Peace of mind: The Bulletin's guide to mental healthcare in Belgium

Mental health encompasses our emotional, psychological and social well-being. It affects how we think, feel, and act and helps determine how we handle stress, relate to others, and make choices.

Problems with mental health can occur at every stage of life, from childhood and adolescence through adulthood, mental ill health covers mild to severe disorders that can affect your thinking, mood and behaviour.

Many factors contribute to mental health conditions, including biological factors, life experiences and family history. The Covid pandemic saw a rise in mental health disorders, especially among young people.

While migration is a known stressful situation, some studies show that expats also have a higher risk of encountering mental health problems, due to work pressure, language difficulties, adapting to a new environment, not understanding how society and services work, loneliness and homesickness.

Warning signs and symptoms range from disruption to sleep patterns, irritability, change in behaviour, increase in alcohol or drug consumption, social-isolation, mood swings, lack of motivation and inability to perform basic tasks either at home or work to hearing voices and thinking of self-harm.

Although mental health is now much more openly discussed, it’s still difficult to recognise when you need to reach out for help or admit to struggling with your well-being. The support role of family and friends can be very important at this stage.

It’s important to know where you can get help when you experience stress, whether it’s to combat serious psychological disorders such as depression, anxiety or addiction or to improve general wellbeing, interpersonal relations or self-efficacy in daily life.

The majority of resources in Belgium are for French- and Dutch-speakers, but some practitioners speak English and there’s increasingly services for other languages, including English.

It has to be pointed out that Belgium’s psychiatric services remain under resourced and there’s a relatively lower number of psychiatrists compared to psychologists. It can be difficult to secure appointments for more serious disorders and to get effective care in crisis situations. The number of available bed in psychiatric units and wards is also under pressure.

Finding a doctor or specialist

Your first port of call should be your GP, whether for yourself or a family member. They can provide advice and make a referral. It’s also possible to approach a psychiatrist, psychotherapist or counsellor, although you’re advised to first discuss any concerns with your GP. In the Brussels region, doctorbrussels.be is a useful site to find a GP, along with docetena.be.

Doctors, specialists and psychologists can be found via the following sites:  Ordomedic (in French/Dutch), medecinbelgique.com (French/Dutch). You can also consult the website of the Belgian Federation of Psychologists to find a recognised psychologist and check the membership list of the Belgian Association for Psychotherapists to find a reliable psychotherapist.

Insurance cover

Appointments with psychiatrists are almost fully reimbursed. Many health insurance funds will partially repay the costs of psychological or psychotherapeutic help but the conditions and amounts differ. Reimbursement of psychotherapy is frequently excluded from complementary cover. Information on all services can also be found in the health sections of regional authority websites or from your health insurer.

Organisation of mental healthcare in Belgium

Mental healthcare policy is partly the competence of the communities and regions as well as the federal government. To encourage cohesion, the Inter-Ministerial Conference on Public Health (IMC Public Health) was set up, which governs reforms of the system.

Reforms focus on healthcare for Adults as well as Children and Young people, resulting in pilot projects for the two sectors that are designed to result in new regulations and funding. There are also steps to create new policies for the Elderly target group.

The guiding principles for reforms in the sector are Socialisation of mental healthcare and Network collaboration.

Socialisation means care is provided in the patient’s immediate environment, including those suffering severe psychiatric disorders. Hospitalisation with more intensive care should be as short as possible with follow-up care provided in the community.  Mobile teams are available among outreach services.

Network collaboration requires care providers and actors to work together to realise personalised care plans, based on the individual healthcare needs of patients. Across the country, there are 20 mental healthcare networks for adults.

More info on adult networks: psy107.be

More info on children and teenager networks: Psy0-18

Brussels region network for under 18s: Bru-Stars

Hospitalisation

Belgium has 51 psychiatric hospitals and 67 psychiatric units in general hospitals. One third of these units have a limited offer in terms of psychiatric care for adults with between one and 30 beds. A full list of hospitals around the country can found at hospitals.be.

As part of reforms, nine High & Intensive Care units have been introduced initially in Flanders, following the Dutch model.

Currently, emergency admissions to psychiatric units are on the rise, especially for teenagers and youth. The corona pandemic is one explanation, along with increasing social isolation.

Involuntary treatment

When a patient refuses voluntary treatment and is regarded as risking either their own health and/or safety or the health of others, compulsory psychiatric admission can be considered. Since 2011, forced treatment has been on the rise.

