Will the kids be alright? Deteriorating mental health, attempted solutions, and misconceptions

The mental health of children and adolescents has increasingly garnered attention in popular culture. Titles such as Johnathan Haidt’s book The Anxious Generation (Haidt, 2024), Netflix’s series Adolescence, and the documentary The Social Dilemma sparked much conversation. The topic has also gained academic interest, with researchers referring to an ongoing youth mental health “crisis” (Fonagy, 2025; McGorry et al., 2025). Although the Dutch youth healthcare system is struggling to keep up, local integrative care initiatives, such as Jeugd Expertise Punt (JEP; Youth Expertise Point), offer hope for change. This piece seeks to offer a brief overview of the challenges in youth healthcare and unpack common misconceptions about integrative care as a solution.

A youth mental health crisis?

The heightened attention on youth wellbeing is warranted, as illustrated by the noticeable upward trend in mental health problems and the use of mental health services in many WEIRD (Western, Educated, Industrialised, Rich, and Democratic) countries (McGorry et al., 2025). In the Netherlands, 1 in 27 youths received help in 1989. This rate has risen to 1 in 7 (Statistics Netherlands, 2024), with long waitlists accompanying these services (Pries et al., 2022).

Evidence explaining these trends is largely correlational, but various social and economic factors have been discussed as contributing elements. These factors include smartphone use, heightened pressure on grading and testing, competition in the labour market, increasing socio-economic and intergenerational inequalities in high-income countries, the COVID-19 pandemic, polarisation, and climate change (Lass-Hennemann et al., 2024; McGorry et al., 2025; Odgers & Jensen, 2020). Alongside an actual increase in mental health issues, the normalisation of seeking help and medicalisation contribute to the growing uptake of health services (Jeugdautoriteit, 2024; Stellaard, 2023; van der Broek, 2021).

More than a matter of money

In the Netherlands specifically, there is criticism toward the system that is supposed to meet this rising demand. Substantial challenges include long waitlists, rising costs per client, shortages of healthcare professionals, increased compartmentalisation and fragmentation of services, and mistrust among care providers due to competition and marketisation of care (Statistics Netherlands, 2024; Jeugdautoriteit, 2024; Stellaard, 2023; van Yperen et al., 2019). Experts have expressed that merely increasing funding will not resolve the issue (Jeugdautoriteit, 2024). Thus, the challenge of youth care in the Netherlands is complex, multifaceted, unstructured, and difficult to define. It is also fraught with dilemmas, as there is conflict between available resources and the desire to provide help to all the children and adolescents who need it.

Few will disagree that these challenges require change. The question is: how?

Sticks in a bundle…

To tackle the complex challenges in youth healthcare, integrative care collaborations are often seen as a step in the right direction (Goodwin et al., 2021; Rijksoverheid, 2022; Rijksoverheid, 2023). Such collaborations work toward the same triple aim: (1) improving the client experience of care, (2) enhancing the population’s health, and (3) reducing healthcare costs (Berwick et al., 2008). Typically, integrative care involves multiple health and sometimes social service providers who bundle expertise, although its definitions and forms are manifold (Goodwin et al., 2021). Compared to more conventional healthcare, it is centred on prevention and holistic outcomes for the person, rather than on diagnosing and treating a single health problem (Goodwin et al., 2021). As such, integrative care affects how care is organised and the type of care individuals receive.

Integrative innovators

During my research traineeship in early 2025, I had the opportunity to contribute to ongoing research on one particular integrative initiative: Jeugd Expertise Punt (JEP; Youth Expertise Point). JEP is a partnership of six youth healthcare providers with different areas of expertise. It serves as a key player in arranging youth healthcare in Veendam, a municipality with the second-highest rate of children seeking youth care in the Netherlands (Statistics Netherlands, 2024). Notably, JEP has managed to eradicate waiting times in Veendam and is gradually reducing costs, without displacing demand elsewhere (Weeda, 2025). Hence, they are making impressive steps towards the aforementioned triple aim. The initiative has recently received national recognition (Actie Leer Netwerk, 2025; Weeda, 2025).

Whereas in conventional setups, highly trained professionals are introduced at the end of the care trajectory, JEP puts experts at the forefront. Expert support is embedded in schools and general practitioners’ offices, facilitating earlier problem identification and enabling support within easy reach. These practitioners can provide help for low-complexity problems, or give further referral where necessary. Rather than working from a shared physical office, JEP offers an accessible shared online entry point across partner organisations where youth and their families can apply for care.

When an application calls for comprehensive help, JEP employs a diagnostic method known as Verklarende Analyse (Exploratory Analysis). This approach involves the child or adolescent and their social environment in examining different areas of life, such as family, school work, and social relationships. This way, the underlying factors contributing to the problem are identified, rather than merely assigning a diagnostic label (Jeugd Expertise netwerk Noord-Nederland [JENN] et al., n.d.; Nederlands Jeugdinstituut, 2025). This builds a holistic and client-centred understanding of the case, uncovering where it is most helpful to intervene. The JEP partner best suited to address the youth’s needs takes charge of their question, sometimes in collaboration with other partners when deemed necessary. The analysis takes time and expert knowledge, but helps to determine the most suitable help in one go.

Misconceptions

Amid the complexities of the youth healthcare field, initiatives such as these demonstrate that tackling care demand is possible at the local level. Yet, during my traineeship, I encountered persistent misconceptions about youth healthcare and integrative care. Such misconceptions can cloud the narrative, shaping public debate, policy, and the expectations of both families and practitioners alike. Some of these I initially held myself, while others were raised in conversations with professionals and in the literature. Below, I have attempted to address a few widespread and stubborn ones.

