Question and answer: psychological care agreement 2022-2023
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We participated in the International Conference on Integrated Care (ICIC) 2023, which this year took place May 22-24 in Antwerp, Belgium. This important event brings together healthcare professionals and experts from around the world to share knowledge and insights on integrated care. The conference provides not only a platform for knowledge exchange, but also valuable networking opportunities.
5 themes were put forward as guiding principles:
- Change management at all levels
- Person-centered care with focus on goals and needs
- Collaboration as a success factor for integrated care
- Everyone cares: anchoring care in the neighborhood
- Population as a lever to support integrated care
The content of the conference is filled by submitted abstracts. 280 of the 782 abstracts, or 36%, were submitted from Belgium.
Specifically, what does this mean for patients?
The point of this agreement is to make the offer more accessible to citizens with needs in different domains including psychological care. In this new step, we focus on psychological care requests that indicate mild to moderate problems. In doing so, we ask the care providers involved to initially give priority to the group of people with an increased risk of developing psychological problems. A more accessible offer should be reflected, among other things, in the aim, that for the patient within 1 week to 1 month after the request for help a first session can go through.
The offer is aimed at children, adolescents and adults, with no age limit, who have a request for help indicating mild to moderate problems. Special attention is also paid to those target groups identified by the Supreme Health Council as vulnerable during the Covid - 19 pandemic but also to people with pre-existing mental health problems, people who have lost a loved one, financially vulnerable groups, people with multimorbidity,
One of the main pillars of the current agreement is the financial accessibility of care. Psychological sessions cost
- 11 euros for an individual session (4 euros for patients with increased allowance)
- 2.5 euros for a group session.
At the first session, the patient does not have to pay anything himself.
A patient does not need a prescription to get reimbursed for a session with a conventional clinical psychologist or remedial therapist. The only requirement is to attend sessions with a clinical psychologist or remedial therapist who has signed an agreement with a network mental health care. .
We reimburse psychological care according to 2 types when it is organized within a mental health network that has signed an agreement with the NIHDI:
- Primary psychological care: short-term and/or low-intensity psychological interventions that contribute to maintaining or regaining general psychological well-being
- Specialized psychological care: interventions that are more intensive in nature and/or require a specific method.
Patients may receive care in: - Individual sessions
- Group sessions (groups of 4 to 15 people with similar issues)
- These group sessions can also be co-led by health care practitioners, social workers, or experts by experience. Do you fall under these categories and would like to co-lead group sessions? Then contact your local network mental health care. (more info below).
Depending on type of care and type of network mental health care. (more info below) the maximum number of sessions to which it is entitled varies.
Primary psychological care:
- In a network "Children and adolescents": maximum 10 individual or 8 group sessions
- In an "adult" network: maximum 8 individual or 5 group sessions
Specialized psychological care:
- In a "children and adolescents" network: an average of 10 individual sessions (max. 20) or a maximum of 15 group sessions
- In an "adult" network: average 8 sessions (max. 20) or maximum 12 group sessions
During the first session, the psychologist/orthopedagogue draws up a functional bilan. This is an overview of the current situation (social, medical, psychological,...) of the patients in their context, including relevant history and gives an indication of what kind of care or help is desired. It contributes to the preparation of the treatment plan. Within this agreement, we place a strong emphasis on cooperation between the various partners around the patient. With the patient's consent, the psychologist or orthopedagogue can discuss this functional bilan with his/her/their treating physician.
The agreement ensures that care is adapted to the local needs that exist and brings psychological care to the patient's neighborhood. To this end, the financial resources available to a network are calculated on the basis of a vulnerability index for each subregion. This vulnerability index is based on scientific research.
In this context, reference is made to the term "finding places. This is a place where persons within the target group already go with a purpose other than psychological support, such as material or social assistance, general care or leisure activities. Psychological needs can be identified there and people can be referred there for appropriate psychological care.
In addition, sessions can also take place in the office of a psychologist or remedial educationalist or digitally (remotely).
An important element in this agreement is the possibility for certain organizations (such as the CPAS, CLB...) to enter into an agreement with a mentalhealth network, and complementary to the missions they already fulfill today, also provide psychological care as referred to in the agreement.
For more information on locations, visit the NIHDI's webpage on psychological care
Mental health networks
A mentalhealth network is an established region in which the actors agree on the organization of psychological care. Maps and the websites of the networks are published on the NIHDI website. There are currently 32 mental health care networks in Belgium.
You can find the list of clinical psychologists/orthopedagogues on the mental health network website for "your" region.
A mentalhealth network brings together all actors associated with mental health issues. Arrangements are made within the organization to ensure effective care. Coordinators are the points of contact and responsible for coordination within the network. Within a mentalhealth network, there are clinical psychologists/orthopedagogues who have an agreement with the network. There are also other caregivers and experts by experience who can be involved in group sessions.
Each network concludes agreements with local collaborations, in Flanders these are the first-line zones, in order to make agreements about the so-called "places of reference" and about the concrete organization and provision of care at the local level.
Each network concludes agreements with local collaborations in order to make agreements about the so-called "places of reference" and about the concrete organization and provision of care at the local level.
The networks mental health care are organized by age to provide relevant care:
- 12 networks for children and youth (up to age 23)
- 20 networks for adults (from 15 years of age)
These age categories overlap. Thus, youth ages 15 through 23 can find care in a network with a specialization in their issues (youth or adult).
For this convention, the networks are expected to cooperate with each other at the provincial level and shape this offering.
Psychological care in primary care is organized through local multidisciplinary partnerships, in Flanders this is through the 60 primary care zones. Specifically, these are geographical zones established to better coordinate the work of local authorities, care and assistance providers so that care is optimally organized and accessible.
The local multidisciplinary partnership, the first-line zone, includes all relevant actors who can be involved in the organization of this offer. The mental health network concludes agreements with the front-line zones, to include:
- The deployment of resources based on local needs as detected by front-line zones (e.g., what group offerings are needed?).
- The commitment of health care providers associated with this agreement (which neighborhood, which site...)
The objective is to organize psychological care in the most accessible way possible. Of course, all social actors can guide or refer people to the services offered within this agreement. They are aware of the local offer of psychological care, they can recognize psychological problems and therefore they can understand when someone needs psychological care.
In addition, the networks and local collaborations (in Flanders, the 60 first-line zones) (see previous question) should inform these referrers about "low-threshold" mental health care (such as online help, telephone helplines), among people with less severe problems.
State of affairs?
Currently, all networks have mental health care in Belgium have an agreement with the NIHDI. They all have a network coordinator and most of the networks also have an additional "local coordinator" who is mainly concerned with facilitating this agreement. Several psychologists and orthopedagogues are already active in these networks, organizing psychological sessions whose details can be found on the networks' websites.
Depending on the needs of the local population, each of the 32 networks conclude mental health services agreements with more clinical psychologists/orthopedagogues. It is expected that in the fall of 2022 all necessary contracts will be concluded.
Also, the networks ensure that agreements are made with a lot of different places to help a maximum of the persons within the target group find their way to care.
Contact the mental health network to get a view of the current state of affairs within your network.
Do you recognize yourself as a potential partner? If so, contact your mental health network to discuss a future collaboration.
Are you a healthcare practitioner, counselor, or experiencer and would like to co-lead group sessions? Then contact your mental health network to discuss their offerings and how you can be a part of them!
