229 General discussion current policy has the potential to establish a foundation for forthcoming developments. The World Health Organization (WHO) describes mental health institutions as poorly equipped to truly meet the care needs of individuals experiencing psychological distress. The WHO has recognized oral health care as an essential component of overall health and well-being. Within the WHO, the significance of integrated care is underscored, with prevention and control, accessibility, policy, and research being key focal points. This dissertation demonstrates that oral health care remains insufficient on all these key points. Our research supports these findings. The World Health Organization has formulated global objectives and solutions aimed at improving oral health such as reducing tobacco use, reducing alcohol use, and encourage healthy eating habits [28]. In the Netherlands, within the Integral Care Agreement [integraal zorgakkoord] (in Dutch) [29], agreements have been made between the Ministry of Health, Welfare and Sport and several large healthcare parties. The ambition of the Integral Care Agreement [29] is to maintain accessible, high quality, and affordable healthcare for everyone. At present, various regional and national working groups are engaged in the implementation of this initiative. The Integral Care Agreement [29] is a significant step towards achieving appropriate care, and is based on four fundamental principles: 1. Appropriate care is value-driven, and thus demonstrably effective with a limited deployment of finances, personnel, and resources. 2. Appropriate care is established in collaboration with and around the client (shared decision-making). 3. Appropriate care provides the right care in the right place and is organized to be as close to the patient as possible and 4. Appropriate care focuses on health rather than illness. These four principles offer a framework that can promote the inclusion of oral health care by emphasizing healthy lifestyles and preventative health. Efforts are ongoing to develop specific agreements that should incorporate oral health considerations. This also complements the further implementation of holistic perspectives on health. The Integral Care Agreement places a renewed emphasis on prevention and lifestyle. This indicates that MHNs are currently in a favourable position, and it is now the time for them to maximize the opportunities within their role, demonstrate leadership, and integrate lifestyle considerations into their nursing routines. 7
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