Continued:

Because even if it is palpable for care providers that a young person sees euthanasia as a way out, the question remains: why is it that the young person sees it that way? What factors play a role? For example, Bottelier points out that you cannot see these young people separately from the family and the social environment.

"Now they are still in dependency relationships like in the family. But there is still a lot to be done in the social emotional field. We also see that young people experience enormous pressure from the media or social media. I wonder whether a young person will then come to such a request in freedom."

Moreover, you cannot quickly determine that a young person has been 'out of treatment', says Bottelier. "I think a major difficulty with young people - unlike when someone has cancer who has exhausted treatment and who you know for sure will die soon - is that we cannot predict how things will go in the case of very severe psychological suffering."

He continues: "And we also see many examples of young people whose lives take a completely different turn over time. That is also why the greatest restraint is in order here."

Nevertheless, at Accare they think it is very important to talk to the young person about the euthanasia wish and to discuss it seriously and openly. "That can actually help to get out of the trap of thoughts of death," explains Bottelier.

Care providers therefore do investigate in conversation with the young people what is going on with that death wish and if a young person can express it to a care provider, there is sometimes room for life again.

Sylvana Knol (23) has experienced it herself; The space that came 2 years ago when she had conversations about euthanasia. That was after a long history of crisis admissions across the country, treatments that didn't help with the major depression she's struggled with since she was 14, and problems with additional diagnoses that only complicated access to treatment.

At the moment, Sylvana can say that she has achieved a 'record': "I can say for 2 years that I no longer just think: I want to die, I want to die, I want to die."

It helped Sylvana enormously that she could talk about her death wish. In the past, there was hardly any room for that. With every crisis admission after self-harm or a suicide attempt, she was only 'kept safe'.

Sylvana says: "I kept getting pushed because it was complicated. Since the decentralization of youth care, you just see that there are few places for these kinds of complex problems. If I had to be admitted there was almost no place, then I was sent to a random clinic, that's how I've seen everything in the Netherlands; Almere, Utrecht, Vught, Almelo, all clinics for crisis admissions."

During those recordings, there was hardly any room to build a treatment relationship, she recalls. "I was admitted and kept safe, but nothing was built up because you had to go back to your own region. I often went back home and in no time it went wrong again. I had to be admitted again."

"If there had been the possibility of investing in a treatment relationship, something would have been built up, that would have been better for me."