1. The more specialised, the better.

Currently, the dominant way of thinking about youth healthcare assumes that increasing specialisation is the ultimate goal. Individuals perceived as “abnormal” are deemed best helped through a specific diagnosis and a corresponding specialised treatment, often separated from their environment (Stellaard, 2023). However, the focus on specialisation, diagnosis, and labelling has fabricated a diverse array of care services operating in a highly fragmented system. Many children are shuffled between services without receiving the appropriate help, particularly if they have co-occurring issues or do not fit a label (NOS, 2017; Stellaard, 2023).

JEP’s approach steps away from this status quo by investing in preventative and holistic care, as experts have long advocated for (e.g., Goodwin et al., 2021; Broersma et al., n.d.; Spijk-de Jonge et al., 2022). The explanatory analysis in particular helps determine the best approach to care, which need not always be specialised. Indeed, whereas the number of specialised healthcare providers in Veendam has subsided drastically, waitlists have disappeared, and demand has decreased (Weeda, 2025). While specialist care is necessary, it should not be the sole focus, given the current challenges in meeting care demand.

2. In integrative care, quality of care diminishes because of the diffusion of responsibility.

When I first heard about the integrative care initiative, diffusion of responsibility amongst employees was a concern of mine. It is a well-known phenomenon in the social psychology literature: when many individuals from different organisations can be held accountable for tasks, they can become negligent (Forsyth, 2019). Ironically, I found the opposite to be true.

The partnership is built to share expertise, allowing solutions to be developed collaboratively by appointing the right individuals to the right positions. Because the solution is found through explanatory analysis (JENN et al., n.d.), caretakers bear significant responsibility. Rather than following label-related procedures and ticking boxes, the professionals are tasked with developing their own meaningful diagnoses. In the partnership, caregivers shared that they noticed a heightened sense of responsibility among one another; there are no longer rules to fall back on or to blame, only one’s own personalised analysis.

3. Integrative care dilutes expertise.

A connected misconception is that expertise is lost in integrative alliances, as caretakers must juggle many new responsibilities. I will not deny that setting up a partnership comes with additional obligations, especially in understanding how to collaborate integratively. However, it is not the case that every professional is expected to be a jack of all trades. In actuality, an integrative partnership often constitutes a network of experts. Through knowledge sharing and collaboration, expertise is not diluted. Rather, it gets to play a role at the time and place where it is most impactful, and prevents clients from being sent down the wrong path.

4. What works in one place will work in another.

Upon learning about the initiative’s success, I couldn’t help but wonder: “Why aren’t we implementing this everywhere, and how can we?”. Here, I encountered a particularly tricky misconception of integrative care: the notion that there is a panacea or a blueprint that can be copied and pasted. However, as we have learned, complex problems rarely lend themselves to one-size-fits-all solutions, and believing this might come at the expense of integrative initiatives.

There are numerous examples of forced integrative networks that have been unsuccessful (Stellaard, 2023). What sets the current partnership apart is not only its unique approach to holistic and preventative care. It is also the fact that their approach is tailored to the local context, the systems in which it operates, and the wishes of individual partners. The partnership’s creators identified several key components as success factors, including mutual trust between partners, trust from the municipality, dedication, and a shared vision. Taking the time to build a collective narrative and trust has previously been highlighted as essential in integrative initiatives (Kaehne, 2019).

Without necessary tailoring, a partnership may not succeed, despite using a setup that has proven fruitful in another context with other partners. To successfully establish an integrative initiative, the context of place and partners need to be carefully considered. Otherwise, we might see integrative initiatives fail due to design and implementation errors, and falsely conclude that all such initiatives are ineffective.

5. We don’t have time or money for integrative care.

Collaboration can be a lengthy and painstaking process. As described above, setting up an integrative partnership requires time, tailoring, and commitment. Moreover, the explanatory analysis approach is more time-consuming than following standard procedures. Alongside the time issue, these elaborate diagnostic processes and putting professionals at the front of the care process might sound like a costly enterprise. With the long waiting lists, rising demand, and financial hardships in the field, setting up complicated partnerships might not seem like the right investment.

However, the current case illustrates that investing in the right type of care can save both time and money. Firstly, slowing down at the moment of diagnosis may help arrive at the correct problem identification in one go. This can prevent the escalation of problems and the need for more intensive care, and also help the person in question get back on the right track. As a result, less time and money are spent on each client. Secondly, an integrative initiative such as this one can even prevent the need for extended professional care by allowing youth mental healthcare to be stationed in schools and at general practitioners. Early identification of potential problems thereby saves individual suffering, while also saving money. Integrative care is a long-term investment.

Complex does not equal hopeless

I hope this article has sparked an interest in the potential of integrative, holistic, and preventive initiatives. The partnership I have discussed demonstrates the possibility of local-level sustainable solutions that can address the growing demand for youth care, ultimately benefiting both the youth and the system. It is tempting to become disheartened by negative headlines and numbers, as well as the lack of a nationwide and quick fix. However, what personally gives me hope is not a blueprint or a policy document, but the determination of small groups of motivated professionals who refuse to give in to cynicism.

Tara is a second-year student in the Research Master Behavioural and Social Sciences, in the track Understanding Societal Change. Her background is in social psychology, sociology, and policy analysis, with a special interest in education and youth wellbeing.

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Header image from Pixabay.