Dr. Rienk Janssens: Get away from an individual approach in a collective rat race

This is an independent article from Dr. Rienk Janssens, strategic advisor at the Association of Netherlands Municipalities, part of the LGA children and young people's mental health think piece series. The piece explores the mental health situation for children and young people in the Netherlands.

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Young people under pressure

What is happening with Dutch young people? On the one hand, they consistently score high internationally when it comes to their mental or physical health and even rank number one in terms of satisfaction with their own lives. On the other hand, indications of pressure on their mental health, insecurity, stress, loneliness and depression are rising sharply. School children aged 11-16 experience more mental problems than their peers over the past 20 years. Also among students, performance pressure and uncertainties about student debt, affordable housing, jobs, as well as climate and wars, are detrimental to their well-being. Meanwhile, the government fails to give young people the help they deserve, for instance after being placed out of their homes.At the same time, the number of young people who do receive some form of care has now risen from 1 in 27 at the beginning of this century to almost one in seven today. What is not going well here? 


From 2015, municipalities in the Netherlands are responsible for supporting young people. This decentralisation of tasks was supposed to give the child support system a boost: ending the fragmented funding, controlling costs, more quality and above all: child support is no longer focused just on the individual but as part of a broader approach taking into account the needs of the young people and their families. By being closer to residents, municipalities would be better equipped to determine these needs: individual treatment of a child or perhaps family support by addressing debt, stress or housing problems. Moreover, municipalities would form 42 regions to cooperate on the provision of more specialised or infrequent forms of care.

Conflict between central government and municipalities

Municipalities' initial enthusiasm for this new task was soon dampened by all sorts of problems. In particular, adequate funding proved to be severely lacking. The transfer of tasks had been accompanied by a cut of 450 million euros, on the assumption that municipalities could deliver on child support more cheaply. That turned out to be an illusion: costs rose from 3.7 billion euro in 2015 to 5.9 billion euro in 2020, and the available budget lagged far behind. Municipalities were forced to cut back on other services such as swimming pools, libraries and community centres. 

Debate between the central government and municipalities about the cause of and the compensation for the shortfall was very heated. While the national government put the ball in the municipalities' court - too much money was being spent on administrative costs and regional cooperation was inadequate - municipalities pointed to the wrongly calculated budget cuts, the separate growing pressures on budgets as a result of a changing society, and the referral routes that municipalities had insufficient control over: after all, a lot of youth care was provided through courts, general practitioners and schools, where municipalities were presented with the bill but did not determine access. In the end, an independent arbitration committee had to come in to settle the dispute between the national government and the municipalities, unique in their inter-governmental relationship. The verdict of this commission was twofold: one, the national government had to reimburse the deficits that had arisen; two, there had to be a joint reform agenda to come up with a solution for the problems.

Youth reform agenda

In June 2023, all stakeholders reached an agreement on the content and responsibility of this joint reform agenda. Once again, controlling expenditure and improving the system will be at the centre of the agenda in the coming years. Among other things, the national government will amend the law so that there are more limits to who is eligible for support. For their part, municipalities will improve regional procurement procedures with a view to reducing administrative overhead and will work on 'robust' local teams of professionals to deal with requests for help at an early stage. In addition, everyone agrees to pay more attention to the underlying causes for both young people's problems and those of child support systems. After all, the fact that one in seven young people are in need of some form of child support, while at the same time urgent help is often not available for others, gives food for thought.  It means we as politicians and society are doing something wrong somewhere:  The problem is probably both over-care (too much help) and under-care (shortage of help). Pumping more and more money into the system is not the solution; no, we will also have to organise and, above all, approach it differently.

Taking young people seriously

First of all, this does not mean that we should downplay young people's problems. The mental pressures and worries about the future are real. Covid-19 may have emphasized these, but even before that, studies were already pointing in the same direction. Discussing this openly  is the first task and it is good that, for example, the Dutch queen Maxima plays a role in this (Letter Royal). But there is more. Discussing it is one thing, it is also about approaching (and helping) young people with a different mindset. Currently - and this has been going on for decades - the mechanism is as follows: in Dutch society, everything (education, group norms, parental expectations) is geared towards getting young people to meet certain collective norms. If they do not, they are either downgraded at school or elsewhere in society, or they are temporarily set apart to be brushed up via individual treatment or homework supervision to meet the high expectations. It is an individual approach in a collective rat race with the same standards for everyone. This can be seen in the early achievement tests to categorise pupils in the education system, in the rise of commercial homework institutes to get into the highest category and in the huge growth of child support as a result of this ever-increasing pressure.  

Radically different support needed

To do something about both the problems of young people and the stalled child support system, a radical turnaround is needed. The reform agenda outlines the first, albeit tentative, steps for this. First of all, variation in norms is needed. Not everyone needs to be able to do or perform the same. Some young people are theoretically educated, others practical. This is neither more nor less, at most different. The current education minister is therefore right to call for much more equality in further education, whether theoretical-scientific or practical-focused.

Secondly, we must move away from the individual focus on problems and help. The individual should not meet the collective via extra guidance, but the collective (school, clubs, neighbourhood) should be organised in such a way that individuals can fully engage with it, sometimes separately but mainly in a group context. The fact that a young person does not keep up is not the child’s fault, but due to the environment that does not know how to respond well to the needs of young people. Thirdly, it, therefore, means a totally different organisation of care and support. The characteristic of the current situation is its organisation in chains, with referrals to an increasingly specialised level within them. However, chains are almost always individually oriented. It is the young person who is diagnosed and referred, not, for instance, the non-functioning classroom, the problematic family situation or the failing school or neighbourhood environment. Furthermore, professionals can only make a career in that individual-oriented chain. A child psychiatrist makes more money than a social worker or an educational support worker. Besides a more environment-oriented support - called the social basis in the Netherlands - the entire training and remuneration structure therefore deserves thorough adjustment.

In conclusion

The fact that young people experience problems is not a bad thing. That is part of life and can make them stronger. However, what we should not want is for policies and public services to exacerbate rather than help reduce problems. This requires a radical change in thinking and action: from collective standards for individual young people to varied standards from collective environments. Let's not tinker with the child, but more importantly with the environment around that child.

This article and views reflected within it were provided and written by Dr. Rienk Janssens.

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