Mental healthcare in Belgium

Around 1 in 7 people worldwide are estimated to suffer from mental or addiction disorders. As an expat, you may be even more likely to experience problems with mental health. The challenges that come with relocating abroad as well as the physical distance from family and usual support systems can often be triggers.

Fortunately for expats moving to Belgium, the country offers a range of mental health services. That said, the combination of public and private healthcare in Belgium can be a source of confusion. To help you navigate this setup and access the support you need, this article provides information on the following topics:

Mental health in Belgium

Mental health problems in Belgium have seen a rise in recent years, particularly during the COVID-19 pandemic. In 2020, 16% of Belgium’s population suffered from depressive disorders. Additionally, 20% of the population experienced anxiety disorders. Belgium also has a high suicide rate compared to other European countries, with depression being a leading factor.

Over the last decade, Belgium has undertaken nationwide reform to improve its mental healthcare sector. It has made a shift away from psychiatric institutions and hospitalization. Instead, the country aims to provide people-centered and community-based mental health support. This includes reducing the stigma attached to mental health problems.

Regardless, only 14% of Belgians reported having consulted a mental healthcare provider in 2018. Waiting times for consultation have increased, which may discourage people from seeking help. The number of psychiatrists in Belgium specializing in severe mental health conditions also remains low compared to the number of psychologists.

As a step towards improving mental healthcare in the country, the Belgian government has announced additional funds for the sector in 2021.

Mental healthcare services in Belgium

Mental health services in Belgium are integrated within the country’s public and private healthcare system. Moreover, responsibility for public mental health services is shared between the state and the different regions. These include the Dutch-speaking region of Flanders and French-speaking Wallonia. The capital, Brussels, also has its own system.

The federal government finances psychiatric hospitals and wards and runs a few dedicated mental healthcare projects. In addition, each region provides:

• psychiatric, psychological and psychotherapeutic consultations through mental healthcare centers and consultation platforms
• specialized treatment for a range of mental health conditions through psychiatric hospitals and psychiatric wards in general hospitals
• preventative and educational programs (e.g., for young people, elderly)

Next to public mental health services, it is also relatively easy to find psychologists and therapists with private practices in Belgium. Additionally, the Brussels-based nonprofit Community Health Service (CHS), offers mental health support for the international community in several languages. CHS services include:

• Counselling and psychotherapy
• 24/7 helpline offering crisis support
• Information and practical advice (e.g., how to find a doctor)

How to access mental health services in Belgium

In Belgium, you can make an appointment with a mental healthcare professional directly. You do not need a referral from your GP/family doctor for this. However, it can be helpful to first consult your GP, particularly if you need support with more severe mental health problems.

Notably, only your GP or a psychiatrist can provide prescriptions for medication, such as sleeping pills or antidepressants. If you’re dealing with addiction or a specific disorder, they will refer you to a clinical psychologist for specialized support.

For an immediate ear, you can always call the 24/7 CHS helpline, which offers free English-language support. CHS also has its own mental health services center where you can access a range of psychotherapies in English and several other languages. Additionally, you can find information on region-specific mental health services in Belgium on the following sites:

• Agentschap Zorg en Gezondheid (Flemish Health and Care Agency)
• Commission Communautaire Française (French Community Commission)

Insurance for mental healthcare in Belgium

If you are living and working in Belgium, you will have to register with a public health insurance fund. This is a mandatory requirement within Belgium’s healthcare system.

Public health insurance funds in Belgium provide different coverage for different types of mental health consultations. In general, the funds reimburse a percentage of the costs of each session with a psychologist or psychiatrist. However, they set a ceiling on the number of sessions and the maximum amount that will be reimbursed.

Since September 2021, you no longer need a referral from your GP to qualify for reimbursements. Further, the Belgian government has planned an increased budget for mental healthcare. This will give people the right to reimbursements for up to 8 individual sessions with a psychologist. For specialized care with a psychiatrist or clinical psychologist, reimbursements will extend up to 20 individual sessions. However, you will need to seek treatment with one of the mental healthcare professionals affiliated with the public healthcare system.

For a broader coverage of the costs of mental health services, you can always take out private health insurance. Private insurance will also cover consultations with private mental health professionals. If you’re in the market for health insurance, it’s important to get a range of quotes to find the best coverage for you.

Companies that provide private health insurance for expats in Belgium include:

• Allianz Care
• Business & Expats Health Insurance
• Cigna Global

If you are in Belgium for a temporary stay or have recently moved here, you may not have access to local insurance. However, if you are an EU/EEA or Swiss citizen, you can still access the public healthcare system using your European Health Insurance Card (EHIC).

Psychologists, psychiatrists, and therapists in Belgium

Finding a therapist or psychiatrist you are comfortable with is crucial when seeking mental health support. Often, this comfort is strongly linked to the language you prefer speaking in.

The Belgian Commission of Psychologists website provides a search function to find a registered psychologist in your area who can offer consultations in your preferred language. You can also find and make an appointment with an English-speaking therapist through Psychologist-Belgium.

