Mental health: what do Belgian parties propose?

What do Belgian parties propose on mental health in 2026?

In 2026, the ten main Belgian parties share the same diagnosis — demand for psychological care has surged and provision is struggling to keep up — but disagree on which lever to pull. On one side, the PTB·PVDA, PS, Ecolo, Groen and Vooruit want to expand public provision and the reimbursement of psychological care. On the other, the N-VA, MR, Open VLD, CD&V and Les Engagés want first to target, prevent and control spending, betting on first-line care and the most vulnerable groups.

This dividing line does not mark a "good" and a "bad" manifesto. It sets two answers against the same constraint: rising needs, real waiting times, but an already stretched health budget. The first answer bets on access: more contracted psychologists, more reimbursed sessions, broader free care. The second bets on targeting: prevent early, treat early, reserve the public effort for the situations that need it most. Both camps say they want a population in better mental health; they are not pulling the same lever.

On the figures, the frame has tightened. The first-line psychological care reform brought a session with a contracted psychologist down to about 11 euros, but the health-care growth norm, kept at 2% for 2026 and 2027, limits the room to go further. It is this tension between climbing demand and a constrained budget that shapes the whole debate this year.

How can you read these positions without taking sides?

Each party gets one sign per lever: a green + when it clearly backs the approach, an amber ~ for an intermediate or conditional stance, a red − when it opposes it. This system replaces stars or marks out of 5, which would suggest a moral ranking.

The key point: no column designates a "good" party. A party marked + on expanding reimbursement is often marked ~ on budget control, and vice versa. The two levers answer different priorities — access to care for one, sustainability and prevention for the other — defended by different voters. Reading the table means spotting the lever each party favours, not handing out a prize for virtue.

For example, the PTB·PVDA gets a + on expanding public provision and a − on control through efficiency, which it sees as a threat to access. The N-VA has the opposite profile. Neither is "in the lead": they are not playing on the same field.

Where does psychologist reimbursement stand?

Since the first-line psychological care reform, seeing a psychologist costs far less than before, on one condition: going through a practitioner contracted within a mental health network. An individual session then costs the patient about 11 euros, 4 euros with the increased intervention (the BIM status for low-income households) and 2.50 euros for a group session. Up to and including age 23, it is free.

In practice, this first-line care is directly accessible, without a doctor's prescription. At the first session, the psychologist assesses whether a short course of support is enough or whether the patient should be referred to more specialised care. The number of reimbursed first-line sessions is capped, however, at around ten a year for individual follow-up: beyond that, the patient moves to specialised care, on different terms.

On the timeline, the reform has been in force since 1 January 2022 and was reinforced by a new convention between INAMI and the mental health networks, parts of which took effect on 1 April 2024. It is championed by the federal Health Minister, Frank Vandenbroucke (Vooruit). This is the base on which the parties position themselves: no one proposes scrapping it, but they agree neither on its funding nor on its scale.

What do the parties that want to expand provision and reimbursement propose?

The left-wing parties want to cut what patients pay out of pocket and increase the number of available carers. The PS writes in its manifesto that Belgium must act quickly and strongly on mental health: strengthen provision, better inform people about the available options and improve reimbursement. The PTB·PVDA holds the broadest line, in line with its call for free first-line care. Ecolo and Groen stress accessibility and young people's mental health.

Vooruit holds a particular place: the party runs the federal Health portfolio and claims the psychological care reform as a concrete social gain. What this camp's programme says: psychological support should not depend on your wallet, and today's under-investment costs more tomorrow, in sick leave and heavier care.

The criticism, voiced by the centre-right and some health economists, concerns funding. Expanding reimbursement and contracting more psychologists requires a budget that a 2% growth norm does not easily free up. So the debate is not about the usefulness of psychological care, on which everyone agrees, but about the pace and cost of its expansion.

What do the parties that want to target and control spending propose?

At the other end, several parties argue that targeting well beats spending more. The N-VA, MR and Open VLD emphasise prevention, strengthening first-line care and efficiency: treat early and close to the patient, stop situations from worsening for lack of early support, and make sure every euro is well directed before spending more. The CD&V and Les Engagés share this logic of proximity, while defending the growth norm and first-line care.

On the figures, this camp relies on the idea that an effective mental health system is judged by its results, not by the total amount committed. It favours local anchoring — community health centres, CPAS, schools, general practice — to spot and refer people in difficulty, rather than a uniform expansion of reimbursement. The Arizona agreement partly reflects this approach, betting on mental resilience and on measures targeted at young people and the elderly.

The criticism, voiced by the left and field actors, is that prevention without extra means stays a slogan, and that a budget norm set too tight ends up translating into waiting times or an out-of-pocket cost for patients who go beyond first-line care. Here too, the same word — efficiency — sounds like common sense to some and like a brake to others.

What does the Arizona agreement plan for mental health?

The De Wever government agreement, concluded on 31 January 2025, devotes a chapter to "mental resilience". It announces a plan for the mental health of young people and the elderly, two groups deemed priorities, and plans to embed first-line psychologists within the public welfare centres (CPAS) to bring help closer to people in precarious situations. In principle, these intentions are fairly consensual across parties.

The tension comes from the budget frame. The agreement keeps the health-care growth norm at 2% for 2026 and 2027. Actors such as the Coalition Santé and the health insurers argue that this ceiling, applied to all care, leaves little room to fund a real expansion of mental health provision, and point to a shortfall of several hundred million euros across the sector. The government, for its part, defends a rising budget and a reallocation towards priorities.

To dig deeper, the comparator lets you place two parties side by side on health, the ranking sums up positions theme by theme, and the quiz starts from your priorities rather than a manifesto. The methodology explains how these positions are collected and remains open to challenge.

Young people's mental health: why is it a flashpoint?

Because that is where demand has risen most and where delays are most visible. Free care up to age 23 has removed the financial barrier, but access also depends on the number of contracted psychologists and child-psychiatry places, which remain limited in several regions. For the "children and adolescents" network, group sessions are not capped, while individual first-line support is limited to around ten sessions.

This front crystallises the two approaches. The expansion camp wants more conventions, more sessions and a stronger network in schools and on campuses. The targeting camp stresses early detection, training front-line adults (teachers, GPs) and coordination between services, so that everything does not rest on reimbursing individual sessions alone.

Neither answer settles the matter, because young people's mental health also depends on factors that go beyond care policy: social media, poverty, the school climate, isolation. That is what makes the debate sensitive and hard to settle with a single budget dial.

What this comparison does not settle

This table does not say which approach "works" best: the real effect of expanding reimbursement or of a prevention policy depends on the number of psychologists trained and contracted, the organisation of first-line care, the actual delays on the ground and social determinants that often weigh more than a single measure. Nor does it factor in your own situation — age, income, region, severity of symptoms — which greatly changes the concrete experience of access to care.

So the right reflex is not to pick a winning camp, but to link each position to the lever it pulls, then to weigh this overview against what you expect from a mental health policy.