Mental Health

Mental health matters. Understanding and supporting mental health matters to individuals, to society, to healthcare systems, and to governments. One of the aims of the Trimbos Institute is to offer guidance and support for the many ways that mental healthcare is provided, as well as offering information and expertise on many different mental health concerns. As a knowledge center, Trimbos has experts who can guide institutions and governments in the development and evaluation of mental health policies.

Mild & Moderate Mental Health Disorders: Stress and burnout

Work-related stress and burnout form a significant burden for individuals, society, and economies; these conditions stem from prolonged exposure to stressful working environments. Psychosocial risks for work-related stress and burnout can arise from:

  • poor supervision and lack of role clarity;
  • lack of control;
  • conflict with peers and customers; and
  • excessive workload.

On an individual level, work-related stress and burnout lead to emotional exhaustion, depersonalization, depression, and a feeling of lack of personal accomplishment. In addition to mental health problems, they may lead to physical ailments such as cardiovascular disease or musculoskeletal problems.

For an organization, costs arising from work-related stress and burnout among employees are significant. Presenteeism, absenteeism, and increased accident and injury rates cost businesses and society billions of euros every year at the national level.

The Trimbos Institute strives to help organizations by maintaining and improving the mental health of employees and helping employees to get back to work safely. For this aim the Trimbos Institute provides expert advice, as well as trainings and services to companies and organizations.

Mild and Moderate Mental Health Disorders: Psychosocial Care

Primary care clinicians see many individuals with psychosocial problems such as loneliness, anxiety or problems in relationships. Those with psychosocial problems make more use of primary care than those without such issues. However, these complaints do not always require care from medical professionals; in many instances, those with psychosocial problems may be better served by community-based social welfare programs. One example is the program Prescription for Well-being. In this program, primary care clinicians and social welfare professionals work together through well-being interventions to improve the mental health of those with psychosocial problems. Examples of such well-being interventions include programs that help people to: identify and make use of their positive and strong traits; understand the role of volunteering in improving and strengthening mental health; make positive future plans and dreams; and experience positive outcomes from creative courses, walking in nature, improving one's lifestyle, learning mindfulness, and conducting a life review.

In Amsterdam, the aim of the Prescription for Well-being program is to connect formal care by professionals with informal care by civilians. Through the program, formal caregivers and professionals are informed about the power of public awareness and are encouraged to promote public awareness of mental health and psychosocial problems. Members of the public can volunteer or work as lay experts in mental health and social welfare programs. By connecting professionals and members of the public in this way, it is hoped that the health of the population will improve, leading to a decrease in the demand for formal, medicalized care.

Mild & Moderate Mental Health Disorders: Depression

Depression is the leading global cause of disability and affects over 350 million people world-wide. Depression causes psychological as well as physical complaints and can have a negative impact on work, school, families, and society. At worst, depression may lead to suicide, which is the second leading cause of death in 15- to 29-year-olds. Though effective treatment for depression is available, less than half of those effected receive treatment.

The Trimbos Institute works at an international level to reduce the toll of depression by providing projects, programs, and services focusing on:

  • preventing depression;
  • helping care providers recognize the signs of depression;
  • developing guidelines and care trajectories;
  • evaluating costs associated with depression and programs to treat depression;
  • self-help and family support; and
  • mental healthcare system reforms.

Mild & Moderate Mental Health Disorders: Anxiety

Anxiety disorders are the most common mental health disorders globally and occur more frequently in the more highly developed countries. Anxiety disorders include a wide range of disorders such as panic disorders, post-traumatic stress disorder, phobias, and separation anxiety disorder. Stigmatization and shame can be barriers to seeking treatment. As such, the provision of accessible and accurate information about anxiety disorders is a fundamental component to their prevention and treatment. The Trimbos Institute plays a role in the dissemination of this information through researching anxiety, developing guidelines for managing anxiety, and training care providers in new strategies for treating and managing anxiety.

Mental healthcare in the Netherlands

The Dutch government highlights the need for those with a mental illness to receive the right kind of care in the right place. In the Netherlands, the GP is responsible for the treatment and management of mild & moderate mental health disorders.

