Objective: To describe the major changes in mental health care for adults in the Netherlands during the past 25 years.
Method: Scientific literature and official documents.
Results: Phases of the reform process are the integration of ambulatory services in the early 1980s and the following implementation of community mental health centres (RIAGGs); the differentiation and extramuralization of mental hospitals; the differentiation within the field of living accommodations; and the final fusion process between these three into integrated regional mental health care organizations. Current issues in the development of services are, e.g. the ever growing demand for mental health care, special programmes for defined target populations, legislation and patient rights, rehabilitation and empowerment.
Conclusion: The Dutch mental health care system has a low threshold and a comparatively good quality. There is a long-lasting and strong influence of user and family organizations on the content and quality of services. Recently important organizational changes are taking place.