“My Dutch Isn't Good Enough to Talk About This”: Language and Mental Health Care
You speak Dutch.
You can order food, talk to your child's teacher, make an appointment, understand most letters and have a conversation with your neighbour.
Perhaps you even work in Dutch.
Then someone asks:
“Hoe gaat het echt met je?”
And suddenly the language you use every day does not feel quite big enough.
How do you explain that you are not exactly sad, but you do not feel like yourself?
How do you describe the difference between being tired and feeling emotionally empty?
How do you explain a relationship dynamic that only really makes sense when you describe the family expectations behind it?
Or something that happened years ago, when even in your first language you have never quite known what to call it?
Sometimes the difficulty is not that you cannot speak Dutch.
It is that you cannot yet be completely yourself in Dutch.
And when the conversation is about mental health, that difference can matter.
Everyday fluency and emotional fluency are not always the same
Learning another language is often measured through practical milestones.
Can you understand a conversation?
Can you read?
Can you write an email?
Can you work or study in the language?
These things matter. But emotional communication asks something slightly different from us.
When talking about something personal, we do not only communicate information.
We search for nuance.
There is a difference between:
I am worried.
I am scared.
I feel unsafe.
I have a feeling something bad is going to happen.
I know I am safe, but my body doesn't seem to believe it.
Those sentences may describe experiences that overlap, but they are not identical.
In your first language, you may instinctively know which one comes closest.
In another language, you may choose whichever word you know.
That can make an experience sound simpler than it actually feels.
Sometimes the words exist, but they do not feel like yours
There is another strange part of speaking about emotions in a language learned later in life.
You may know the correct word.
You may even use it correctly.
But it does not carry the same emotional weight.
Words connected to childhood, family, affection, shame, conflict or grief can be deeply tied to the language in which those experiences were first lived.
Perhaps verdriet means sadness to you intellectually, while the equivalent word in your first language immediately brings a feeling with it.
Or perhaps the opposite happens.
Talking about something painful in Dutch or English creates a little distance. The second language makes the story easier to tell because the words do not feel quite as close.
Neither response is necessarily better.
Language and emotion can have a complicated relationship.
The important thing is recognising that being able to translate a sentence is not always the same as being able to translate an experience.
Mental-health conversations depend heavily on language
This matters particularly in healthcare because professionals need to understand what you are experiencing in order to make appropriate decisions with you.
The Dutch multidisciplinary guideline Omgaan met taalbarrières in de zorg en het sociaal domein, published in 2025, was created specifically to improve accessibility and quality when language barriers may affect communication.
Pharos notes that almost 2.5 million people in the Netherlands do not have Dutch as their mother tongue. They include people who came to the Netherlands for work, study, family reasons and forced migration. For some, communication with healthcare or social-care professionals is not sufficiently possible without language support.¹
That does not mean 2.5 million people need an interpreter.
It means speaking a language other than Dutch at home is common, and language needs vary considerably.
Someone may need no support at all.
Someone else may manage an ordinary appointment perfectly well but struggle when the conversation becomes medically complex.
And another person may need professional language support throughout.
The question is not simply:
“Do you speak Dutch?”
A more useful question may be:
“Can you explain what you need to explain, and understand what you need to understand, in this conversation?”
“But my Dutch is actually quite good”
This is where people can become hard on themselves.
You have lived here for years.
You passed an exam.
You work with Dutch colleagues.
Your children answer you in Dutch even when you speak another language to them.
So asking to speak English, slowing a conversation down or admitting that you did not understand something can feel like going backwards.
It is not.
Language ability is not one fixed level that applies equally to every situation.
You may be completely comfortable discussing your work and still struggle to describe panic.
You may understand a news programme but not a rapidly explained treatment plan.
You may speak fluent Dutch and still prefer talking about your marriage in the language in which that relationship developed.
You may understand almost everything a professional says until you become emotional. Then words that normally come easily disappear.
That is not necessarily evidence that your Dutch is poor.
It may simply mean the conversation is demanding something different from you.
Emotion itself can make communication harder
Think about how difficult it can be to explain yourself even in your first language when you are upset.
You lose your train of thought.
You forget what you wanted to say.
You simplify.
You say “I'm fine” because explaining the actual answer feels too complicated.
Now add another language.
A conversation about mental health may require you to remember events, describe bodily sensations, distinguish thoughts from feelings, understand unfamiliar terminology and answer questions you did not expect.
At the same time, you may be anxious about whether you are saying things correctly.
Part of your attention is therefore on the experience itself.
Another part is managing the language.
That can be tiring.
And occasionally it can mean that the version of your story the professional hears is not quite the version you were trying to tell.
Culture can be hidden inside language too
Not every communication difficulty is solved by finding the correct translation.
Sometimes the difficulty is meaning.
