Does SGPP/SSPP need democratization?

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Question 1: Do psychiatrists in the professional association SGPP/SSPP lack direct voting rights?

Answer: Unfortunately, that is correct. In 1996, general voting rights and the right to directly elect professional representatives were abolished within the SGPP/SSPP. As a result, key decisions are now made by a small group of delegates and presidents who do not represent the majority of SGPP/SSPP members.

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Question 2: Is it true that the SGPP/SSPP Delegates' Assembly is determined by external associations and groups outside of the SGPP/SSPP?

Answer: Yes. SGPP/SSPP delegates are exclusively appointed by external associations with their own goals and members, many of whom are not psychiatrists or members of the SGPP/SSPP. Some of these associations even have interests that conflict with those of psychiatry (e.g., psychology, social work, non-psychiatric medical specialties).

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Question 3: The SGPP/SSPP claims that the cantonal associations serve as a democratic foundation. Is that incorrect?

Answer: Contrary to what the SGPP/SSPP board claims, the cantonal associations are not sections of the SGPP/SSPP. They collect their own membership fees and pursue their own organizational goals. SGPP/SSPP policy at the federal level is not discussed there, and delegates from these external associations are not accountable to the SGPP/SSPP membership.

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Question 4: What rules govern how these external associations send representatives to the SGPP/SSPP Delegates' Assembly?

Answer: The presidents of the societies, which are strictly separate from the SGPP/SSPP, automatically ("ex officio") become SGPP/SSPP delegates without ever having been elected to this position. Additionally, these external associations send further delegates to the SGPP/SSPP assembly. The internal processes by which these representatives are appointed are inconsistent and often opaque.

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Question 5: Why don't SGPP/SSPP members simply join an external association to elect SGPP/SSPP delegates?

Answer: First, SGPP/SSPP members must be accepted into the external association, which involves paying additional membership fees on top of the CHF 600 SGPP/SSPP fee. However, there are no clear rules on whether or when such a person would be allowed to vote for SGPP/SSPP delegates, making the process highly uncertain.

Question 6: Is there no other way to become an SGPP/SSPP delegate?

Answer: There is a second option: to join one of these external associations and, over the years or decades, rise to the position of president. Presidents of these external associations have exclusive rights within the SGPP/SSPP, as they automatically become "ex officio" SGPP/SSPP delegates.

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Question 6: Is there no other way to become an SGPP/SSPP delegate?

Answer: There is a second option: to join one of these external associations and, over the years or decades, rise to the position of president. Presidents of these external associations have exclusive rights within the SGPP/SSPP, as they automatically become "ex officio" SGPP/SSPP delegates.

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Question 7: Wait—SGPP/SSPP members can't elect their own delegates, but presidents of external associations are automatically SGPP/SSPP delegates?

Answer: Yes. All presidents of external associations automatically become "ex officio" SGPP/SSPP delegates without ever being elected by SGPP/SSPP members, while SGPP/SSPP members themselves have no voting rights.

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Question 8: What are the consequences of this hierarchical structure, typical for the SGPP/SSPP?

Answer: The SGPP/SSPP system reinforces existing power structures within the Swiss Psychiatric Association and entrenches the privileges of a small, closed circle around the SGPP/SSPP board. At the same time, the majority of medical SGPP/SSPP members are excluded from participating in key decisions.

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Question 9: Why is the lack of elections and voting problematic for a professional association?

Answer: The main task of any professional association is to represent the rights and interests of its members without external interference. A professional association that excludes its own members from decision-making and delegates leadership roles to unelected presidents and delegates from external organizations loses its legitimacy and credibility.

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Question 10: Why is it problematic if representatives of other professions participate in the decision-making of a professional association?

Answer: Representatives whose interests are unrelated to the direct professional representation of psychiatrists and medical psychotherapists should not have influence within a psychiatric professional association.

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Question 11: How does the current hierarchy affect transparency within the SGPP/SSPP?

Answer: The absence of elections and the appointment of exclusively external representatives inevitably lead to a lack of transparency. Without democratic oversight, voting options, or accountability to members, it remains unclear whose interests are being represented in decisions.

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Question 12: What impact does the increasingly autocratic structure of the SGPP/SSPP since 1996 have on Swiss psychiatry?

