Jan Buitelaar At a closer look
The public and societal esteem of youth care in the Netherlands, and in its slipstream youth mental health and child and adolescent psychiatry, is low. Should we continue to be passive observers who wait and see? No, says Jan Buitelaar. We need to redesign and reorient.read more
Jan Buitelaar At a closer lookAbout one out of ten children and adolescents in the Netherlands receives a particular form of youth care. The numbers regarding children and adolescents with psychiatric problems are substantial: 8% of all young people suffers from severe psychiatric problems and another 15% from moderately severe problems. However, the public and societal esteem of youth care, and in its slipstream youth mental health and child and adolescent psychiatry, is low. There is an accumulation of negative media coverage, for example, about waiting lists, scandals of physical and sexual abuse, disorganized routing of families seeking help, and financial problems of institutes.
The new Youth Care Act (2015) was introduced with the best intentions to redirect youth care and youth mental health much more towards the local municipalities. However, it’s very poor preparation and lack of piloting, the lack of central control and guidance, the associated budget cuts, and the forced push to a commercial market model of health care altogether have had a destructive impact on the system of youth care and youth mental health services as a whole.
Should we continue to be passive observers who wait and see? No, says Jan Buitelaar. We need to redesign and reorient at multiple levels:
- We need to gain more central guidance with regard to the implementation of the Youth Care Act.
- We need to adjust our inflated expectations of what child and adolescent psychiatry and youth mental health services can and should offer. We should develop a more realistic perspective on what is ‘mentally healthy’. ‘Happiness’ is not something that can be produces, nor is ‘luck in live’.
- We need to empower patients to organize and self-direct their lives: they need to learn how to deal with limitations and handicaps, rather than strive for a ‘perfect normality’.
- We need to be aware of the trade-off between overdiagnosis with its risk for stigmatization on the one hand, and acknowledging that all sorts of (subclinical) subthreshold problems cause suffering and impairment of functioning on the other hand.
- We need to value the merit of scientific research: both fundamental research that focuses on the architecture of the brain and genetic and environmental risk factors, and clinically applied research are important.
- We need to invest in expanding our knowledge and expertise in a child’s early development (the ‘first 1001 critical days’) and intensify efforts for prevention.
- And above all that: we need no stay curious to study the complexity and heterogeneity of the human mand and the mechanisms that underlie and govern our human behavior.
Date, time and location Valedictory lecture
- Date: 20 September 2019
- Time: 15.45 hrs
- Location: De Vereeniging
Jan Buitelaar is professor of psychiatry and child and adolescent psychiatry at the Radboud university medical center, and at the Donders Institute for Brain, Cognition and Behaviour (DCMN) in Nijmegen, The Netherlands since 2002. He is also head of Karakter Child and Adolescent Psychiatry University Centre in Nijmegen and chair of the National Knowledge Centre of Child and Adolescent Psychiatry. Jan has a strong clinical and research interest in neuropsychiatric disorders such as ADHD, autism and impulsivity and aggression related disorders, and has directed pharmacological, cognitive, clinical, genetic, and neuroimaging studies in these disorders. His current active research is focused on translational studies aiming to identify new molecular targets for ADHD and autism through matching preclinical models to human imaging genetics studies. Jan research is supported by numerous grants from the European Union, NIH, and from the Dutch Medical Research Council. He has been editor in chief of European Child and Adolescent Psychiatry from 2003-2014. He has published more than 800 peer-reviewed scientific papers with more than 40,000 citations, and is among the top 1% of most-often cited researchers worldwide. He has supervised more than 100 PhD theses to completion. Jan has been awarded several honors, such as the research price of the Dutch Society of Psychiatry in 2011, the international travelling speaker fellowship 2011/2012 of the Association for Child and Adolescent Mental Health, and the Merz Guest Professorship at Goethe University in Frankfurt in 2014. Jan is vice-president of the ADHD World Federation, treasurer of Eunethydis (European Network for Hyperkinetic Disorders) and fellow of INSAR (International Society for Autism Research).