Discussion
In this article we described the development from evidence based clinical guidelines to standards of care and generic standards for mental health care in the Netherlands over the last decades and presented the standard of care for depressive disorders as an example.
In the present situation there are more than 40 standards of care/generic standards that have been authorized by all relevant professional organizations. The standards of care addresses specific mental disorders while the generic standards refer to overlapping themes in clinical practice. The generic standards connect the different standards of care. This complex matrix structure of standards encompasses the whole field of mental health care and describes good clinical care from the perspective of patients with mental disorders in all aspects.
This process of the development of these standards was ambitious and as far as we know worldwide unique. Several important discussions were raised on the way: How to integrate scientific evidence with clinical expertise and experiential knowledge? And how to implement more than 40 standards?