Morbihan tested it between 2018 and 2022. Since April 5, it has been made permanent and now extended to the entire national territory. The MonPsy system, launched on April 5, provides health insurance for consultations with a psychologist. Open to all, ages 3 and up, Monpsy only targets patients with mild to moderate anxiety. It is limited to eight sessions per year, all are reimbursed and are renewable a second time. The first session, called evaluation, is billed 40 €. 30 € for the following. This rate includes the participation of the health insurance up to 60% and that of the complementary organizations up to 40%. It is no more and no less than reimbursing, taking care of, with a psychologist, sessions that until now have been fully paid for by the patient. A device that has been tested in the department for four years and on which the primary health insurance fund (CPAM) of Morbihan looks back.
“We were chosen as the experimental unit because the region is very characterized by mental disorders,” explains Mohamed Azgag, director of the CPAM. “In Brittany we consume seven times more anxiolytics or antidepressants than nationally. When a patient presents to his doctor for psychological distress, there are two options: either we prepare a drug treatment or, if the condition is milder, the doctor sends him to a psychologist to treat the anxiety that lies ahead. As part of the experiment, he had to fill in an evaluation grid to then enable a scientific approach to the device. The attending physician now writes a referral letter. The psychologist always has an evaluation schedule, if he wants it”.
40 psychologists registered in the department
A list of volunteer psychologists can be found on the website dedicated to the scheme (1). They are currently about forty in Morbihan. Excluded from the scheme are patients with major depressive disorders, who are at risk of suicide or who are dependent on various psychoactive substances.
“It is a success in the department,” argues Mohamed Azgag. In addition, the Court of Auditors has issued a favorable opinion to label the operation”. During this four-year experiment, 5,600 policyholders held consultations with MonPsy. 95 psychologists have joined, accounting for 1.5 million euros in healthcare expenditure. Also during these four years, 693 GPs, out of 709, or 97%, used it. Since April 5, it has been extended to all of France.
As part of the experiment, we saw that there was an effect on absenteeism due to illness. A scientific committee is working with the senior health authorities to prepare an assessment.
The purpose of what health insurance services define as light care is to take psychological problems upstream, to prevent a prescription drug and more severe symptoms from occurring. “As part of the experiment, we saw that there was an effect on absenteeism due to illness. A scientific committee is working with the senior health authorities to prepare an assessment. France was the only European country that did not provide access to reimbursed mental health care. This is not an envelope transfer. It is an additional investment. It destigmatises mental health care and completes the liberal offer’, explains the director of the CPAM.
A new patient
It is clear that the health crisis has accelerated the process and brought in new patients. At a time when 15% of the French admit to being anxious, this first appointment can give the most vulnerable and modest population access to psychological follow-up. “The Morbihan experiment showed that people we had never seen before consulted a psychologist: single-parent families, poor workers,” emphasizes Gaspard Lallich, deputy director. “We want this device to be simple and discreet and for the patient to have a free choice between doctor and psychologist”.
As part of the experiment, 250 sessions were reimbursed each month. According to health insurers, 70 psychologists should be accredited by the end of 2022.