IRL: How the Dutch healthcare system is failing me 24/08/2023

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Content Warning: This blog post involves mentions of self-harm and suicidal thoughts.

Spoken version: (coming soon…)

Text version:

Hi readers,

It’s another more real life focused blog post.

This time it will be about my personal story with the healthcare system, specifically for mental health, in The Netherlands.

Back in 2015, my first year of high school, I was forwarded by my doctor to Lentis. Lentis is an organization responsible for most psychological help in the northern of The Netherlands, in my case, this is the province of Groningen that they are (also) responsible for. Unlike other provinces, there are little to no alternatives in certain areas.

This is where my autism diagnosis comes from. This helped me get some approval for adjustments while I was in high school and also I was taught some things and had assistance with understanding how an ordinary human would think and react.

Skipping to when I graduated in August 2018, I started to get very depressed. Since I had to drop out of college, I was at home 24/7. I already was struggling enough with being transgender (and having to wait almost two years before I could talk to anyone about me), however I also started to get depressed. I didn’t talk to people anymore. No friends, no contacts, no talking, just loneliness and isolation. I had mentioned this with Lentis, however they did not know what to do initially. A lot of what happened here I don’t remember. However the TLDR is that nothing was done, and just talking about things didn’t help me. Something that startled me was when in 2019 things were getting really, really bad for me.

At this point things were bad enough that suicide was starting to become the only option for me, with (I guess) the people there not taking me seriously or whatever. At some point during a session with my psychologist, I was starting to get open about my suicidal thoughts. The person I was talking to pretty much told me that if my suicidal thoughts are real, they are going to hold me there against my will. As soon as she said that, I started faking that I was doing better. I didn’t feel safe talking there anymore, all I could do was to lie. To make it clear, I was still honest about that I felt very sad and upset with myself. However I would never mention my suicidal thoughts again from that point on. My psychologist at the time mentioned that my depression could be from trauma, so something like EMDR may be an option. However she also mentioned that she thinks I should considering opening up to the idea of ECT, considering that my anti-depressants at the time were not really helping me.

Now, as some of you can imagine, as soon as ECT was mentioned (and what they said about holding me), I immediately informed my psychologist that I will no longer be seeing her. This was right before the pandemic, near the end of 2019.

I did see her one more time afterwards, but I fully lost trust in her. As at this point I was 18.5 years old, and she was technically for 18 years and younger, I was passed onto a new team that is for adults (18+). Unfortunately I was scared enough that even with a new psychologist and psychiatrist, I couldn’t get myself to be honest about my feelings anymore. I was always “fine”, or “doing okay”. I would never use the word “good”, or “great”, but I was never honest about how I truly felt anymore. I just couldn’t.

Eventually in either 2020 or 2021, I stopped my care at Lentis, as there was no point for me to go there if I can’t even be openly honest about how I truly felt. From telling myself that “I’m fine ™” I actually felt a bit better, sort of. Luckily in 2022 I was able to start Hormone Replacement Therapy, which really got my mood up and I was excited. However, unfortunately, near the end of 2022 I was rapidly getting worse again.

I never dared to ask my doctor for help, as I wasn’t up to being held somewhere against my will, so I just kept things quiet. In April 2023, I had decided to go on a trip to Berlin. I felt so bad that my goal was to commit suicide on my way back home. I already had the letters ready, the text messages, the cancellation notice for the datacenter, everything was fully prepared. Luckily, and (in a way) unfortunately, I had an online friend, who I was saying farewell to, confess that they were in love with me ever since we met in mid-2018. He convinced me to go to my doctor and openly talk about the situation to him. However, he didn’t take me seriously and I, for the first time, started cutting myself with a knife in my arm.

I met my -now boyfriend- in real life in May 2023. I was there for around 50 days before returning home in early July 2023. I had a parent and someone from a hospital contact my doctor, and he was starting to take me seriously. I was given appointments with one of his assistants who used to be a psychologist. Eventually, I was forwarded to Lentis their “crisisteam”. Their crisisteam is a very-short-term (but quickly available) team to be send to for usually suicidal people. Their sole purpose it to take the “crisis” out of a situation and try to find a place for help afterwards. You can only have five appointments maximum with them (intake not included), and they openly mention how most people actually get send back to them at least one more time. Now that’s not something to be proud of, I would think. But it certainly sounded like they meant it that way. Anyway.. after two intakes and two appointments.. the unthinkable happened. The psychiatrist told me: “the laws changed and we’re not allowed to hold anyone against their will, as long as they know what the consequences of suicide are. In your case, you know what consequences it has, so we can’t (and won’t/don’t want to) hold you against your will. However, because of this and how close to killing yourself you are, we are afraid of helping you, as we think that if we do anything wrong, you may kill yourself, and none of us want to live with that decision. So, we have to ask you to leave. We cannot help you.”

Now that was a shocker, the literal last resort that a doctor would call, gave up on me. I was “too difficult” and they were too scared to help me. Now, that lead to two occasions where I was very close to killing myself. The doctor’s assistant said that my mood swings aren’t from HRT, which the hospital agrees with. They think it’s from something else, and put me on a waiting list to see a psychologist or psychiatrist, back with Lentis at the same location I went to when I was moved to the team that handles adults. Right now, when I type this on August 24th 2023, I am on the 8 month waiting list to see anyone.

I’m holding on tight, and still cut myself on my left arm often to make life bearable for me. The physical pain is a lot easier than the mental pain. My boyfriend tries to help me, and I try to hold on to him.

Thanks for reading. Let’s hope these 8 months, if I make it, are worth it.