There is a non-urgent procedure and urgent procedure. For both, the judicial authority is involved. The non-urgent procedure requires an application and medical recommendation (not older than 15 days) by a concerned party (usually a family member) to the local Justice of the Peace. A GP may initiate the procedure, retaining an advisory role. The Justice of the Peace will visit the patient, in home or in hospital, accompanied by a lawyer and psychiatrist, and makes a decision within 10 days.

The period of assessment in a psychiatric unit can last up to 40 days. For the urgent procedure, the local prosecutor is contacted and their deputy makes the decision on hospitalisation based on an immediate psychiatric assessment. Within 24 hours the request and recommendation are sent to the Justice of the Peace who will visit the patient in hospital within 10 days.

The 40-day assessment period can be prolonged if the medical director of the psychiatric hospital considers it necessary. The Justice of the Peace revisits the patient and decides on further detention. An appeal process is available to the patient. Unlike other countries, such as the UK, there is no specific role for a social worker.

Further links for mental health services

Belgian Association for Psychotherapy
abp-bvp.be

Brussels Region Mental Healthcare
ccc-ggc.brussels

Commission of Psychologists
About us | Commission of psychologists (compsy.be)

Psyche (Flanders)
Home - Psyche - Geestelijk gezond Vlaanderen

Wallonia Region healthcare
Accueil | AVIQ

Support for mental health and psychosocial disorders

ADHD – ASC – Dyslexia Family Resources Belgium
Multidisciplinary network providing support to English-speaking families.

Alcoholics Anonymous
English-speaking support group in Brussels, online as well as in-person meetings.

Alcohol Hulp
Alcohol addiction information and support (in Flemish).

ANBN
Online and phone advice from Leuven centre on eating disorders (Dutch).
Telephone: 016.89.89.89

AnoréVie
Nonprofit offering different therapeutic approaches to anorexia, bulimia and eating disorders (in French).

AWEL
Flemish helpline for children and young people. The service, run by volunteers, guarantees anonymity.
Telephone: 102

Brussels Mindfulness Institute
Anti-stress therapy in eight-week courses, free workshops and monthly mindful happy hours. Plus courses for mindful parenting.

Buddywerking
Flemish peer support project for people with mental health conditions.

Centre de Prevention du Suicide
The suicide prevention centre (French/Dutch) also helps people of all ages with their mental health.
Helpline (French): 0800.32.123

Centrum Ter Preventive Van Zelfdoding
The suicide prevention centre (services in French/Dutch) also helps people of all ages with their mental health.
Helpline (Dutch): 1813

Community Help Service (CHS)
24/7 telephone hotline offering support and advice in English alongside mental health centre for adults, children, adolescents and families with multidisciplinary and multilingual team.
Hotline: 02.648.40.14

Druglijn
Service and helpline providing anonymous information, advice and guidance on alcohol, drugs, psychoactive medicine and gambling.

Ecoute-enfants
Free anonymous helpline, daily from 10.00 to midnight (French). The service is for children, teenagers and parents.
Telephone: 103

Le Chien Vert
Mental health support for children, adults and families.
Telephone: 02.762.58.15

CRéSaM
Reference centre for mental health professionals and services in Wallonia.

Ligue Bruxelloise Francophone pour la Santé Mentale
Alliance of mental health professionals.

Mens Sana
Online information for chronic mental health conditions, in particular schizophrenia (French).

Infor Drogues
Drug addiction information, support and prevention in Brussels and Wallonia.

Mental Health Europe
Independent umbrella organisation representing mental health associations in Europe, advocating for a psychosocial approach.

Narcotics Anonymous Belgium
Support and hotlines available in French/Dutch/English by this community-based organisation.
Antwerp: 0478.62.62.62
Brussels and South region: 0476.64.30.54
Namur: 0488.70.65.75

Plateforme de Concertation pour la Santé Mentale
The mental health association serves French- and Dutch-speaking people.

Psygroup
Multilingual centre in Etterbeek run by association of independent psychologists. Offers therapy and coaching

Similes
Support for families and friends of people suffering from psychiatric and psychic problems. Associations in Brussels and Wallonia (French) and Flanders (Dutch).

Schizophrenia 24x7
Support for sufferers of schizophrenia and psychosis (French/Dutch). Platform provided by Janssens pharmaceutical company.

Te Gek
Organisation in Flanders providing information and campaigns to reduce stigma and increase awareness about mental health.

Télé-Accueil
Six centres in Brussels and Wallonia offer a helpline for people of all ages (in French).
Telephone: 107

Ups & Downs
Self-help in Flanders for people with bipolar disorder and chronic depression.

Zelfmoord
Suicide prevention, all ages (in Dutch).
Telephone: 1813

This article was updated in October 2023.