If it is decided to refer a patient to our specialized mental healthcare practice, the patient will undergo a comprehensive intake process. This involves our triage nurse, one of our psychiatrists as the coordinating therapist, and a treating clinician.

Clinics Arnhem, Breda, and De Bilt
Ms. M. Ramcharan MSc (Madhwie)
Psychiatrist and coordinating therapist

Clinics Haarlem, Oegstgeest and Zwolle
Ms. M. van den Bergh MSc (Marguerite)
Psychiatrist and coordinating therapist

Clinic Rotterdam
Ms. C. Herben MSc (Christel)
Psychiatrist, coordinating therapist, and rTMS professional

General

Mr. B. Wernsen MSc (Bram)
Owner and rTMS supervisor

Ms. M. van den Broek MSc (Marieke)
Healthcare psychologist (GZ-psychologist)

Specialized care practice

We are a specialized specialized mental healthcare (sGGZ) practice focusing on repetitive Transcranial Magnetic Stimulation (rTMS). Unlike regular care institutions, we do not take over long-term care trajectories. Our care is aimed at patients for whom rTMS may be an appropriate treatment. If rTMS does not produce the desired result, we refer back to the original referrer with advice on possible further treatment options.

What you can expect from us

• A clear and well-defined treatment trajectory, specifically focused on rTMS.
• Transparent communication about progress and results.
• No takeover of care, but specialized support within a collaborative approach.

Important advice regarding medication

We advise not to change your medication at the start of rTMS treatment. Medication changes can be neurologically stressful and make it difficult to accurately assess the treatment effect of rTMS. If your medication is prescribed by your GP, we can — based on indication — consider tapering or medication adjustments at a later stage of the treatment.

Communication and consultation for referrers

Do you have questions about a referral or would you like to discuss a treatment first? Please contact us at secretariaat@rtms-international.com. We will be happy to schedule a call to discuss your questions.

Referral and registration for adults aged 18 and older

The patient can register themselves via the registration form, and the referral letter can be attached as a file with the registration.

The referral letter for an rTMS treatment is valid when it meets specific requirements set by the Dutch Healthcare Authority (NZa) and insurers. The referral letter must at least include:

• Referral to specialized mental healthcare (specialistische ggz) for an rTMS treatment trajectory
• Date of referral (must be no more than six months before the first treatment date)
• Name and position of the referrer
• AGB code of the referrer
• Practice stamp and/or signature of the referrer
• Patient details (name, address, date of birth)
• Indication of a psychiatric disorder or suspicion thereof, optionally specifying the disorder (supported by a validated mental health screening tool)
• The main diagnosis on the referral must be stated: treatment-resistant depression (in addition to OCD)
• Preconditions for rTMS treatment: at least two previous treatments attempted. Either one course of psychotherapy and one antidepressant, or two courses of psychotherapy, or two antidepressants

For specialized mental healthcare within our practices, the following codes are used, among others:

• CO0789 Quality statute Section II — Physician specialist, psychiatrist as coordinating therapist required according to LKS Diagnostics
• CO0781 Outpatient — Quality statute Section II — Other professions Diagnostics
• CO0326 Outpatient — Quality statute Section II — Other professions Treatment
• TC0014 Surcharge for repetitive Transcranial Magnetic Stimulation (rTMS)
• OV0126 Repetitive Transcranial Magnetic Stimulation (rTMS) performed by the rTMS Technician

Contraindications for referral to our care practice

• History of seizures
• Psychotic depression
• Brain damage due to illness or injury, such as brain tumor, stroke, or traumatic brain injury
• Metal or implanted medical devices in the body

Because of the magnetic field produced during rTMS, the treatment is not recommended for people with the following devices:

• Cochlear implants
• Electrodes for monitoring brain activity
• Implanted stimulators
• Implanted vagus nerve stimulators or deep brain stimulators
• Implanted electrical devices such as pacemakers or medication pumps
• Stents
• Aneurysm clips or coils