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Why the arranging model is more important than ever in times of Covid-19

Due to the Covid-19 pandemic and its measures, maintaining mental health is becoming increasingly difficult for many people (FSP, 2020). We know from various studies that quarantine has a negative effect on a person’s mental state. In a review, Brooks et al. (2020) have reported the negative psychological effects of quarantine, including anxiety, sadness, nervousness, anger, and post-traumatic stress symptoms. During a quarantine, people can manifest a variety of stressors such as fear of infection, boredom, frustration, insufficient care, stigmatization, and financial loss. These stressors can cause long-term effects such as mental disorders (Brooks et al., 2020). According to the WHO, quarantine and its effect on humans could lead to higher levels of loneliness, harmful alcohol and drug consumption, depression, and it is expected that self-harm or suicidal behavior will also increase (WHO, 2020).

According to a press release of the FSP, 1300 psychologists report in a survey about an increased demand from patients since summer 2020 (FSP, 2020). More than 70% of the patients were rejected due to a lack of therapeutic capacity. Due to the corona pandemic, 31% of the participants suffered from new mental illnesses, with some of the participants already carrying a pre-existing mental burden before the corona pandemic. Furthermore, psychologists reported that 47% of their existing clients reported that corona and the nation wide lockdown worsened their symptoms (FSP, 2020). In the field of mental health, there have been barriers to care in Switzerland for quite some time (Stettler, Stocker, Gardiol, Bischof, & Künzli, 2013; Stocker et al., 2016). According to the FSP, patients often have to wait up to six months for ambulatory treatment, which is a considerable amount of waiting time while being in a position of need (FSP, 2020). 

For this reason, the barriers to ambulatory psychotherapy must be reduced as quickly as possible. Until now, ambulatory psychotherapy by psychological psychotherapists has only been reimbursed by the basic insurance as soon as they are employed under a psychiatric doctor. This is the so-called delegation model, which greatly limits the number of psychotherapy places available and leads to long waiting periods (FSP, 2020). Therefore, the critical delegation model should be replaced by the arranging model. The purpose of this model is to enable psychotherapy to be carried out by self-employed psychotherapists in the future, where the costs are also covered by the basic insurance. However, the assignment of patients to a therapist should be made on the instructions of a medical doctor. The regulation change, which is necessary for the introduction of the arranging model, has been available since summer 2019. The consultation process has been completed since October 2019, and the Health Commissions of the Council of States and National Council also support the change. It is now up to the Federal Council to ensure that, in the near future, all people have rapid access to psychotherapeutic services financed by the basic insurance (FSP, 2020).  

Bibliography :
  • Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet, 395(10227), 912–920. doi: 10.1016/S0140-6736(20)30460-8
  • Föderation der Schweizer Psychologinnen und Psychologen [FSP] (2020). Covid und die Psyche – Mehr Anfragen bei Psychologen seit dem Sommer. Retrieved November 11, 2020, from https://www.psychologie.ch/covid-und-die-psyche-mehr-anfragen-bei-psychologen-seit-dem-sommer 
  • World Health Organization [WHO] (2020). Mental health and COVID-19. Retrieved November 11, 2020, from https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/noncommunicable-diseases/mental-health-and-covid-19 
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  • Standing Jake (n.d). How to address business growth barriers. Retrieved November 12, 2020, from https://www.platinumpublishing.co.uk/platinum-business-magazine/2019/07/how-to-address-business-growth-barriers/

Author : Alexander Ariu