While it certainly requires courage to reach out for psychological support, in Luxembourg many patients also require extreme patience. Waiting lists are often at least six months long, while many therapists are no longer taking on new patients.
In recent years, from 2016 to 2023, the number of psychotherapists in Luxembourg has risen by over 600% in response to increasing demand for their services. In 2024, more than 15,500 people insured in Luxembourg benefited from a total of almost 100,000 psychotherapy sessions at home and abroad, including over 4,400 patients between 30 and 39 years old.
Alain Massen, a psychotherapist and the treasurer at Fapsylux (the Federation of Associations Representing Psychotherapists in Luxembourg), explains:
"The demand in our society (…) is much larger. And because of the reimbursement, the inhibition threshold has perhaps also become much lower (…) That means we are not meeting the demand."
Psychotherapy has only been reimbursed by the National Health Fund (CNS) since 2023, covering 70% of costs for adults and 100% for minors. But patients must still pay for their sessions upfront themselves, as the immediate direct payment, or PID, is not available for therapists.
"We've always been told by the CNS that we can't use PID for our patients (...) The co-pay, which is 30%, is still a lot of money for some people."
All these issues could be regulated in an agreement between the CNS and Fapsylux.
However, while the agreement was largely finalised years ago, it still needs to be reviewed by the Health Fund's legal service. Until then, the work continues based on a ministerial regulation. While generally this works, Fapsylux says, the sector is plagued by long waiting lists because for many therapists, self-employment in Luxembourg is not attractive enough.
"(…) As a result, we have all these waiting lists, where it sometimes takes months to find a place, (…) because the conditions are simply not good enough for therapists to work as freelancers. It's better for them to work for the National Education Agency in a school, as a psychologist, with a good salary (…) and without all the risks that you have as a freelancer in this country."
Seeking help from a psychotherapist is one thing, but getting it in a timely manner remains a challenge in Luxembourg.
