Barriers to access to psychotherapy are reduced 2

Barriers to access to psychotherapy are reduced

According to research, every other person living in Switzerland suffers from a mental disorder requiring treatment at least once in life. It has been scientifically proven that psychotherapy can reduce suffering. The most common are depression, anxiety disorders and addiction. It is also recognized that psychotherapy can prevent economic overtime, such as long-term absence from work and high social benefits. But it must start on time.

Still, Bundesrat long hesitated to ease access to psychotherapy. The present regulation, the so-called delegation model, was introduced almost 40 years ago as a temporary solution – and since then it has been responsible for the dispute. Reason: Psychologists working as psychotherapists now have to be employed by psychiatrists to cover the cost of the basic insurance.

Payments are made by a psychiatrist who prescribes and supervises the therapy. If the psychologists open the practice themselves, they can only accept patients who pay for therapy or have additional insurance. Many psychologists find this system boring and humiliating.

The decision was postponed for years

That is why several health ministers introduced them with a systematic change in which they would be allowed to focus on health insurance funds as independent service providers. However, due to the cost, the Federal Council delayed its decision for decades. Recently, however, the pressure of the parliament and, above all, of the psychologist was so great that he could not help compete the path to the new regulation: yesterday he sent a change of consultation regulation, which foresees a system similar to that used by physiotherapists. In the future, psychologists should be able to offer their psychotherapy in their own practice and settle accounts independently with basic insurance, provided they are made by a physician's order. It does not necessarily have to be a psychiatrist. The home, pediatricians or gynecologists can now prescribe therapies.

This model makes it easier for patients to access psychotherapy, Health Minister Alain Berset (SP) told the media yesterday. Children and adolescents, as well as adults in crisis situations, could advance the supply of bottlenecks in supply. The Federal Council estimates the additional costs in basic insurance amounting to CHF 100 million a year. This corresponds to the amount that patients pay today for psychotherapy or are paid with additional insurance.

If costs rise "excessively", the Federal Council must take corrective measures, says spokeswoman Matthias Müller.

To monitor cost development, Berset wants to establish surveillance and limit the schedule: up to 15 sessions should be possible before patients need to contact the doctor again. Medical and psychological psychotherapists must consult with the health insurance company after 30 instead of the 40 previous sessions.

The Santésuisse Health Insurance Association supports its support for the new model, dependent on cost development. It requires automation: if costs grow "excessively", the Federal Council must take corrective measures, says spokeswoman Matthias Müller. In addition, health insurance against which every doctor should prescribe psychotherapy. They still wanted to give this competence to "qualified doctors" only "to ensure quality".


The decision of the Federal Council for psychological associations is a milestone for psychotherapeutic care. By changing the design model, an obstacle can be eliminated, which prevents access to ambulatory psychotherapy. Today, patients sometimes have to wait a long time.

The Pro Mente Sana Foundation, which works for mentally ill, speaks of "encouraging sign". The sooner they recognize the mental illness, the more likely they are to recover, says CEO Roger Staub.

I do not agree with psychiatrists. They fear it
Quality of treatment suffers when psychologists become more independent: "For crises and emergencies, psychologists are less educated," says Pierre Vallon, president of the Swiss Society for Psychiatry and Psychotherapy. He also thinks Berset's cost estimate is wrong: psychologists wanted to make better money and move to their exercise rooms, which is why it is possible to predict "volume expansion".

(Editors Tamedia)

Created on: 26.06.2019, 16:14 hours