Imagine someone says:
“My family expects me to do this.”
What does expects mean?
A preference?
A cultural tradition?
A moral responsibility?
Financial dependence?
Fear of rejection?
A family structure in which individual decisions are rarely considered individual at all?
Without context, the sentence does not tell us enough.
The same is true of words such as respect, independence, privacy, family, marriage, duty and even home.
Different people can use the same English or Dutch word while carrying very different assumptions about what it means.
Thuisarts specifically encourages people who are relatively new to the Netherlands to tell their healthcare professional about things that matter in their lives, including family, culture, habits and religion. It also advises asking about an interpreter when Dutch is not sufficient for the conversation.²
Culturally responsive care is therefore not simply a matter of translating vocabulary.
It requires curiosity about the meaning behind the words.
You should not have to perform fluency
There can be pressure when living abroad to demonstrate that you are adapting successfully.
You learn the language.
You handle your own administration.
You try not to ask people to switch to English.
You may even feel embarrassed when someone hears your accent and immediately changes languages.
That effort can be understandable. Learning Dutch can support independence, participation and connection.
But a healthcare conversation is not a language examination.
The goal is not to prove that your Dutch is good enough.
The goal is for you and the professional to understand one another well enough for appropriate care and informed decisions.
The 2025 Dutch guideline on language barriers explicitly focuses on whether communication is sufficient for good care or support and provides a decision process for determining when and what kind of language support may be appropriate.¹
That is a different standard from everyday conversational fluency.
What can language support look like?
A language barrier does not have one solution.
The current Dutch guideline describes several possible forms of support depending on the situation. These include using a professional interpreter, transferring or referring to a professional who speaks the person's language, using translated information or digital tools in appropriate situations, involving a cultural mediator, and in some circumstances having an adult relative or other trusted person assist with communication.³
Importantly, the guideline specifically advises against using children as interpreters.³
Which form of support is appropriate depends on the conversation and the degree to which the language barrier affects communication.
A brief practical exchange is different from discussing diagnosis, consent, medication, trauma or complex treatment choices.
Professional interpreting may be particularly important when accuracy, confidentiality and nuance matter.
And availability or funding can differ between healthcare sectors and circumstances, so it is worth asking the provider what arrangements are possible rather than assuming either that an interpreter will automatically be available or that you must organise everything yourself.
Bringing someone you trust can help, but it is not always the same as an interpreter
Thuisarts suggests that someone who is relatively new to the Netherlands may bring a trusted person to an appointment and can ask for an interpreter if Dutch is difficult.²
Having someone familiar beside you can make an appointment feel less intimidating.
They may help you remember information, understand how the system works or ask questions you forgot.
But there are situations in which asking a partner, friend or relative to translate very personal information can become complicated.
Will you say the same thing with them sitting beside you?
Do you want them to know everything being discussed?
Can they translate accurately rather than summarising or answering for you?
Are they emotionally involved in what happened?
For an ordinary practical conversation, informal help may sometimes be enough.
For sensitive, complex or consequential conversations, professional language support can offer a different level of neutrality and accuracy.
The important thing is to consider what the conversation requires.
It is okay to ask someone to slow down
Language support does not always require an interpreter.
Sometimes you simply need the conversation to change pace.
You can ask:
Could you say that more slowly?
What does that word mean?
Could you explain that in another way?
Can I check whether I understood you correctly?
Could you write that down for me?
Can we speak English for this part?
I know the Dutch word, but I can explain this better in English.
These are not signs that you are difficult.
They are ways of participating in your own care.
A good conversation is not one in which the professional speaks perfectly and the patient politely nods.
It is one in which both people have enough shared understanding to know what is being discussed.
Your first language may reveal a different version of the story
I think this is one of the most interesting parts of working across languages.
People sometimes sound different when they change language.
Not because one version is false.
Different languages can give access to different memories, expressions, humour and ways of relating.
Someone may be more formal in Dutch and more emotionally expressive in their first language.
Another person may find English easier for difficult conversations because they learned much of their psychological vocabulary through education, books or therapy in English.
Someone else may move between languages in a single sentence because one language contains the precise word that the other does not.
For multilingual people, this can simply be part of how their emotional world is organised.
Support does not always need to force that world into one language.
Sometimes allowing someone to search for the word, explain the cultural context or briefly use another language is part of understanding them properly.
Language barriers can also affect whether people seek help at all
Communication difficulties do not begin once someone enters the consultation room.
They can affect whether a person reaches it.
Pharos notes that language barriers can contribute to misunderstandings in healthcare and may lead some people to avoid asking questions or even avoid care because they are worried they will not be understood.⁴
Think about everything that happens before the actual appointment.
You may need to understand a website.
Make a telephone call.
Explain why you want an appointment to a receptionist.
