A Small Revolution in Belgium: Psychologists to be Recognized Health Professionals

Nadia Mahjoub
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In Belgium, patients with mental health problems mostly receive drug treatment despite the emphasis in international guidelines on the importance of psychological approaches. Currently one in ten Belgians takes antidepressants. That makes Belgium the European leader when it comes to antidepressant prescriptions and costs our country 300 million euros annually. This has been a glaring concern for our Minister of Health.

From January 1, 2016, all psychologists and psychotherapists in Belgium will need to register in an official list. This should slash the number of unqualified therapists and help more Belgians stay off antidepressants.

The bill, introduced on 5 November 2013 with support from 8 different parties, seeks to include clinical psychologists in the Royal Decree of 78 on healthcare professionals. This means these professionals will be able to work independently, providing psychological assessment, prevention, support and treatment of psychological and (psycho)somatic suffering. To do so, they will need to hold a 5-year master’s degree in clinical psychology.

Members of the Belgian Federation of Psychologists are relieved about the bill, which will affect an estimated 12,000 colleagues working illegally in private practice. The logical next step is ensuring a rebate for those who see a psychologist. Right now these patients only get a refund when they consult legally recognized health professionals such as psychiatrists and GPs. Rebate reforms would help more people to access to psychological counseling.

The new law will give clinical psychologists the same full and independent powers as other health professionals. The freedom of these psychologists to work separately from general practitioners is something the Federation has been working towards for over 20 years.

Some critics have voiced concerns that the change will overtax the health insurance system. However this seems a bit premature. Research in Canada and France has shown that rebates for psychological treatment can be cost-effective. As it is, current arrangements are taking a heavy toll on Belgium’s health insurance system: we are, after all, the leading swallowers of psychotropic drugs, and one-third of those unable to work for long periods are struggling with mental health problems.

5 COMMENTS

  1. “From January 1, 2016, all psychologists and psychotherapists in Belgium will need to register in an official list. This should slash the number of unqualified therapists and help more Belgians stay off antidepressants.”

    I can see how an official list would help patients find trained providers and probably keep them from going to untrained therapists.

    But how does this imply that more Belgians will stay off antidepressants? Presumably untrained therapists cannot prescribe antidepressants. So how does such a list limit access to antidepressants?

  2. It might be a good thing to have access to psychological service that is paid by your health insurance, but

    I don’t see why it should lower the prescriptions of antidepressants. As a clinical psychologist you most likely have to diagnose your patients to get billed(?).

    Most psychologist don’t take clients who show “symptoms” of a “psychiatric disorder”. They learned it’s a biological thing with the brain, they send the client to a psychiatrist.

    In which way are clinical psychologist better educated than psychiatrists or a non-clinical psychologist? I would say regardless of profession 80% of them do more harm than good. They just so preoccupied with all the concepts, theories and diagnoses, they just don’t get it what it is that people need.

    Maybe it is a revolution for the Belgian Federation of Psychologists, but it won’t change anything about the influence of psychiatry.

  3. actually it is one in eight Belgians who are on antidepressants. I don’t know how on earth who got to the point were one in eight of our population is “depressed”. Are we such an unhappy nation ? Or are Belgian doctors very keen on writing antidepressant descriptions ? Maybe it is because here general doctors can prescribe psycho-pharmaceutical medication, so you don’t even need a diagnosis to be put on medication.
    You know I was put on an antidepressant and a anti-psychotic at the age of 16 after having seen a psychiatrist only once and I did not even said a word to him. Afterwards I continue taking the medication for 6 more years without ever seeing him , my doctor just give me a prescription when I asked for it without asking questions.

  4. There is an assumption that clinical psychologists are better than psychotherapists and therefore psychotherapists cannot practice on their own without the supervision of a clinical psychologist. This is completely based on lack of knowledge and stereotypes. And this is going to limit the quality of care that can be provided to Belgians. The law should be equal for psychologists and psychotherapists, like it is in UK and USA, and other parts of the world.