The optimization of mental healthcare pathways for young adult women in The Netherlands
Abstract
Introduction: Young adult women (18-25 years) are a vulnerable group as regards mental health. The pressure on mental healthcare in The Netherlands is high, resulting in limited availability of appropriate care, incorrect referrals, and long waiting times. The objective of this study is to contribute to the optimization of mental healthcare pathways for young adult women with mental health problems, by providing insights into influencial structural barriers and facilitators.
Methods: In a qualitative study, 12 mental healthcare professionals shared their perspectives in semi-structured interviews in the larger urban area. Interviews were recorded and transcribed verbatim. The data were analyzed using a hybrid coding strategy using the Atlas.ti program. Reliability and validity were strengthened by a standardized interview guide and member checks.
Results: At the level of system integration (macro), health insurers influence treatment conditions and financing, leading to diagnosis-based care, budget caps and contract conditions. This hampers access to integrated and person-centered care and contributes to the waiting time problem. Barriers at the level of organizational and professional integration (meso) are insufficient transparency, uncoordinated communication and a lack of central referral platforms. Multidisciplinary Team-meetings and proactive consultations are facilitators. Within functional integration (micro), administrative burdens from health insurers are barriers.
Conclusions: The diagnosis-oriented model of care does not adequately fit the diffuse, psychosocial problems of young adult women. A broader policy approach, centralising holistic, demand-oriented care, with effective collaboration amongst primary care, mental healthcare, and the social domain is crucial. Improving mental healthcare pathways (including policy development), will benefit the broader population with mental health complaints (not only young women).
Key messages: • Macro, meso and micro level barriers in the mental health care system in The Netherlands hinder the inflow and through-flow of patients into treatment, creating waiting lists and blockages.
• This study exemplifies how different actors on different levels within the field of mental health care in a certain country may interact/ cooperate/ counteract for the recovery of their patients.
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BibTeX
@article{heijde2026optimization,
title = {{The optimization of mental healthcare pathways for young adult women in The Netherlands}},
author = {CM Van der Heijde and GT Blokhuis and CIEA Van ‘t Klooster and S Wieringa},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1991},
url = {https://doi.org/10.1093/eurpub/ckag169.1991},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - The optimization of mental healthcare pathways for young adult women in The Netherlands
AU - CM Van der Heijde
AU - GT Blokhuis
AU - CIEA Van ‘t Klooster
AU - S Wieringa
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1991
UR - https://doi.org/10.1093/eurpub/ckag169.1991
AB - Introduction: Young adult women (18-25 years) are a vulnerable group as regards mental health. The pressure on mental healthcare in The Netherlands is high, resulting in limited availability of appropriate care, incorrect referrals, and long waiting times. The objective of this study is to contribute to the optimization of mental healthcare pathways for young adult women with mental health problems, by providing insights into influencial structural barriers and facilitators. Methods: In a qualitative study, 12 mental healthcare professionals shared their perspectives in semi-structured interviews in the larger urban area. Interviews were recorded and transcribed verbatim. The data were analyzed using a hybrid coding strategy using the Atlas.ti program. Reliability and validity were strengthened by a standardized interview guide and member checks. Results: At the level of system integration (macro), health insurers influence treatment conditions and financing, leading to diagnosis-based care, budget caps and contract conditions. This hampers access to integrated and person-centered care and contributes to the waiting time problem. Barriers at the level of organizational and professional integration (meso) are insufficient transparency, uncoordinated communication and a lack of central referral platforms. Multidisciplinary Team-meetings and proactive consultations are facilitators. Within functional integration (micro), administrative burdens from health insurers are barriers. Conclusions: The diagnosis-oriented model of care does not adequately fit the diffuse, psychosocial problems of young adult women. A broader policy approach, centralising holistic, demand-oriented care, with effective collaboration amongst primary care, mental healthcare, and the social domain is crucial. Improving mental healthcare pathways (including policy development), will benefit the broader population with mental health complaints (not only young women). Key messages: • Macro, meso and micro level barriers in the mental health care system in The Netherlands hinder the inflow and through-flow of patients into treatment, creating waiting lists and blockages. • This study exemplifies how different actors on different levels within the field of mental health care in a certain country may interact/ cooperate/ counteract for the recovery of their patients.
SN - 1101-1262
SN - 1464-360X
ER -