Read a referral letter.
Complete a questionnaire.
Understand an email about waiting lists.
Navigate a patient portal.
For someone already struggling emotionally, each additional communication barrier can become another reason to postpone asking for help.
Accessibility therefore involves more than what happens between practitioner and client once the door closes.
Finding a professional who speaks your preferred language can matter
For some people, one of the simplest solutions is finding a professional with whom they share a language.
That may allow more spontaneous expression and reduce the cognitive work of translating.
But language match alone does not determine whether someone is the right professional.
Their qualifications, scope, experience and suitability for what you need still matter.
A practitioner speaking your first language is not automatically culturally responsive.
And a practitioner from a different cultural background is not automatically unable to understand you.
The same principle we discussed in the previous article applies here:
Look at the whole fit.
Language is one part of it.
Professional competence is another.
The quality of communication, curiosity, safety and clarity matter too.
If English is the language in which you can explain yourself best
Many internationals in the Netherlands do not share the same first language.
But English may become the common language through which they work, study, build relationships and seek support.
For some, English is actually the language in which psychological ideas are easiest to express.
For others, it is simply more comfortable than Dutch.
That can be a perfectly practical preference.
At Astramía, counselling can take place in English, and for Filipino clients it can also naturally include Tagalog or a mixture of languages when that helps expression.
But the principle is broader than Astramía.
When seeking any form of support, it is reasonable to ask beforehand:
In which language can I communicate most accurately when the conversation becomes personal?
Then ask the provider what is possible.
You are allowed to need words that feel like yours
Learning the language of the country where you live can be valuable.
It can create independence, connection and a stronger sense of participation in everyday life.
But becoming fluent in Dutch does not require every part of your inner world to become Dutch too.
Some memories may always arrive first in another language.
Some emotions may have words that feel more precise somewhere else.
Some stories may need explaining rather than simply translating.
And when you are talking about your mental health, your relationship, your family or something painful that happened to you, being understood matters more than demonstrating perfect grammar.
Perhaps the question is not:
“Is my Dutch good enough to talk about this?”
Perhaps it is:
“What would help me say what I actually need to say?”
That is a much more useful place to begin.
If language is making it harder to ask for help
If you are seeking healthcare and are worried that a language barrier may affect the conversation, tell the provider when making the appointment if possible.
Ask what language support is available.
You can also ask whether an interpreter is appropriate, whether the professional can communicate in another language, whether written information is available in a language you understand, or whether extra time may be needed.
For psychological complaints in the Netherlands, the huisarts remains an important first healthcare contact when you are unsure what kind of assessment or treatment you need. Thuisarts specifically advises people who do not speak Dutch well enough for the conversation to ask about interpreter support.²
If psychological symptoms are severe, worsening or substantially affecting your ability to function, language difficulty should not become a reason to delay seeking appropriate healthcare.
Where Astramía fits
Astramía Counselling provides preventive, psychosocial and non-clinical counselling for adults and couples, particularly around migration, relationships, motherhood, identity, emotional recovery and major life transitions.
Sessions can take place in English. For Filipino clients, communication can also naturally include Tagalog or move between Tagalog and English when this makes expression easier.
Astramía does not replace medical care, psychological assessment, crisis services or specialist GGZ treatment when those forms of care are needed.
Language accessibility matters, but so does making sure that the level and type of support match the person's needs.
If you need urgent help
If you are in immediate danger or experiencing an acute psychological crisis, seek urgent help even if communicating in Dutch feels difficult.
Contact your huisarts during practice hours or the huisartsen-spoedpost outside those hours. If immediate emergency assistance is required, call 112.
If you are thinking about suicide, contact 113 Zelfmoordpreventie.
Tell the professional if you need language support to communicate what is happening.
Sources & further reading
1. Patiëntenfederatie Nederland et al. (2025). Richtlijn Omgaan met taalbarrières in de zorg en het sociaal domein.A multidisciplinary Dutch guideline developed to improve accessibility and quality of healthcare and social support when language barriers may affect communication.
2. Thuisarts.nl. (2026). Ik heb psychische klachten en woon pas kort in Nederland. Van wie krijg ik hulp?Dutch patient information about seeking help for psychological complaints, including asking for an interpreter and discussing family, culture, habits and religion when relevant to care.
3. Pharos. (2025). Taalbarrières in zorg en sociaal domein.Practical information accompanying the national guideline, including different forms of language support and the decision-making process for choosing appropriate support.
4. Pharos. (2025). Nieuwe richtlijn helpt omgaan met taalproblemen in zorg en sociaal domein.Background information on why language barriers matter for accessibility, communication and quality of care in the Netherlands.
This article provides general psychoeducational information and is not intended as individual psychological or medical advice. Language-support arrangements and funding can differ between healthcare settings and may change over time.
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