We need to rethink how we talk, think, and act about mental health
David van den Berg, endowed professor at Vrije Universiteit Amsterdam, calls for a fundamental change in mental healthcare. He advocates moving away from rigid classifications towards recognising the complex interplay between biological, psychological, and social factors. On 13 December, he will deliver his inaugural lecture.
Mental healthcare in the Netherlands (GGZ) does a lot of good and helps countless people each year, Van den Berg emphasizes. But there is still room for improvement. “Many people struggle with severe, long-term mental health issues, and our sector is at a turning point. We need to fundamentally change the way we work.” He believes that change starts with embracing complexity. “Mental health issues arise from an intricate interaction of biological, psychological, and societal factors. Since these elements constantly influence one another, we can never fully know what causes or sustains someone’s problems.”
Van den Berg argues that mental healthcare should focus on understanding and breaking these interaction patterns. This means using new language, fostering more equal relationships with clients, and promoting agency – empowering clients to take control of their own care. “We need to adopt a more humble stance. Our knowledge is valuable, but it must be applied in collaboration with the client.”
Complexity as a foundation for change
Van den Berg combines his work as a clinical psychologist with academic research. He leads the Mark van der Gaag Research Centre, part of the Parnassia Group in The Hague, and holds the endowed chair of Clinical Psychology at Vrije Universiteit Amsterdam. His work explores how embracing complexity and fostering equal partnerships can lead to better care.
Driven by a passion for improving mental healthcare, Van den Berg sees his role as a bridge between science and practice. “On one hand, I work with colleagues at the university, and on the other, I’m on the ground, engaging directly with clients. Our work is grounded in science, and science is one of the most important tools for transforming mental healthcare.”
Moving away from rigid classifications
Van den Berg highlights the tendency to use standardised treatments based on fixed diagnoses, even though each client’s experience of, for example, depression, is unique. “The current system often causes harm: mild issues are sometimes overtreated, while complex problems are undertreated.”
He envisions a future where care goes beyond labels to consider factors such as home life, physical health, and social context. “It may take more time upfront to explore all these factors, but in the long run, it saves time and prevents prolonged treatment.”
A concrete example is a new diagnostic process that Van den Berg and his team are developing. “Currently, a client often receives a diagnosis after just one session, playing a passive role in the process. We’ve initiated an experiment involving three sessions.” In the first session, the client’s life story is explored: who they are, what they’ve experienced, and what their life looks like. In the second session, clinician and client work together on a visual map of the client’s mental health issues using a smartboard. The third session focuses on the future, developing a recovery plan. “We work through co-creation, not hierarchy. Loved ones are actively involved. This often helps clients with complex issues feel truly understood – and better understand themselves.”
The stigma around complex mental health issues
Van den Berg emphasises that stigma is a significant barrier in current mental healthcare. “People diagnosed with conditions like borderline personality disorder or schizophrenia are often stigmatised. They face fewer opportunities, are reluctant to date, and struggle to find work. This is why we aim to develop language that better reflects reality and reduces the divide between ‘ill’ and ‘healthy’.”
Through this new approach, Van den Berg hopes that clients will feel more understood and that treatment outcomes will improve. “When people feel seen and taken seriously, they better understand their situation and what’s needed for recovery. That’s the key to sustainable change in mental healthcare.”