Four health insurance funds, including those of Haute-Garonne and Morbihan, are currently testing the reimbursement of consultations with the psychologist, when they are carried out on medical prescription.
Will the sessions with the psychologist soon be reimbursed at 100% by health insurance? This is the experiment currently being carried out in four departments over a period of 3 years: Haute-Garonne, Bouches-du-Rhône, Morbihan and Landes. In these four departments, the primary health insurance funds have signed agreements with psychologists in order to provide 100% support for the psychotherapy of the most disadvantaged patients.
Reduce the prescription of psychotropic drugs
The objective of this experiment? Reduce Social Security spending related to mental illnesses, in particular by reducing the number of days off work, but above all the consumption of antidepressants, anxiolytics and sleeping pills, which have undesirable side effects and lead to dependence.
Following the recommendations of the Haute Autorité de Santé published in 2017, which recommend psychotherapy to reduce the consumption of psychotropic drugs, this test, carried out in four French departments, concerns all patients aged 18 to 60, without means-testing.
Currently, only consultations carried out by a psychiatrist, under medical prescription, are reimbursed by Social Security at the rate of 70%, the remainder being chargeable which can be supplemented by the insured’s complementary health insurance. If the experiment set up proves to be conclusive, a patient may be reimbursed for his sessions with a psychologist in a private practice on one condition: that they have been prescribed by a general practitioner.
How it works ?
The general practitioner must first issue a prescription for a 45-minute assessment session, to be performed by a licensed psychologist. A report is then sent back to him by the health professional. If it turns out that the mental disorders observed in the patient are of “weak to moderate” intensity, a second prescription of 10 sessions of supportive psychotherapy of 30 minutes is sent. It may be supplemented, if necessary, by 10 structured psychotherapy sessions of 45 minutes. In the event of a heavier pathology, the patient may be referred to a psychiatrist. The frequency of the sessions is fixed between the patient and the therapist. A maximum of 20 sessions may be reimbursed by Health Insurance.
The distress of psychologists
Claimed for many years by psychologists, reimbursement by Health Insurance for psychotherapy sessions in four departments has been welcomed by many professionals. “This is a great step forward in opening up our profession to a patient population who, without reimbursement, does not consult. It is for them that we are satisfied, and to fight against the excessive consumption of antidepressants”, declared to France 3 clinical psychologist Fanny Villain. The latter has already received five patients on prescription from a general practitioner.
On the other hand, all or almost all agree that the prices imposed by Health Insurance are far too low: 22 euros for the first 10 sessions, 32 euros for the next 10. Asked by The Dispatch, Patrice Bouchaïb, psychologist in Toulouse and representative of the National Union of Psychologists for the Occitanie region, regrets that the price offered by the CPAM is “ridiculously low”. “I think they forgot that we were working in an office. In the center of Toulouse, an office costs approximately 850 euros per month, and consultation fees are around 50 euros”. To demand a review of reimbursement rates, a petition was launched by the National Union of Psychologists and sent to the Minister of Health Agnès Buzyn.
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