Switzerland considers mandatory psychiatric diagnosis for psychotherapy access

The Health Commission of the Swiss National Council (SGK-N) has majority-supported a reform that could restrict direct access to psychotherapy through mandatory basic health insurance. The proposal requires a mandatory initial diagnosis by a psychiatrist before psychotherapeutic services can be billed.

This move aims to implement stricter medical triage within the healthcare system to ensure the medical necessity of treatments. Proponents argue it will distinguish clinical treatments from general counseling, while critics express concerns regarding potentially longer waiting times for patients.

The legislative discussion is driven by significant cost increases in the sector. According to commission documents, expenditures for psychotherapeutic treatments rose from 2022 levels to nearly 1 billion Swiss francs in 2024. Additionally, there are discussions regarding the creation of a prevalence database to enable more data-driven management of healthcare provision.