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?