In the end, the “psychologist bonus” arrived in the Milleproproghe approved by Parliament, with two different projects contained in the same final amendment, one aimed at enhancing the public service, the other of a private nature responding to the voucher policy, with an overall economic commitment almost symbolic. Beyond the media and political emphasis, compared to the 50 million rejected in the Budget Law, 20 million euros are allocated, of which 10 are destined for recruitment for the mental health services of the ASL, with a positive signal for the NHS, and another 10 for the real “psychologist bonus”, which may concern a very small audience of about 16 thousand citizens, to be regulated by a subsequent inter-ministerial decree.
It is called a “psychologist bonus” but in reality it can also be used by child psychiatrists or neuropsychiatrists. The law, in fact, provides that citizens through the bonus can go to the specialists enrolled in the register of psychotherapists, to whom both psychologists and doctors access, after specific training.
Psychological bonus, it will be useful but only for a few
by Valeria Pini
From the point of view of resources, to explain their scarcity, just think that it is 20 million compared to the shortage for the protection of mental health in Italy of about 2 billion and 300 million. Figures that can also be easily deduced from the reading of the recent sentence of the Constitutional Court n. 22 of 2022 relating to the problems of waiting lists for Rems (Residences for security measures). The Court, in fact, highlights a percentage expenditure for mental health which regressed to 2.9% of the national health fund, compared to the historic commitment of 5% assumed by the presidents of the Regions themselves in 2001, never achieved.
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by Valeria Pini
The “psychologist bonus” was however claimed as a success by all political forces, but it appears more as an illusory effect, which is not the right way to tackle the serious problem of mental illness, which has worsened with the pandemic. The privatistic way of bonuses can be appropriate for the purchase of a commodity, a car or a television, and can only lead to a further impoverishment of the public service, to the detriment of those who cannot afford to go to the private sector.
The dramatic experience of the pandemic has shown how the public health network, beyond the critical issues, has in any case demonstrated the inestimable value of the national health service. No one was asked for a credit card in the emergency room, and rightly no one thought about the establishment of the “virologist bonus”. Also for mental health and for psychotherapy itself, already included in the essential levels of assistance, the path of the right to health must be followed, with equal dignity as the physical one, through the NHS to protect appropriateness and all citizens, starting with the less well-off. For these reasons, mental health policy interventions can no longer be limited to spot projects for certain pathologies, from autism to eating disorders, or the “psychologist bonus”.
Psychologist bonus of 600 euros per year, Isee ceiling of 50 thousand
It is time to build an overall, structural and financed plan, starting from the path of the necessary recruitments, started with the project now financed with 10 million in the Milleproroghe, not present in the initial bipartisan amendment promoted by the National Council of Psychologists rejected by Parliament. A plan that is not limited to psychological assistance alone, moreover certainly to be implemented in schools, health districts, community homes, hospitals themselves, but with an overall strengthening of the NHS mental health world. In a renewed vision of mental health, in the light of new needs, which overcomes biomedical reductionism based on the outpatient / psychotropic / hospitalization axis and having the bio-psycho-social paradigm as its polar star.
Starting from the PNRR and the forthcoming redefinition of the requirements and standards of local services, it is time that the policy decides to really invest in the protection of mental health, with projects and financial resources bound for the public service, to be defined in the next Law of Budget, without the need for petitions. A new forgetfulness would be unforgivable.
* psychiatrist, director of the ASL Roma 2 Department of Mental Health