Mental health care and the opposition movement in The Netherlands

In The Netherlands, there is a more or less recognized movement in the field of mental health care which is referred to as the psychiatric opposition movement or the patients movement. The nucleus of the Dutch movement consists of patients and ex-patients. As far as mental health professionals are participating in the movement, they do so as more or less passive supporters of a movement dominated by patients and ex-patients. This article is dealing with two questions. The first question is how and to what degree the opposition movement in The Netherlands has succeeded in breaking through or at least questioning the closed nature of Dutch mental health care system. The second question will be whether the dilemma between resistance and dependence in the position of patients and ex-patients is visible in the activities of the opposition movement, and whether this dilemma acted as an obstacle to their efforts to influence the mental health care debate in The Netherlands. An effort is being made to answer this question by describing the position of the opposition movement with respect to the Insanity Law and with respect to the organization of mental health care. In conclusion, three stages were found to be crucial in the development of Dutch opposition movement. In the 1970s, the opposition movement appeared to operate within the borders of a closed system in which the medical profession had a high degree of autonomy.(ABSTRACT TRUNCATED AT 250 WORDS) Dutch mental health care is described as a traditionally closed system in which the medical profession has a high degree of autonomy. Since the 1970s the traditional system has been challenged by an opposition movement that is dominated to an unusual extent by mental patients and ex-patients. A sociological analysis of the development and role of this opposition movement is presented, with particular regard to its efforts in pressing for changes in the law on compulsory hospitalization and for a reorganization of the mental health system to give patients more say in their own care and to abolish large psychiatric hospitals