Can legislation provide a better match between demand and supply in psychotherapy?

Abstract

Background: There is evidence showing that psychotherapy very often does not reach the persons most in need of it. A change in patterns of “consumer behaviour” is difficult to achieve on the basis of individual behavioural change. Can it be achieved by changes in legislation? Methods: By comparing socio-demographic criteria of patients seen at the University Clinic of Psychoanalysis and Psychotherapy between 1990 and 1996, we are able to give some evidence that changes in legislation, concerning psychotherapy, which took place in the years 1991, 1994 and 1995, had a significant effect on the socio-demographic composition of our patient population, showing a convergence of patient population towards the socio-demographic criteria of the population of Vienna. Conclusion: We argue that the changes in legislation in Austria, concerning funding of psychotherapy, and introducing a new profession “psychotherapist”, have a measurable effect which works in two ways:

1) direct effect: decreased financial charge of patients;

2) indirect effect: increased motivation of patients, resulting from a reduction in stigmas attached to the role of “psychiatric patient”.