Insurer cracks down on mental health clinics that refuse complex psychiatric cases
Mental health clinics that refuse to treat patients with complex psychological conditions will no longer be eligible for contracts with Menzis, a major Dutch health insurer, Trouw reports.
Patients facing severe mental health issues, such as autism, suicidal tendencies, and addiction, are often rejected by providers in the Netherlands, according to research by the patient advocacy group Mind. Clinics tend to prioritize individuals with milder conditions, which are easier to treat and yield quicker results. This leaves patients with the most pressing needs waiting years for proper care.
“Care providers are transparent about their selection criteria. They often explicitly state on their websites that they do not treat individuals with autism,” Aukje Eggenhuizen, policy officer at Mind, told Trouw. Suicidal tendencies, crisis sensitivity, intellectual disabilities, and addiction are also common grounds for rejection. “This is concerning because these individuals need care the most,” Eggenhuizen added.
Menzis is the first insurer in the country to take action on this issue. According to Janine Groeneveld, who oversees mental health care procurement at Menzis, “Excluding patients in mental health care is upside-down logic. You wouldn’t see that in hospital care. People would go abroad if necessary to get the care they need.”
Currently, clinics with contracts through Menzis are no longer allowed to refuse patients who are suicidal or at risk of a psychiatric crisis. Starting in 2026, additional contract conditions will take effect, prohibiting the exclusion of patients based on conditions like autism or IQ levels. “These criteria say little about whether the provider can offer the appropriate care,” Groeneveld said.
Groeneveld emphasized that providers must always engage directly with those seeking care. “Only then can a proper assessment be made about what help can be provided,” she told Trouw. If a provider is unable to offer the right treatment, they are required to refer the patient to another care provider who can.
Menzis is also working to eliminate the damaging cycle of providers endlessly referring patients back and forth, a practice Groeneveld described as “traumatizing” and something that “worsens mental health problems.” The insurer will intervene when necessary through care coordination, and may even purchase additional care to fill treatment gaps.
In a notable case last year, Menzis took action after discussions with Mind and seven patients in need of highly specialized treatment for the effects of early childhood trauma. The insurer purchased extra services from two specialized centers for diagnosis and therapy as a result of those talks.
One of the patients, 31-year-old Jip, who identifies as agender, was severely traumatized at a very young age and has had negative experiences with mental health care since the age of 16. “But now I’m receiving care from a clinic where they have the right knowledge and treatment. I’m doing well now,” Jip said to Trouw. However, the treatment is expensive and could take up to ten years.
Eggenhuizen praised Menzis for its commitment to patients with complex psychiatric conditions and urged other insurers to follow suit. “Menzis can’t improve care alone,” she said. She also stressed that insurers must consult patients directly to improve their care policies. “Health insurers are legally required to have member councils. But those councils don’t include people like Jip, who know what is really needed.”
