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.