Research on continuity-of-care

Freudche research and literature reviews on continuity-of-care.

May 27, 2026 · 6 min read

The patient did not leave. The system let go.

In Dutch mental health care, an ending is not always the patient drifting off. The system terminates the relationship through structurally different mechanisms: a patient refused entry for being "too complex" after a long wait; a short-term trajectory that closes at a by-design 8 to 12 sessions; a financing ceiling that, while it was live, stopped treatment for 33% of affected people in the GGZ and blocked new care for 69%; and disputed discharges a tribunal sometimes judged careless, including one referral made without asking the patient. The financing cutoff is now being dismantled for independent practices. What stays is the question of how an ending is done, because a cold ending compounds the wound and a warm one does not.

therapeutic-process continuity-of-care The Tussen Gentle Handover

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.

therapeutic-process continuity-of-care access-to-care The Tussen Gentle Handover

May 25, 2026 · 6 min read

The gap between two therapists is where the patient is quietly lost

A referred patient waits weeks between one therapist and the next, and many do not arrive. Studies have long found that of 100 people who contact a clinic, only about 33 reach a first therapy session; baseline premature termination sits at 19.7%; and when the therapist changes, dropout in one inpatient sample rose from 7.1% to 40.4%. In the Netherlands, 108,878 waiting spots stood open in October 2024, with 67% past the intake norm and an average 28-week wait for personality disorders. The structured transfer leaves no lasting symptom mark, but the recovery window is real, and the dropout that happens inside it is the part nobody counts.

therapeutic-process continuity-of-care The Tussen Gentle Handover