Redesigning Psychiatry

Abstract

The mental healthcare system in the Netherlands is in dire need of anupdate. With 90,000 people on the waiting list, an urgent shortage instaff, regular occurrence of ‘incorrect’ diagnoses, and a persistentstigma on mental health, this was exactly what was on RedesigningPsychiatry’s mind (Redesigning Psychiatry, 2020). Steering clear of theproblems of today and rather focusing on a desired future, they crafteda vision for mental healthcare in 2030. The purpose of this project is tosupport Redesigning Psychiatry in their efforts to move towards themental healthcare system they envisioned.By gaining understanding of how societies and their functional systemstransition, a theoretic framework depicting societal change will bedeveloped. This newfound knowledge is enriched by studying ways toinfluence transitions. In parallel, a context study will be performed,to understand how change happens in the mental healthcare sector,and how people working in the sector perceive change. The theoreticframework will be used to structure and understand the findings fromthis context study, providing insight into what is influencing the systemin moving towards its desired goal. The aspects influencing change(and transition) are boiled down to four primary themes, that describeenablers next to blockers:> The challenges of addressing system lock-ins;> The inertia of mental healthcare organisations and theirinexperience with innovation;> The balance between intuitive and scientifically funded change;> The effect of growing public interest on the system.Making use of the newly gained understanding of transitions andways to influence them, a strategic repertoire is created to addresseach of the challenges. Furthermore, the most relevant challenge forthis project—the challenge of organisational inertia—is addressedin a more specific strategy. The strategy outlines a way to structureinnovation in mental healthcare organisations as a means to increasethe organisation’s capability to address systemic problems, and thusits readiness for transitions. Redesigning Psychiatry’s role in this is asa facilitator of design processes and knowledge exchange. The resultsof this project have been evaluated with experts, which enabled afurther detailing of the proposed strategies.