Additionally, as an expat, you can approach CHS to make an appointment with one of their psychologists or therapists. CHS offers consultations in several languages, including English, German, Spanish, and Italian, besides Dutch and French.

When searching for a psychologist or therapist directly, make sure they are registered with the Belgian Commission of Psychologists or are members of the Belgian Association for Psychotherapists. You can also check the qualification and affiliation of your healthcare professional on the website of the National Institute for Health and Disability Insurance (available in Dutch or French).

Session costs and waiting times

Consultation costs vary by therapist and depend on whether they are affiliated with the public or private health insurance system. Typically, a session with a private therapist lasts 45–60 minutes and costs between €50 to €70. During your intake interview, your therapist will ask questions to understand the problems you wish to address. They will determine how many sessions you should begin with and discuss this with you.

Consultations that fall under public health insurance can cost as little as €11. However, the waiting times for public healthcare professionals may be longer. In 2018, Flanders-based healthcare centers reported an average waiting time of over 50 days.

Drug and alcohol services in Belgium

The most common addiction disorders in Belgium relate to alcohol and cannabis. Substance addiction involves both physical and psychological problems that require specialized care. As an expat, finding the right support to tackle addiction may be challenging.

If you are facing problems with drug or alcohol addiction, your GP is the best point of contact. Your GP can assess your case and provide a referral for appropriate outpatient or inpatient care. Alternatively, you can go to one of the specialized rehabilitation centers affiliated with the public healthcare system.

Costs of consultation and care will be partly reimbursed by public health insurance. You should be aware though that hospitalization costs related to this treatment are not sufficiently covered in your basic public health fund membership. You will need to get an additional insurance package to cover these costs.

Waiting times at public rehabilitation centers can be as long as four weeks. By contrast, private rehabilitation centers may provide faster support. Regardless, this is an expensive option if you don’t have adequate coverage through private health insurance.

Helplines and support groups for addiction

If you have to wait a while to begin treatment, there are several helplines and support groups you can contact in the meantime:

• Narcotics Anonymous Belgium – Helpline for people experiencing problems with drug or alcohol addiction with three numbers you can call (Antwerp: +32 478 62 62 62, Brussels & South region: +32 476 64 30 54, Namur: +32 488 70 65 75).
• DrugLijn – Belgian helpline (+32 78 15 10 20) for alcohol and drug problems also offering support in English.
• Alcoholics Anonymous Central European Region – English-speaking support group that organizes online as well as in-person meetings in Brussels.
• AlcoholHulp/Aide-Alcool – Dutch/French website offering online self-help and guidance for alcohol addiction.

Services dealing with eating disorders in Belgium

The number of patients with eating disorders in Belgium has doubled since the start of the COVID-19 pandemic. While most patients are young girls aged 14-16, hospitals are seeing children as young as 10 or 11 with conditions such as anorexia and bulimia. Moreover, doctors state that patients often come to them in a worse state than was the case previously.

Public health services for eating disorders in Belgium can be accessed following a referral from your GP/family doctor. Treatment for these disorders is complex and usually takes time. It involves a multidisciplinary team of healthcare professionals addressing both physical and psychological aspects.

Unfortunately, waiting times for some treatment clinics are over four months. In Belgium, children and young adults get greater reimbursements for public healthcare services, including psychologist and psychiatric consultations. Even so, insurances may reimburse only part of the total care and consultation costs.

In addition to seeking professional help for eating disorders, you can also contact the following support groups:

• ANBN – Belgian self-help organization for people with eating disorders
• Overeaters Anonymous – International support group that offers weekly meetings in English in Brussels and in Dutch and French in several Belgian cities.

Services for severe mental health problems in Belgium

If you’re suffering from severe or long-term mental health problems, you will likely need to consult a psychiatrist or clinical psychologist. This includes conditions such as severe anxiety, depression, chronic conditions or personality disorders, PTSD, and others. You can approach your GP for a referral or go directly to a mental healthcare center.

The responsibility for psychiatric support in Belgium is shared between the federal government and the regions. The federal government finances and sets the conventions for psychiatric hospitals and wards, while the regions are responsible for treatment provision. Following healthcare reforms, Belgium has been making a shift away from psychiatric institutions and hospitalization. Instead, it aims to provide people-centered and community-based mental health support, inspired by the community care model of Geel.

Psychiatric care is usually provided by multidisciplinary teams of psychiatrists, psychologists, and social workers. Services include therapy and counseling, daycare, residential care as well as sheltered housing.

The number of psychiatrists in Belgium remains low compared to the number of registered psychologists. As a result, waiting times for treatment can be long, usually upwards of a month. For emergency support, you can always go to your local hospital. Bear in mind though that you’ll need to take out supplementary insurance to cover hospitalization costs.

Consultations with clinical psychologists and psychiatrists are almost entirely covered by public health insurance, provided you consult a specialist affiliated with the public health insurance system. Additionally, here are some support groups for people with chronic conditions:

• Ups & Downs for people with bipolar disorder or severe depression
• ADHD – ASC – Dyslexia Family Resources Belgium (AFRB) for people with ADHD and conditions such as dyslexia, dyscalculia, dyspraxia and Asperger’s syndrome.

