Announced almost six months ago by President Emmanuel Macron to deal with the wave of malaise caused by the Covid-19 epidemic, the reimbursement of eight sessions with the psychologist will begin on April 5. Wind up against this new device called “MonPsy”, clinical psychologist Camille Mohoric-Faedi, co-founder of the Manifeste Psy collective, explains the reasons for her anger.
– Why doctor: Can you detail how the new MonPsy device works?
Camille Mohoric-Faedi – To benefit from this device, you must first consult a general practitioner, so that he can assess your mental health and give you a medical prescription if he considers it necessary. Once in possession of the prescription, it is then necessary to choose from the government directory a registered psychologist, who has agreed to integrate the new system. It will then be possible to benefit from 8 psychological support sessions, including one dedicated to the evaluation of the patient’s condition. This process can be repeated every year.
– What are the mental pathologies concerned?
Virtually none, since only “anxiety and depressive disorders of mild to moderate intensity” can give rise to a free liberal consultation. In fact, the following pathologies are excluded in adults: burn-out, chronic depression, complicated mourning, generalized anxiety disorder, TOCS, eating disorders, addictions, cognitive disorders, illnesses neurodegenerative disorders, autistic disorders and post-traumatic stress disorders. Patients who can benefit from the MonPsy device must also not have taken anxiolytics, antidepressants and sleeping pills for more than three months, not have been admitted to a psychiatric hospital in the last three years before their consultation, and not be in sick leave for more than six months for psychological reasons.
In children over three years of age, the conditions are the same, also excluding speech disorder, dyslexia, dysorthographia, dyspraxia, separation anxiety, identity and gender questioning, self-mutilation, social inhibition, language disorders, ADHD and school bullying.
– Which mental health professionals can integrate the MonPsy device?
At first, only clinical psychologists and psychotherapist psychologists could agree, because they are the only ones qualified to do psychotherapy. But today, as the government could not find anyone, all psychologists with “clinical experience” are invited to join the system, that is to say practically everyone.
– You are very critical of the MonPsy system. In your opinion, how is it harmful for patients?
Several things are problematic. First, this device obliges the French to confide in their general practitioner, who is not a mental health professional, and who, in certain regions, is very difficult to access or has little time. Then, they cannot freely consult the psychologist of their choice, because they must stick to the list of contracted professionals. Moreover, they will not benefit from real psychotherapy sessions, but from “psychological support”, which, for us, means nothing. Finally, they expose themselves to a break in care, which can be harmful to their mental health. 7 sessions are rarely enough to solve a problem.
– And for liberal psychologists?
Here again, several elements are problematic. First, the price of the sessions, set at 40 euros for the evaluation session and 30 for the others: no liberal psychologist doing his job properly can live decently on such a package (we have between 40 and 60% of charges fixed). Two solutions are then offered to him in the event of integration into the MonPsy system: reduce the time of his consultations and rush them to make the figure, or put the key under the door after a few months.
Moreover, with MonPsy, our code of ethics is no longer respected, since it is no longer the psychologist who sets the therapeutic framework with his patient, but the Government who becomes the prescriber. Medical secrecy is also no longer guaranteed, since the patient is obliged to tell his psychic intimacy to another professional before coming to see us, and we are required, at the end of the 8 sessions, to make a report. to the general practitioner.
– Some patients complain that their health insurance company has stopped paying for psychological care since the MonPsy system was set up. Is this a trend you are also seeing?
Yes, the mutuals have almost all decided to remove their psychological packages because of this new system. The MonPsy device is like the bubonic plague: it spreads at high speed and affects everyone.
– Aren’t there all the same things to save in this government initiative?
No nothing at all. MonPsy is not the solution. What we want is the death of the device, and we call on all mental health professionals to boycott it.
– In your opinion, is this a purely electoral approach?
It is indeed nothing more than an electoral stunt, intended to make the French believe that they can all go to see a liberal psychologist for free, which is completely false.
– Access to liberal psychologists is, in fact, most of the time very expensive, and many French people cannot afford it. What should be done for these people, in your opinion?
Already, instead of putting 50 million in MonPsy, we should invest in public structures that ALREADY offer free psychological care with the Vitale card: the CMP (Medico-Psychological Center)CMPPs (Medico-Psycho-Pedagogical Center) and the CMPI (Medico-Psychological Center for Children). For 30 years, these systems have been in the process of collapsing, for lack of creation or renewal of positions, full-time permanent contracts and salary increases, while they provide high quality psychotherapeutic services. In some regions, waiting times for consultation can go up to two years, it’s madness!
Then, we are not against a refund of sessions in liberal, but not under these conditions. It is necessary to destroy the MonPsy device to rebuild it, by consulting health professionals, which has not been done at all so far.
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