Deputy promotes more psychotherapy under medical insurance

On the last day before New Year's Eve, as usual, Zhong Can, director of the outpatient department at the Wuzhou Red Cross Hospital in Guangxi Zhuang autonomous region, received several patients with chronic gastritis caused by psychological problems, China Youth Daily reported.

As a general practitioner, in recent years Zhong has often met patients who need psychological treatment in outpatient clinics, with many being teenagers. In addition to chronic gastritis, these patients may also have headaches, dizziness, insomnia and other problems.

For patients who suffer from mental illness, it usually takes around six months or longer for treatment. However, currently treatment methods for mental illnesses usually include medication, psychological counseling and rehabilitation therapy, but only a small portion of these are covered by medical insurance, leaving the majority of the burden on the patients themselves.

Zhong, also a deputy to the 14th National People's Congress, included the difficulties faced by patients with mental illnesses in seeking medical treatment in her proposal during the NPC annual session in March 2023. Her recommendation focused on incorporating psychological treatments into the medical insurance system, especially for mental illnesses like depression.

In response, Zhong received a detailed written reply from the National Healthcare Security Administration in August. The NHSA indicated that, at the national level, rehabilitation therapies such as the Autism Diagnostic Interview (ADI) assessment and occupational therapy training for mental disorders had been included in the basic medical insurance payment scope. Provincial-level medical security departments are encouraged to include clinically necessary, safe, effective and cost-appropriate therapeutic medical services in the local medical insurance payment scope based on clinical needs, medical technology development and the operation of the medical insurance funds. This includes certain psychological treatment programs.

Addressing Zhong's suggestion to reimburse mental diseases like depression through unified accounts, the NHSA referenced a list the administration released in 2021, which clarified that drug maintenance treatments for serious mental illnesses could be managed and paid for similarly to inpatient treatments. Many regions have already included drug maintenance treatments for severe mental illnesses in their coverage.

For the next step, the NHSA plans to guide localities in improving medical security work, consolidating the level of inpatient treatment, enhancing outpatient mutual aid security, and gradually raising the level of outpatient security to better protect the medical insurance rights of all insured individuals, including those with mental illnesses.

Zhong is satisfied with the response. Although the reimbursement items for medical insurance vary from province to province, progress has been gradually made.

With the upcoming annual two sessions, Zhong plans to focus her next proposal on addressing the shortage of psychiatrists, which has also led to some general hospitals facing the challenge of establishing psychiatric departments but struggling with a lack of available doctors. She said she hopes that the government can provide more support.