridge care outside their remit. Every hop restarts because every room belongs to someone else, and the seams belong to no one.
May 26, 2026 · 8 min read
The waiting list is the part of the illness nobody counts
The wait between asking for help and receiving it is administered as a neutral queue, an "in progress" on a form. The evidence reads it differently. Longer waits for early psychosis care tracked worse 12-month outcomes (Reichert & Jacobs, 2018), and a network meta-analysis found being placed on a waitlist did worse than no treatment at all, with disappointment proposed as the mechanism (Furukawa et al., 2014). After referral, disengagement is a risk marker, not passivity: patients with mental-health conditions who missed more than two appointments a year had an 8.37-fold higher mortality (McQueenie et al., 2019), and reaching psychiatric care within seven days of a suicide attempt was associated with roughly half the reattempt risk (Kim et al., 2022). All of it observational, all caveated by its authors. In the Netherlands, 108,878 ggz waiting positions stood open in October 2024 (NZa, 2025). The wait is the least-counted stretch of the illness.