Severe Mental Health Disorders: Schizophrenia

Schizophrenia is a severe and chronic mental health disorder which can have a significant impact on quality of life. Currently, approximately 50% of people world-wide with schizophrenia lack access to adequate treatment. With appropriate treatment, people diagnosed with schizophrenia can live a full life. Appropriate treatment does not merely consist of anti-psychotic medication but requires a holistic, multidisciplinary approach.

The Trimbos Institute aims to improve the lives of people with schizophrenia through the development and dissemination of appropriate holistic treatment options for schizophrenia. To this end, the Trimbos Institute has provided support to the Multidisciplinary Guideline for Schizophrenia task force, as well as conducting research and implementing programs to enhance treatment for schizophrenia.

Severe Mental Health Disorders: Dual diagnosis

Dual diagnosis refers to patients who simultaneously suffer from a substance abuse problem and a mental illness. Dual diagnosis encompasses a wide range and combination of substance abuse disorders and mental illnesses. The interaction and comorbidity between disorders are often very complex. A dual diagnosis calls for a tailored, integrated treatment approach carried out by a multidisciplinary team. The Trimbos Institute offers help and support to professionals, institutes, and organizations on how to deal with dual diagnoses. More information can be found here.

Severe Mental Health Disorders: Geriatric psychiatry

Working with the elderly with complex mental health concerns can be tricky. Treatment and management of these complex mental health concerns should take into account declining physical condition, changes in social and living conditions, and comorbidities. The Trimbos Institute offers support and information to caregivers and organizations working with elderly clients with complex mental health concerns; this support is offered through the Netherlands Knowledge Center for Geriatric Psychiatry (NKOP).

Severe Mental Health Disorders: Bipolar disorder

Bipolar disorder is a severe, chronic condition which impacts mood, energy, and ability to function. People who suffer from bipolar disorder frequently suffer simultaneously from other mental disorders and physical illnesses. If left untreated, bipolar disorder can be very disabling. Nevertheless, appropriate treatment for bipolar disorder is available and can have a significant positive impact on quality of life.

The Trimbos Institute aims to improve the organization and delivery of care for severe mental health conditions, including bipolar disorder. To do so, Trimbos has been involved in the development of appropriate evidence-based guidelines to treat bipolar disorder since 2015.

Severe Mental Health Disorders: Dementia

Dementia is a growing concern in most aging societies. The Trimbos Institute works to reduce the harms and consequences associated with dementia. This work comes via researching the living situations of those with dementia, developing and researching e-health interventions for family members of those with dementia, and exploring treatment and management activities to improve the quality of life of those with dementia.


Staff from the Trimbos Institution author or co-author nearly 200 publications a year. These range from peer-reviewed articles in distinguished Dutch and international journals to research reports and doctoral theses. Some of these articles and reports can are listed below.

van der Ham AJ, van Erp N, Broerse JE. Monitoring and evaluation of patient involvement in clinical practice guideline development: lessons from the Multidisciplinary Guideline for Employment and Severe Mental Illness, the Netherlands. Health Expect. 2016; 19(2):471-82. 

Willemse BM, de Jonge J, Smit D, Dasselaar W, Depla MF & Pot AM. (2016). Is an unhealthy work environment in nursing home care for people with dementia associated with the prescription of psychotropic drugs and physical restraints? International Psychogeriatrics [Epub ahead of print]

Bruffaerts, R., Demyttenaere, K., Kessler, R. C., Tachimori, H., Bunting, B., Hu, C., ... & Levinson, D. (2015). The associations between preexisting mental disorders and subsequent onset of chronic headaches: a worldwide epidemiologic perspective. The Journal of Pain, 16(1), 42-52.

van Hoof F, Knispel A, Aagaard J, Schneider J, Beeley C, Keet R, van Putten M. The role of national policies and mental health care systems in the development of community care and community support: an international analysis. J Ment Health. 2015; 24(4):202-7.

