[External referrals within the Wvggz at a mental health institution in the Rijnmond region].

Background: Since 2020, the Compulsory Mental Healthcare Act (Wvggz) has been in effect in the Netherlands. This law provides the option for ‘compulsory care’ for individuals experiencing severe harm as a result of a mental disorder. A new element introduced by this law is the ‘external referral’ (externe aanwijzing). This allows anyone to raise concerns about a citizen’s mental condition and report it. This can lead to an external referral of a medical director (GD), initiated by the public prosecutor. The GD is responsible for determining whether care is needed in the context of a care authorization or ‘zorgmachtiging’ (ZM).

Aim: To analyse the process of the ‘externe aanwijzing’ within Antes.

Methods: This observational study is conducted at Antes, an institution for mental healthcare, where 128 externe aanwijzingen were analyzed during the period of 2020-2021.

Results: The majority (60%) of the analyzed externe aanwijzingen resulted in a positive recommendation for a ZM by the GD. Externe aanwijzingen through a forensic route more frequently led to a ZM (68%) compared to those through the municipality (39%). Nearly all patients with a ZM received active treatment.

Conclusion: Individuals with a forensic externe aanwijzing more commonly receive a ZM directly as a result of this process. The externe aanwijzing proves to be a valuable means of engaging individuals averse to care, including voluntarily. This study provides insights into the process of externe aanwijzingen and care authorizations within Antes.