Answer: SGPP/SSPP decisions are made only within small, closed circles of functionaries. These individuals are never directly accountable to the members, as all participatory rights, except for the ballot vote, have been abolished. In the past, SGPP/SSPP officials lobbied in the name of all members for goals that were against the interests of patients and psychiatrists.

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Question 13: Are there examples of lobbying taking precedence over member interests within the SGPP/SSPP?

Answer: For years, the SGPP/SSPP board supported the "Yes to Managed Care" initiative, which sought to abolish the freedom of doctor choice and was driven by lobbyists. In the federal referendum on June 17, 2012, the Swiss electorate decisively rejected this initiative.

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Question 14: Does the SGPP/SSPP structure contradict the values that psychiatrists should uphold?

Answer: Swiss psychiatrists should uphold values such as autonomy, respect, and humanity. The autocratic SGPP/SSPP structure contradicts this basic principle by not allowing its members to elect their representatives. A medical professional association that disregards the participatory rights of its members can hardly credibly advocate for the welfare and rights of its patients.

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-The only remaining SGPP/SSPP participatory right: The ballot vote

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Question 15: What is the last remaining participatory right for members in the SGPP/SSPP?

Answer: The last remaining right for members to participate in SGPP/SSPP decision-making is the ballot vote. Otherwise, SGPP/SSPP members have no opportunity to elect or remove delegates or professional representatives.

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Question 16: How is a ballot vote organized within the SGPP/SSPP?

Answer: According to the SGPP/SSPP statutes, a ballot vote must be requested by at least 200 members. Over the past 18 years, only three ballot votes have been initiated because their planning and implementation required significant effort.
Two ballot votes were conducted, but the latest one, from June 8, 2022, is still being blocked by the board.

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Question 17: What exactly does the ballot vote on democratization of the SGPP/SSPP demand?

Answer: The ballot vote "Democratization of the SGPP/SSPP" demands that all SGPP/SSPP members be granted the right to vote directly on key internal issues and to elect their professional representatives.
Two models are proposed:

1. Holding an annual general assembly (which may also be conducted online/digitally),
   or

2. A system with SGPP/SSPP sections in which delegates are democratically elected by the members—without requiring them to join one or more paid associations.
   The goal is to restore participation rights within the professional association.​

 

The ballot vote: Ongoing blockade and censorship attempt

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Question 18: What is the original text of the ballot vote?

Answer: The text of the vote, as proposed by 349 colleagues, reads:
"BALLOT VOTE REQUEST: SGPP/SSPP DEMOCRATIZATION
Do you want to approve the following proposal? I support the democratization of the SGPP/SSPP and want every member to receive voting and election rights. Every member has one vote: YES or NO.
Tie-breaking question: If the proposal is accepted, the following options A or B are available. Please mark the applicable option:
A: Members exercise their voting rights at an annual general assembly (possibly digital).
B: Members’ interests are represented by delegates. One delegate is elected for every 50 members."

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Question 19: What is the censored version of the ballot question by the board?

Answer: The board has not provided an official French translation. Here is the altered German text by the board:
"BALLOT VOTE SGPP/SSPP: ABOLITION OF THE EXISTING DELEGATE SYSTEM
Questions: Do you want to abolish the existing delegate system of the SGPP/SSPP and replace it with one of the two options? YES or NO
Question 2: If you support the abolition of the current system, which option do you prefer?
A: General assembly (annually, possibly digital).
B: Delegates are elected for every 50 members."

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Question 20: Why can’t the original text of the ballot vote be changed afterward?

Answer: Only the text signed by 349 SGPP/SSPP members reflects the demands of these psychiatrists. The initiators aim for the democratization of the SGPP/SSPP, which goes far beyond merely abolishing the current delegate system.

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Question 21: Is it legally problematic to alter the ballot text afterward?

Answer: Any unilateral change of the text by the board violates the rights of each individual SGPP/SSPP member who signed it and distorts the goal of the initiative, which is democratization. A censored vote could be legally challenged by any of the signatories.

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Question 22: Why was legal action necessary to conduct the ballot vote?

Answer: The ballot vote correctly requested by 349 members in 2022 is being blocked by the SGPP/SSPP board, which is attempting to alter the text afterward. After unsuccessful negotiations with the board, the initiators had to go to court to defend their right to an uncensored vote.

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Question 23: Why does the SGPP/SSPP board object to the ballot text proposed by 349 members?

Answer: The board wants to completely prohibit the term "Democratization of the SGPP/SSPP" from appearing in the ballot text, even though democratization is the central goal of the 349 initiators.