Bruffaerts, R., Posada-Villa, J., Al-Hamzawi, A. O., Gureje, O., Huang, Y., Hu, C., ... & Borges, G. (2014). Proportion of patients without mental disorders being treated in mental health services worldwide. The British Journal of Psychiatry.

Wamel, A. van, Rooijen, S. van, Kroon, H. (2015). Integrated treatment: The model and European experiences. In G. Dom (ed.), F. Moggi (ed.), Co-occurring addictive and psychiatric disorders: A practice-based handbook from a European perspective (pp. 27-45). Berlin: Springer Berlin Heidelberg. doi:10.1007/978-3-642-45375-5-3

Smit, D., De Lange. J., Willemse B.M., Twisk, J. & Pot, A.M. (2015). Activity involvement and quality of life of people at different stages of dementia in long term care facilities. Aging and Mental Health, 2016;20(1):100-9.   

Smit, D., Willemse B.M., De Lange. J., & Pot, A.M. (2014). Wellbeing-enhancing occupation and organizational and environmental contributors in long-term dementia care facilities: an explorative study. International Psychogeriatrics, 26 (1), 69-80.

Willemse, B.M., Downs, M., Arnold, L., Smit, D. de Lange, J. & Pot, A.M (2014). Staff-resident interactions in long-term dementia care: psychological needs and residents’ well-being. Aging and Mental Health, epublication ahead of print.

Willemse, B.M., Depla, M.F.I.A., Smit, D. & Pot, A.M (2014). The relationship between small-scale nursing home care for people with dementia and staff’s perceived job characteristics. International Psychogeriatrics, 26(5), 805-816.

Willemse, B.M., De Jonge, J., Smit, D., Visser, Q., Depla, M.F.I.A. & Pot, A.M (2014). Person-centeredness towards people with dementia in relation to work and well-being: a cross-sectional survey study in nursing homes. Journal of advanced nursing, epublication ahead of print.

Michon H, Van Busschbach JT, Stant AD, van Vugt MD, Van Weeghel J, Kroon H (2014). Effectiveness of Individual Placement and Support for People with Severe Mental Illness in the Netherlands: a 30 months Randomized Controlled Trial. Psychiatric Rehabilitation Journal 37(2): 129-36.

Vugt M van, Kroon H, Delespaul PA, Mulder CL (2014). Assertive Community Treatment and association with substance abuse problems. Community Mental Health Journal 50(4):460-5.

Pot AM. (2013) Improving nursing home care for dementia: is the environment the answer? Aging and Mental Health, 2013;17(7):785-7.

Smit D, de Lange J, Willemse B, Pot A.M. (2012). The relationship between smallscale care and activity involvement of residents with dementia. International Psychogeriatrics, 6:1-11.

Willemse, B.M., De Jonge, J., Smit, D., Depla, M.F.I.A. & Pot, A.M. (2012). The moderating role of decision authority and coworker- and supervisor support on job demands in nursing homes: A cross-sectional study. International Journal of Nursing Studies, 49, 822–833.

Willemse, B.M., Smit, D., Lange, J de & Pot, A.M. (2011). Nursing home care for people with dementia and residents’ quality of life, quality of care and staff wellbeing: Design of the Living Arrangements for people with Dementia (LAD)-study. BMC Geriatrics 17, 11-11.

van Wamel, Anneke , Jansen, Hendrik and Kuijpers, Erik(2010) 'Addiction and personality disorders:towards integrated treatment. Implementation in an Axis II treatment team', Mental Health and Substance Use: dual diagnosis, 3: 3, 219 — 226. DOI: 10.1080/17523281.2010.505174

Smit, D. & Willemse, B. (2009). Design and environment, does size matter? Australian Ageing Agenda’s Dementia Supplement, September-October, 54.

van Wamel, Anneke, Kroon, Hans and van Rooijen, Sonja (2009)'Systematic implementation of integrated dual disorders treatment in The Netherlands', Mental Health and Substance Use: dual diagnosis,2:2,101 — 110. DOI: 10.1080/17523280902932649