(Health Times reporter Shi Mengzhu)
Psychotherapists are psychotherapy patients. Photo by Cao Zihao
A table, a box of tissues, two chairs, this is the most basic decoration in the psychological counseling room.
The Health Times reporter consulted a number of hospitals and social psychological counseling institutions and learned that in such a psychological counseling room, it takes nearly a thousand yuan to talk face-to-face with a professional psychotherapist or counselor for less than an hour. The cost of psychological counseling is becoming another "heart disease" for more and more patients with mental illness.
Psychological counseling that was forcibly terminated
Xiao Zhen (pseudonym) remembers how much power the small room in the hospital once brought to herself.
Since being diagnosed with depression and anxiety three years ago, Xiaozhen has taken her medicine on time according to the doctor's instructions, and has come to a public tertiary hospital for two periods of psychological counseling and treatment every week, and the doctor is friendly and willing to listen to all her troubles, "Just like a sudden sun shining on me on a cloudy day." Xiao Zhen said that she could feel that she was slowly standing up, slowly walking out of the abyss, and even looking forward to meeting the doctor every week.
In August last year, Xiaozhen was forced to terminate psychological counseling because the cost of counseling after the price increase was unaffordable. In the last consultation, Xiaozhen's psychologist told her that the hospital decided to adjust the price of psychological consultation, from more than 100 yuan plus 300 yuan per period of time before, to 800 yuan per period, without having to pay the special registration fee.
"Each consultation takes two periods, 1600 yuan a week, plus the cost of the usual drugs, which is really expensive." The price increase of nearly twice has overwhelmed Xiao Zhen. After a fierce ideological struggle and a doctor's evaluation, she finally chose to terminate psychological counseling.
After returning home, Xiaozhen began to inquire into some psychological counseling institutions in the society, and found that although some institutions only need one or two hundred yuan for the first consultation, they will have five or six hundred or even thousands of yuan for each period after that.
"Asking about the cost makes me more depressed" "The price is really unaffordable"... The topic of the inexpensive nature of counseling is being refreshed every day, reflecting the many annoyances of people with mental illness who suffer from high consultation fees.
The Health Times reporter consulted a number of psychological counseling institutions and learned that in general, the quotation of novice counselors is about 300 yuan, while the price of mature consultants is usually 500 yuan to 1000 yuan per 50 minutes, and some are as high as 1000 yuan or more. And because the onset of psychological counseling is relatively slow, patients need to go through as few as 5-6 times, more than twenty times of consultation, even at the median price of 500 yuan, it also needs to spend thousands of yuan to tens of thousands of yuan.
According to the data of One Psychology's "2021 Mental Health Industry Annual Report", at the beginning of 2020, the younger the age, the lower the mental health index. Anxiety levels in young people under the age of 18-25 are significantly higher than those of other age groups; among the mental and psychological problems that young people are most likely to develop, anxiety and depression are the most common. This part of the population often does not have a strong economic foundation, and some are still in school.
Most of the drugs for the treatment of mental illness have been included in the list of basic drugs, but at present, psychological counseling and psychological treatment in many areas are not within the scope of medical insurance, resulting in patients with mental illness mainly relying on drug treatment and lacking effective psychological counseling and rehabilitation treatment. Moreover, the treatment of mental and psychological diseases, including depression and autism, is long and expensive, and many families are difficult to bear.
Tang Jing, a national second-level psychological counselor, told the Health Times reporter that psychological counseling has an irreplaceable importance in the treatment of mental illness. The most important significance of psychological counseling is to provide clients with stable psychological support to help them achieve psychological growth and ultimately have the ability to solve their own problems. Psychosocial problems often develop with deep psychological roots, and if the psychological roots are not addressed, the problem may recur even if the symptoms are briefly relieved by medication. Through psychological counseling and treatment, the client's inner depression and trauma can be deeply dealt with, and the client can be helped to truly get out of the pain.
