H.H. (Hermien) Dijk, PhD

Current projects:

When Feeling Blue Gets You into the Red: The effect of Mental Health Problems on the Onset of Problematic Debt 

Problematic debts can have far-reaching consequences for debtors, creditors and society as a whole. This study investigates whether there is a causal effect of mental health problems on the onset of individual problematic debt. We use nationwide individual-level panel data on mental healthcare use and problematic debt. We employ a fixed effects instrumental variable approach, using the death of a sibling or child as instruments for mental health problems.

Optimal Organization of Youth Mental Healthcare

Mental health problems in childhood and adolescence can lead to long-term consequences. Prevention and early intervention are important, which makes access to good quality mental healthcare essential. Decentralization of youth mental healthcare in the Netherlands was supposed to incentivize municipalities to focus on prevention, early detection, and early intervention. As each municipality has the possibility to organize and purchase youth care in their own way, it is likely that there is variation between (groups of) municipalities in contracting, reimbursement, pricing, and other requirements to providers. Each way of purchasing care may have (unintended) implications.

This research project is twofold: first, it seeks to examine whether current ways of purchasing care elicit provider responses, such as responses to (perverse) financial incentives, and what the effects of these responses are on treatment and outcomes of children and adolescents with mental health problems. Second, we will examine the impact of having a small number of contracted providers in a municipality on treatment and outcomes of children and adolescents with mental health problems, for instance as a result of market power.

PhD-student: Caitlin Kiernan. Project funded by a UEF M20 PhD grant.

The Effect of Accessible Mental Healthcare at the GP on Secondary Child and Adolescent Mental Healthcare Use

In many municipalities, child and adolescent mental healthcare practitioners (Dutch: praktijkondersteuners jeugd-GGZ: POH-jGGZ) offer children and adolescents accessible mental healthcare at their GP and refer them to secondary mental healthcare when necessary. The aim is to prevent a worsening of problems through secondary prevention and rapid, early and adequate help. One of the intended results of the use of a POH-jGGZ is a decrease in referrals to and costs of secondary child and adolescent mental healthcare. In this project, we use administrative municipal data to investigate what the effects of the use of POH-jGGZ are on referrals and the costs of these referrals.