Fully reimbursed psychotherapeutic follow-up. On paper, that sounds appealing. But in reality, what is it? A year ago, the government launched the MonPsy platform, since renamed MonParcoursPsy. This system, devised after the Covid-19 crisis, allows anyone over the age of 3 with mild to moderate psychological suffering to benefit from eight reimbursed psychotherapeutic follow-up sessions. Liberal psychologists wishing to be part of the system must volunteer in order to be approved by the Health Insurance. The government has set the price of the consultation at 40 euros for the first session and 30 euros for the following ones, a session not being able to exceed thirty minutes.
A year after its launch, more than 90,000 people, including 14,000 minors, have benefited from at least one session via this device, according to figures provided by the Ministry of Health. “MonParcoursPsy is a success”, welcomed François Braun, the Ministry of Health, on March 3 at the end of the National Strategic Committee devoted to Mental Health and Psychiatry, in Lyon. However, on closer inspection, only 2,200 psychologists volunteered from April 2022 to March 2023, or 7% of liberal psychologists. “It’s not enough,” admits François Braun. “It’s a failure”, slice for his part Florent Simon, secretary general of the National Union of Psychologists (SNP), knowing that since its creation, many psychologists have demonstrated to oppose the establishment of this platform.
Only 7% of participating psychologists
In some departments, the psychologists who have volunteered can be counted on the fingers of one hand. In Charente, for example, only three psychologists participate in the system for 350,000 inhabitants, i.e. one psychologist for 117,000 inhabitants. In Haute-Savoie, five professionals for 829,00 inhabitants, or one psychologist for 166,000 inhabitants.
For the secretary general of the SNP, there are many reasons why so few professionals have joined the adventure. “This device is unsuitable, both for patients and for psychologists”. The duration of a session, first of all, of thirty minutes, poses a problem. “You have to manage to get better in four hours [huit fois trente minutes], protests Florent Simon. Whereas in psychotherapy, we need time to establish a bond of trust. Depression cannot be cured like a cold.
Pascal Zamparini, a liberal psychologist in Paris and Vincennes, joined the MonParcoursPsy platform in August. Since then, patients suffering from mental overload, burn-out or living in conflicting relationships have followed one another in his office. If he recognizes that “we could do better in the implementation” of the device, the therapist understands that “it is necessary to set limits”. According to him, eight sessions already allow some progress… even if he admits that it often exceeds half an hour. “Some consult a psychologist for the first time and tell me about traumas that they had never told anyone before. I’m not going to cut them because we’ve gone over thirty minutes. The therapist concedes: “That’s a terrible hourly rate… It’s a psychological investment for both the patient and the therapist. »
“Some patients are in a real precarious situation”
Another reason that would slow down the use of the device, according to the secretary general of the SNP: the letter that the doctor must send to the psychologist to send him a patient. When MonPsy was launched, many psychologists protested against this letter of address. “Already, the patient must succeed in finding a general practitioner, which is complicated in certain territories. Then it adds an extra step. The patient will indeed have to share his psychological difficulties with his doctor, before talking more in depth to the psychologist. According to Florent Simon, some people would throw in the towel before crossing the door of a psychology office. On the contrary, Pascal Zamparini sees these addressing letters in a positive light. “Many of the people I have had in consultation would not have thought of going to see a psychologist if their doctor had not spoken to them about it. »
Didn’t have the idea… nor the means. The liberal psychologist estimates that about a third of his patients would not have enough to pay for psychotherapeutic follow-up if the latter was not reimbursed. “Some patients, especially students, are in a very precarious situation. If I joined the device, it is because I do not see why only a small part of the population would have access to psychologists. »
Only 10% of precarious patients
However, according to figures from the Ministry of Health, among the 90,000 people who have benefited from at least one session via MonParcoursPsy, only 10% are in a precarious situation. “Some patients have the means but do not necessarily want to spend a lot, analyzes Pascal Zamparini. They are very happy that it is taken care of, as is the case for medical expenses. »
For the secretary general of the SNP, these figures show that the device “misses its target”. Moreover, according to him, structures intended for people who do not have the means to pay a psychologist already exist: the medico-psychological centers (CMP). The therapist believes that it would be better to invest in these already existing structures rather than developing a device “not at all up to the challenges”. Despite its mixed results, MonParcoursPsy is currently maintained and will be evaluated no later than September 1, 2024 by the Ministry of Health.