Estonia's therapy fund was established to allow patients to see a clinical psychologist, speech therapist or physiotherapist for free.

For years, millions of euros in the fund would go unused, but patients were unable to get appointments. This year, the fund is expected to be used in full, but the shortage of service providers still remains a concern. For private clinics, it simply isn't financially viable to operate under EHIF.

Professional Association of Estonian Clinical Psychologists (EKPK) deputy director Iiris Velling noted that the price offered by EHIF doesn't cover psychologists' actual costs.

"The rate for paid services is one thing; the rate offered by EHIF is another," Velling noted.

"If you look at the difference, the rates offered by EHIF simply don't cover the costs," she explained. "We've essentially reached a point where institutions say they have clinical psychologists and are ready to provide services at EHIF rates, but they still can't offer them because EHIF just doesn't provide sufficient funding for it."

The Health Insurance Fund denies there is a problem.

"In Estonia, 45 partners currently provide clinical psychologist services under EHIF funding, and another five partners will be joining starting July 1," said EHIF partnerships manager Ergo Pallo. "So it can be said that the rate we offer is sufficient for covering clinical psychologists' costs."

This year, Estonia's state therapy fund amounts to €15 million. Three counties, however, have no access whatsoever to free clinical psychologists.

Velling warned that the situation could soon get even worse.

"Institutions have indeed addressed this problem to us, saying they are stretched to the limit," the EKPK deputy chief noted. "In fact, many have already started scaling back their workloads and their capacity to provide services."

Since the availability of psychological care is a priority for the Health Insurance Fund this year, additional funding for mental healthcare is likely. However, according to Minister of Social Affairs Karmen Joller (Reform), how much extra funding there might be won't be clear until the Reform-Eesti 200 coalition agreement is finalized.

"I looked at the numbers — the number of appointments — and saw that over the past year, the number of appointments paid for by EHIF has quadrupled," Joller noted. "In that sense, I think help has indeed gotten more accessible, but we really need to examine those numbers closely to understand what could be improved, and possibly adjust the pricing as well."

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