Mental healthcare for children and young people in Belgium

Belgium ranks eighth in the list of best countries in the world to bring up children. However, when it comes to children’s mental well-being, Belgium drops to 17^th place. Moreover, mental health among young people in Belgium has been worsening following lockdown during the COVID-19 pandemic.

This has placed Belgium’s mental healthcare services under extreme pressure, resulting in long waiting times. The Belgian government addressed this shortfall, announcing an additional €20 million in April 2021. The funds will be used to hire additional staff and increase hospital capacity for child psychiatry.

Children and young people in need of mental healthcare in Belgium can be referred to an appropriate mental healthcare center or professional by their GP. The Belgium public healthcare system has special provisions for children and young people. This involves greater and sometimes complete reimbursements for several healthcare services, including consultations with doctors and specialists.

Special networks and services for children

Since 2015, Belgium has introduced several GGKJ (Geestelijk Gezondheid voor Kinderen en Jongeren/Santé mentale pour enfants et adolescents/Mental health for children and youth) networks around the country. Each network consists of several care professionals and institutions working together. The networks organize programs providing psychological and psychiatric help. Children and young people under the age of 23 can register for these programs directly with the network.

Additionally, many hospitals in Belgium have dedicated children’s psychiatry units. These include:

• GZA in Antwerp
• Queen Fabiola Children’s University Hospital in Brussels
• UPC KU Leuven
• UZ Gent

The CHS clinical team also has several mental health professionals specialized in offering support for children.

Mental healthcare services for specific groups in Belgium

People with disabilities as well as the elderly who need special support or long-term care have access to several benefits in Belgium. Additionally, the following agencies provide assisted living as well as psychosocial support to people with disabilities:

• The Flemish Agency for Persons with Disabilities (VAPH)
• Personne Handicapée Autonomie Recherchée (PHARE)

In general, mental health services for the elderly have the shortest waiting times. By contrast, waiting lists for mental health services are the longest for people with disabilities and for children and adolescents.

Belgium also has special care centers and helplines for victims of sexual abuse and assault. These are known as Zorgcentrum na Seksueel Geweld (ZSG) in Dutch and Centre de Prise en Charge des Violences Sexuelles (CPVS) in French. These centers are located in hospitals in different Belgian cities and offer immediate medical and psychological care.

Other helplines offering information, counseling, and emotional support to specific groups in Belgium are:

• S.O.S VIOL and Helpline 1712 for victims of sexual abuse and assault
• Samusocial for people who are homeless

Prevention and education programs for mental health in Belgium

Prevention and education programs for mental health in Belgium are the responsibility of the regions. Each region has its own priorities and initiatives for this. For instance, in Flanders, the Vlaamse Oudenraad (Flemish Older People’s Council) has launched a campaign to promote discussion about mental health problems among the elderly.

Mental health provision in Belgian schools has also improved in recent years. For instance, the Flanders region has developed an integrated strategy to promote collaboration between youth and health services. Additionally, both the Flemish Center of Expertise for Alcohol and Other Drugs (VAD) and the Commission of the French Community (COCOF) have introduced programs and interventions to prevent addiction disorders.

Emergency support and crisis lines in Belgium

In case of an emergency, you can always call 112. This is a pan-European number, from where you will be redirected to the appropriate service for your situation.

Additionally, here are some 24/7 helplines you can call for counseling and psychological support:

• Community Help Service (CHS) – English-language helpline for people experiencing emotional problems of any kind (call 02 648 40 14)
• Narcotics Anonymous Belgium – Helpline for people experiencing problems with alcohol or drug use (call any of these three numbers 0478 62 62 62, 0476 64 30 54, 0488 70 65 75)
• DrugLijn – Dutch-language helpline for alcohol and drug problems, also offering support in English (call 078 15 10 20)
• Zelfmoord1813 – Suicide prevention hotline (call 1813 or get help online)
• Tele Onthaal – 24/7 support line for Dutch speakers in Belgium experiencing emotional problems of any kind (call 106 or get help online)
• Télé-Accueil Bruxelles – 24/7 support line for French speakers in Belgium experiencing emotional problems of any kind (call 107 or get help online)

Useful resources

• Community Health Service (CHS) – Voluntary organization running a helpline and mental health services center for the international community in Belgium.
• Te Gek (in Dutch) – Flanders-based organization that provides information and runs campaigns to reduce stigma and increase awareness about mental health.
• RIZIV(in Dutch)/INAMI (in French) – Website of the National Institute for Health and Disability Insurance providing information on the Belgian public healthcare system, including reimbursements for mental healthcare services.
• FPS Public Health, Food Chain Safety, and Environment – Website of the Belgian federal public service that provides information on health and safety services and standards, including those for mental healthcare.
• Commission of Psychologists – Government agency responsible for the registration of psychologists in Belgium and for monitoring the quality of services they provide.