There is no uniform industry standard for counselor pricing
"Psychological counseling is still in its infancy in the mainland, and social norms and industry norms still need to be improved." Tang Jing said that the pricing of psychological counselors does not have a unified industry standard, generally based on the consultant's qualifications and experience of self-pricing, while the number of domestic psychological counselors is limited, the higher the general qualifications, the higher the price will be relatively higher.
A psychological counselor in Guangdong told reporters that the pricing of psychological counselors is generally affected by comprehensive factors, including the cost of learning, the professional recognition of the consultants, the quality and quantity of orders, the level of regional consumption, and so on.
Taking the cost of learning as an example, the training of psychological counselors is very time-consuming and costly, "First of all, it requires at least a postgraduate degree or above." After leaving the school, there are also training in various genres, post-work consultation and supervision, etc., which are not a small expense. The psychological counselor helped the Health Times reporter to calculate that each school of psychology needs to participate in some long-distance training courses, with an average duration of two or three years, and the price is about 20,000-30,000 yuan per year.
A psychological counselor in Jiangxi said that in general, there is more demand for psychological counseling in beijing, Shanghai and Guangzhou, and the cost is relatively high, and the consulting fee in Jiangxi is generally about 300 yuan, which is also related to the local income consumption level.
However, there are fewer ways to find psychological counseling in non-first-tier cities, and some of the more famous consulting institutions and consultants in the industry are mainly gathered in first-tier cities. Xiaozhen told the Health Times reporter that she had previously asked doctors to help her patients find professional psychological counselors or psychotherapists in the northeast region, but even doctors could not say that there were several suitable peers.
Tang Jing said that the price cannot be used as a criterion for judging and choosing. In the consultation process, it mainly depends on the professional ability of the consultant himself and the feelings of the client during the consultation. "A consultation can basically feel whether the counselor is suitable for you, and you must be loyal to your feelings."
Experts recommend improving social security for the treatment of mental and mental illness
A number of psychiatrists and psychotherapists told reporters that due to various factors, the demand for psychological counseling has become increasing in recent years.
In March 2021, the Guangdong Provincial Medical Insurance Bureau and the Provincial Department of Human Resources and Social Security issued the Catalogue of Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Diagnosis and Treatment Projects in Guangdong Province (2021), which includes "psychological treatment" diagnosis and treatment projects into the scope of payment by the Guangzhou Social Medical Insurance Fund, which does not include psychological counseling. The basic supply of psychological counseling services is still outside the system of these policy pilots.
"Stop seeing mental and psychological problems as an invisible and untouchable emotional impulse, but treat it scientifically and rigorously." Lu Lin, an academician of the Chinese Academy of Sciences, believes that at present, psychological counseling is still in its infancy, and there is a lack of unified standards for the definition and treatment process of psychological counseling, and it is difficult to form a scientific and standardized diagnosis and treatment process, which is not conducive to the establishment of a reasonable reimbursement directory and reimbursement ratio, and has hindered the inclusion of medical insurance.
The establishment of the scope of application and unified standards for psychological counseling and psychotherapy is conducive to improving the catalogue of medical insurance reimbursement projects and improving the efficiency of the use of medical insurance funds and medical resources. Lu Lin said that it is necessary to regulate the price of psychological counseling and psychological treatment at the national level, as a reference pricing for medical institutions and social psychological counseling institutions in various places, which can not only prevent this system from "deviating", but also effectively improve the quality and efficiency of the operation of medical insurance funds.
"It is recommended that psychological counseling and psychotherapy services be included in the medical insurance catalogue as soon as possible, and social security for the treatment of mental illness should be improved." At this year's "two sessions", Gan Huatian, a deputy to the National People's Congress, professor at West China Hospital of Sichuan University, and doctoral supervisor, submitted a "Proposal on Promoting the Diagnosis and Treatment of Mental Illness into Medical Insurance". In February this year, a psychological counseling platform reached a strategic cooperation with a technology company, saying that it would further promote the integration of psychological counseling and commercial insurance.
Some patients give up on themselves, no longer willing to take medicine, or no longer accept psychological counseling, although Xiaozhen feels sorry for this, she herself is still unwilling to give up, because she will always remember the warm feeling of the sun shining into her heart.
