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Health Policy. 2014 Feb;114(2-3):263-8. doi: 10.1016/j.healthpol.2013.07.009. Epub 2013 Aug 7.

Recommendations for the organization of mental health services for children and adolescents in Belgium: use of the soft systems methodology.

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shiftN, Belgium.
Belgian Healthcare Knowledge Centre, Belgium.
Belgian Healthcare Knowledge Centre, Belgium. Electronic address:


The prevalence of mental health problems among children and adolescents in Western countries is high. Belgium, like many other Western countries, struggles with the set-up of a coherent and effective strategy for dealing with this complex societal problem. This paper describes the development of a policy scenario for the organization of child and adolescent mental health care services (CAMHS) in Belgium. The development process relied on Soft Systems Methodology including a participatory process with 66 stakeholders and a review of the existing (inter-)national evidence. A diagnostic analysis illustrated that the Belgian CAMHS is a system in serious trouble characterized by fragmentation and compartmentalization. A set of 10 strategic recommendations was formulated to lay down the contours of a future, more effective CAMHS system. They focus on mastering the demands made on scarce and expensive specialized mental health services; strengthening the range of services - in particular for those with serious, complex and multiple mental health problems - and strengthening the adaptive capacity of and the ethical guidance within the future CAMHS system.


Adolescent; Belgium; Child; Health Services Research; Mental health services; Organizational policy

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