Thank you for that very important question. In essence, it's a more political question than a medical question.
What I witnessed in the last 30 years is that psychiatric care, especially for the people most severely affected by mental suffering—like the population I mentioned earlier, the people with autism, personality disorders and traumatic histories—has been selectively reduced in the Netherlands.
Our health care system, which is a commercial system, is run by health care insurance companies. For health care insurance companies, providing care for the most severely psychotic ill patients is not very profitable.
In the last 15 years, this care in the Netherlands has been reduced quite significantly. The patients I could treat 20 years ago quite adequately and effectively are now perishing on long waiting lists. These waiting lists are getting longer and longer in the Netherlands. Many patients come to me, or sometimes even their parents or family members, saying, “If this system can't provide proper care to my loved one, I at least ask you, as a doctor working in that system, to be able to provide euthanasia to this person, to this family member, because you can't provide any care anymore.”
That's causing a lot of moral stress in Dutch psychiatrists, as you can understand. This has made quite an impact on many psychiatrists I speak to on a daily basis. They are very reluctant and very wary about what's happening now in our country.
We have to be quite clear that people die now, who could have been treated 10 to 20 years ago quite effectively. I've done it myself. It's actually a real shame.