Primary mental health care      

AnnemiekeVanStraten

Prof. dr. Annemieke van Straten

During the last decade several initiatives have been taken to strengthen Dutch primary mental health care. Starting in 2014 mental health care will be delivered by (1a) mental health nurses in GP practices who clarify the request for help and deliver very brief interventions. They refer patients with a DSM diagnosis who need treatment to (1b) ‘general mental health services’ where low intensity psychological treatments are delivered. Together, the treatments offered by a mental health nurse or general mental health services are called ‘Basic mental health care’. More severe, complex or chronic patients are referred to (2) specialized mental health services where longer, more intense, treatments are delivered. In this program we study these basic mental health services. We examine the (cost)effectiveness of low intensity treatments for different mental health problems (e.g. depression, anxiety, insomnia) and different target groups (e.g adults in general, pregnant women, people with a physical disease, adolescents) with a special emphasis on Internet treatments. We also study the most efficient and effective way to deliver those services (e.g. through stepped care). The department of Clinical Psychology has established an academic collaboration with Prezens (a basic mental health service) in order to (1) perform research into  different aspects of basic mental health care (2) train future psychologists in basic mental health care (3) establish a best mental health practice. 

Main projects:

Examples of recently finished or current projects are:

  • effectiveness of a Stepped care program in primary care for depression and anxiety,
  • cost-effectiveness of offering Internet treatments to people on the waitlist for regular face-to-face treatment,
  • effectiveness of Internet treatment for insomnia (in general and for breast cancer patients),
  • effectiveness of Internet treatment for pregnant women with low mood,
  • qualitative research on the role of the mental health nurse in GP care.

Representative publications:

  • Bower P, Kontopantelis E, Sutton A, Kendrick T, Richards DA, Gilbody S, Knowles S, Cuijpers P, Christensen H, Meyer B, Huibers M, Smit F, van Straten A, Warmerdam L, Barkham M, Bilich L, Lovell K, Tung-Hsueh Liu E. Influence of initial severity of depression on effectiveness of low intensity interventions: meta-analysis of individual patient data. BMJ 2013;346:f540.
  • Kenter R, Warmerdam L, Brouwer-Dudok de Wit C, Cuijpers P, van Straten A. Guided online treatment in routine mental health care: an observational study on uptake, drop-out and effects. BMC Psychiatry 2013, 13:43.
  • Seekles W, van Straten A, Beekman A, van Marwijk H, Cuijpers P. Effectiveness of guided self-help for depression and anxiety disorders in primary care: a pragmatic randomized controlled trial. Psychiatry Res. 2011;187(1-2):113-20.
  • van Straten A, Seekles W, van ‘t Veer-Tazelaar N, Beekman ATF, Cuijpers P. Stepped care for depression in primary care: what should be offered and how? Medical journal of Australia 2010; 192: S36–S39.
  • van Straten A, Emmelkamp J, de Wit J, Lancee J, Andersson G, van Someren EJW, Cuijpers P. Guided Internet delivered  cognitive behavioural treatment for insomnia: a randomized trial. Psychological Medicine, In press.