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Chapter 7176provide support during the waiting period transition (Chapter 6). General practices in both the Netherlands and Canada have had positive experiences with consultative psychiatry for the general population: a psychiatrist visits a practice every one to four weeks and provides practitioners with advice on diagnosis, treatment, or referral to MH services. 63, 64 In Canada, this has resulted in a 66% reduction in referrals to MH services. 64 To implement this for patients with MID, it is, of course, important that the psychiatrist has knowledge and experience regarding patients with MID. Furthermore, consultative ID physicians in general practices may bring additional benefits, but this requires further elaboration and exploration, as the number of ID physician in the Netherlands is very limited. A third challenge is the observation that a low IQ can be posed by MH services as an exclusion criterion for general MH services, resulting in patients continuing to consult their GP with severe or complex MH problems (Chapter 6). 65 This is a surprising stance, given that an estimated 40% of patients in these services are suspected of having MID. 44 This seems like a good reason to make general MH services available to people with MID, also considering that specialized ID MH services are very limitedly available. Fortunately, there are increasingly more MH services such as GGZ Rivierduinen in Leiden, the Netherlands, which has developed treatment modules for patients with MID. 66The fourth challenge is to coordinate all care, both medical and nonmedical, effectively. Patients with MID expect the practitioner to oversee and coordinate all care relating to the patient and rely on them when problems persist (Chapters 2, 5, and 6). Because it seems that no one else is addressing this, practitioners feel responsible for it, but this also consumes a large amount of their time and effort (Chapter 6). To support practitioners and to facilitate effective domain-transcending collaboration, regional agreements and initiatives with sufficient project support are needed. This will ensure coordinated care, including clearly defined roles and responsibilities regarding the patient for all stakeholders (Chapter 2).33, 56 A good Dutch example of this is the ‘Blauwe Zorg in de Wijk’ initiative in the province of Limburg, the Netherlands. 61 As part of this initiative, monthly multidisciplinary meetings take place involving GPs, MHNPs, psychiatrists, Katrien Pouls sHL.indd 176 24-06-2024 16:26