The health crisis has highlighted the importance of mental health. Psychologists have rarely been so involved. Yet their independence and working conditions have never seemed so threatened.
“We ask the government and the public authorities to stop making fun of psychologists!“, alert the National Syndicate of Psychologists (SNP), the French Federation of Psychologists and Psychology (FFPP), the CGT and the European Inter-University Research Seminar in Psychopathology and Psychoanalysis (Siueerpp), in their June 10 call.
Psychologists in the public and private sectors are in fact protesting against a succession of reports and regulations who, “under the guise of humanistic concern for mental health, increasingly denigrate psychologists and threaten their practices more and more”. Among others: the experimentation with reimbursement of ten annual sessions for adults with mild to moderate mental health disorders, the supervision of free consultations for students, and the introduction of a gradation of care which induces a lack of freedom in the choice of therapeutic methods.
— Souad Cousinier 🇨🇵🇪🇺 (@Psy_Lyonnaise) June 10, 2021
Unsuitable “psys packages”
The introduction of “shrink packages” seemed attractive in theory. It is much less so in practice. This system is based on an experiment implemented in four departments since 2018 (Bouches-du-Rhône, Haute-Garonne, Landes and Morbihan). Validated by a report from the Court of Auditors on February 16, 2021, it offers reimbursement of sessions to patients “in mental suffering, for anxiety or mild” and should be quickly perpetuated throughout the country. Psychologists do not denounce the reimbursement of sessions as such – which would allow better access to care – but the protocol that frames them.
“For a patient to have access to the sessions, it is first necessary that a general practitioner (not necessarily aware of mental health issues) prescribed the first consultation. Then, the psychologist meets him for the first time and sends him back to the general practitioner who then prescribes ten 30-minute sessions! If he wants ten additional sessions, he must return to the general practitioner, then to a psychiatrist “, explains Guillaume Lelong, clinical psychologist and member of the Manifeste des Psychologies (#Psy manifesto). The same is the case for the free consultations offered to students in the context of the Covid-19 epidemic, with the difference that the initial ten sessions cannot be renewed.
Psychologists denounce not only a deterrent and potentially violent obstacle course for patients, but also an a limited number of sessions too short, which prevents a correct follow-up from being carried out: “30 minutes is too short! An appointment generally lasts between 45 minutes and 1h30”, underlines Guillaume Lelong. He also regrets the problems of access to professionals and confidentiality, “in the event that a patient consults his family doctor in the first place”.
Increase in reimbursements and fee overruns
Psychologists demand access free for sessions, which should be reimbursed by social security, at “decent” rates. They are for the most part in favor of reimbursing their consultations, but consider that the price of 22 to 32 euros (without exceeding fees) offered by the Health Insurance is derisory:
“If you deduct the rent of the practice, the therapeutic tools, and the training at the expense of the liberal psychologist, the net sum does not make it possible to make ends meet, explains Guillaume Lelong. It is a shame, at the end of the ‘a bac + 5 “diploma. The shrinks who will choose to multiply the appointments to get by are likely to endanger their own mental health, to the detriment of their patients.
Several other requests are on the table:
- the massive job creation in the audience,
- the establishment of additional resources for institutions,
- a better recognition the qualification of psychologists and the respect for the diversity of approaches,
- and an salary increase, up to the five years of study and the 500 hours of internship required to obtain the title of psychologist.
A disguised guardianship, which worries psychologists
A stopped taken on March 10, 2021 also crystallizes the tensions. In particular, it provides that psychologists “comply with the recommendations of good professional practice established by the High Authority for Health (HAS)”. Thus restricting the choice of therapy most suitable by the professional. “We demand respect for the law of 1985, respect for the autonomy of psychologists and the plurality of their methods and practices […] We denounce the intention, manifest, which consists in wanting to control the profession, to put it under supervision, to paramedical it “, mentions the appeal of June 10.
Finally, the bill nº 4055 (April 2021) aiming to create a Order of Psychologists divides the profession. The stated objective is to clarify and regulate more precisely the organization of the various sub-fields of the profession. Some psychologists fear being placed under the supervision of doctors, while others regret that the profession was not consulted in the context of this proposal.