Motion 26.4067: Access to psychological psychotherapy

Motion 26.4067 would change the conditions for accessing psychological psychotherapy through Switzerland's mandatory health insurance. It asks the Federal Council to require a confirmed medical diagnosis of a mental disorder, established by a psychiatrist, to be available when treatment begins. Patients without such a diagnosis would need psychiatric assessment before they could begin treatment through this insured pathway. The proposal concerns conditions for insured treatment, rather than a general prohibition on diagnostic work by psychological psychotherapists. [1]

The National Council's Social Security and Health Committee presents the motion as a response to rising expenditure. Its explanatory statement questions whether the current prescribing arrangements adequately distinguish illness from difficulties without clinical significance. It argues that psychiatric diagnosis at the outset would help direct insured treatment to patients with illness-related needs. [1]

PsyCH-Students' position

PsyCH-Students is the national umbrella association of psychology students in Switzerland. It represents the interests of current students, including those who intend to pursue postgraduate training in psychotherapy and become psychological psychotherapists.

PsyCH-Students' stated position is to oppose Motion 26.4067 and support the petition calling for its rejection.

How access and diagnosis work today

Since July 1, 2022, psychological psychotherapists have been able to bill mandatory health insurance independently on an eligible physician's prescription. Coverage is restricted to treatment of illness. Each regular prescription covers up to 15 sessions, with an exchange between the prescriber and therapist required before a further prescription is issued. Continuing treatment beyond 30 sessions requires insurer authorization. Where treatment was prescribed by a specialist in general internal medicine or pediatrics, the continuation report must also include a psychiatric case assessment. [2]‍

Requirements for independent billing include a federal or recognized foreign postgraduate qualification in psychotherapy, a cantonal license to practice, separate cantonal admission to provide services under mandatory health insurance and at least three years of psychotherapeutic experience. [2]‍

The Federal Office of Public Health, or FOPH, recognizes psychological psychotherapists' competence to diagnose mental disorders and plan treatment. Its June 2026 report explains that diagnostic clarification may require several sessions and that a working diagnosis may be appropriate when treatment is prescribed. Further diagnostic assessment may also form part of the treatment assignment. [3]‍

In the same report, the FOPH found no indication in the evaluation results that additional regulatory measures were necessary and appropriate to ensure suitable treatment indications and delivery of psychological psychotherapy. This assessment predates Motion 26.4067. [3]

Waiting times and psychiatric capacity

The ZHAW evaluation commissioned by the FOPH found that the prescription model was generally regarded as successfully implemented and access was reported to have improved. Waiting times had not shortened over the period examined. Shortages remained particularly pronounced for children and adolescents and in rural regions. The evaluation also identified difficulties in obtaining psychiatric case assessments for longer treatments because of specialist shortages, particularly in child and adolescent care. [4]

These findings describe the existing system. The evaluation examined the early effects of the 2022 reform through surveys, interviews and insurance claims data. It did not test the requirement proposed in Motion 26.4067 and does not establish how that requirement would affect waiting times. Its observation period was too short to establish medium-term and long-term effects of the reform. [4]

What the cost figures show

Mandatory health insurance expenditure on psychological psychotherapy rose from CHF 528 million in 2021 to CHF 922 million in 2024. The FOPH's June 2026 communication attributes around 30% of the increase to higher tariffs and just under 25% to population growth and an existing trend toward greater use of psychotherapy. Just under 45% relates to other factors that cannot be directly observed, including possible shifts from private payment and supplementary insurance into mandatory insurance. These percentages concern the increase in expenditure, not total expenditure. [5]

Taken on their own, these figures do not show how much of the increase reflects inappropriate treatment. The Federal Council has announced continued cost monitoring and more detailed analysis of service provision. [5]

FSP, ASP and SBAP on Motion 26.4067

The Federation of Swiss Psychologists, FSP, opposes the proposed requirement and supports the petition. In its public statement on LinkedIn, it warns that an additional psychiatric assessment could prolong waiting times, lead to additional costs and disrupt established primary care referral pathways. It also raises concerns that delays could worsen the course of illness. [6]

The Association of Swiss Psychotherapists, ASP, opposes Motion 26.4067 in a statement published on its website on September 9, 2026. It argues that the requirement would create an additional barrier to psychotherapy, use already scarce psychiatric capacity and unnecessarily question psychotherapists' professional competence. The ASP explicitly supports the petition and encourages readers to sign and share it. [7]

The Swiss Professional Association for Applied Psychology, SBAP, also rejects Motion 26.4067 and supports the petition. Its statement on LinkedIn argues that the proposal would unnecessarily make psychotherapy harder to access for people who need support. The SBAP also highlights cooperation between professional associations and individual supporters in responding to the motion. [8]

In summary, the additional delays, costs, and barriers to access described by the associations reflect their concerns regarding the proposal - concerns that we also share. [6] [7] [8]

The motion and the petition

The official parliamentary record provides the motion's wording and information on its parliamentary progress. The petition "Zugang zur Psychotherapie sichern - Hilfe statt Hürden", meaning "Ensuring Access to Psychotherapy - Help, Not Obstacles", sets out its organizers' objections and asks members of the National Council to reject the motion. The full petition text and signature form are available on Campax. [1] [9]

Sources

[1] Swiss Parliament. Motion 26.4067: Obligatorische Krankenpflegeversicherung. Gezielter Einsatz der Prämien- und Steuergelder. Motion text, explanatory statement and parliamentary progress.

[2] Federal Office of Public Health. Neuregelung der psychologischen Psychotherapie ab 1. Juli 2022. Official guidance on prescriptions, professional admission and reimbursement.

[3] Federal Office of Public Health. June 24, 2026. Formative Evaluation der Neuregelung der psychologischen Psychotherapie. Bericht des BAG. See section 7.2.3, pages 32-33.

[4] ZHAW Zurich University of Applied Sciences. December 2025. Formative Evaluation der Neuregelung der psychologischen Psychotherapie. Management Summary. Commissioned by the Federal Office of Public Health.

[5] Federal Office of Public Health. June 24, 2026. Neuregelung der psychologischen Psychotherapie hat sich etabliert. Federal communication on the evaluation, expenditure and further monitoring.

[6] Federation of Swiss Psychologists (FSP). Public statement on Motion 26.4067 and the petition. Official LinkedIn post. Accessed September 20, 2026.

[7] Association of Swiss Psychotherapists (ASP). September 9, 2026. Statement on Motion 26.4067 and the petition, published in Aktuelles & Publikationen on the association’s website.

[8] Swiss Professional Association for Applied Psychology (SBAP). Statement on Motion 26.4067 and support for the petition. LinkedIn post beginning "Der SBAP. lehnt die Motion 26.4067", available among the updates on the association's official page. Accessed September 20, 2026.

[9] Petition organizers. Zugang zur Psychotherapie sichern - Hilfe statt Hürden. Petition addressed to members of the National Council and hosted on ACT by Campax.