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Question 24: What justification does the SGPP/SSPP board give for blocking the ballot vote?

Answer: The board claims that the wording of the ballot question is suggestive and that SGPP/SSPP psychiatrists may not understand the implications of the vote.

Question 25: What are possible reasons for the board’s blockade of the ballot vote?

Answer: Several SGPP/SSPP officials oppose the democratization vote due to obvious self-interest. In a democratically governed SGPP/SSPP, privileges such as "ex officio" positions would be abolished, and all professional representatives would have to stand for fair and transparent elections by the members.

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Question 26: Is it true that the board is protecting members by censoring the ballot text?

Answer: It is absurd for the SGPP/SSPP board to claim that highly educated specialists need protection from unclear or misleading ballot questions. In reality, the board is trying to preserve the status quo and its own power by censoring the text and blocking the vote.

The high level of organization as a governance issue in the SGPP/SSPP.

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Question 27: What is the central governance issue of the SGPP/SSPP?

Answer: The main problem with SGPP/SSPP governance lies in the lack of democratic processes. SGPP/SSPP members have no voting rights to elect their representatives. Instead, delegates and professional representatives are selected from an exclusive circle of privileged doctors. Specifically, these are exclusively presidents and delegates from external organizations.

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Question 28: What are the consequences of SGPP/SSPP governance?

Answer: SGPP/SSPP governance creates a hermetically sealed power and decision-making system that is almost entirely unaccountable to regular members.

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Question 29: How could the SGPP/SSPP improve its governance and transparency?

Answer: To improve governance and transparency, the SGPP/SSPP could implement the following reforms, which have long been standard practice in other medical associations:

• Introduction of democratic elections: SGPP/SSPP members should be able to elect their representatives to ensure accountability and legitimacy.

• Introduction of performance-based criteria: If appointments are necessary, they should be based on clear, performance-related criteria rather than privileges.

• Publication of decisions and policies: Transparency could be increased through open communication about the rationale behind major decisions and policies.

• Establishment of an independent supervisory body: An independent internal SGPP/SSPP committee should ensure that governance processes remain fair and transparent.                                                                                                                      ​

 

Question 30: SGPP/SSPP President Fulvia Rota claims in her newsletter that the SGPP/SSPP has a “high level of organization.” Why is this questionable?

Answer: If the president is referring to the extent of rules and norms used to formalize and manage SGPP/SSPP operations, she is correct.
However, a high level of organization mainly means a network of connections among other association presidents, while excluding SGPP/SSPP members from meaningful participation.

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Question 31: What is the basis of the SGPP/SSPP’s organizational structure?

Answer: The SGPP/SSPP’s structure is based on central control and exclusivity rather than member participation. This top-down controlled professional association is promoted by SGPP/SSPP leadership as efficient but, in practice, leads to member exclusion, lack of innovation, and stagnation.

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Question 32: Doesn’t the SGPP/SSPP’s high level of organization lead to better representation of the majority of psychiatrists who are not SGPP/SSPP members?

Answer: The SGPP/SSPP claims that its “high level of organization” ensures broader representation of all 4,600 psychiatrists in Switzerland, given that only 2,200 psychiatrists are SGPP/SSPP members.
In reality, however, a high level of organization in this context means that all SGPP/SSPP delegates come from external associations and organizations, while SGPP/SSPP members themselves have no voting rights.

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Question 33: Doesn’t this system engage more psychiatrists?

Answer: The SGPP/SSPP system only formally and superficially appears to involve a larger number of psychiatrists. In practice, all SGPP/SSPP decision-makers come from a small privileged circle, while SGPP/SSPP members are effectively powerless.

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Question 34: Why are only 2,200 of the 4,600 psychiatrists in Switzerland members of the SGPP/SSPP?

Answer: Since the abolition of key membership rights in 1996, the SGPP/SSPP has evolved into a hierarchically organized and opaque professional association.
Without opportunities for member participation, it is evident that the majority of Swiss psychiatrists question the legitimacy of their SGPP/SSPP professional representation.

Costs and implications of the SGPP/SSPP democratization vote,

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Question 35: What are the costs of implementing the proposed reforms?

Answer: In the medium term, the costs of democratizing the SGPP/SSPP would be much lower than those of the current cumbersome and inflated system involving presidents, delegate assemblies, external organizations, and delegates—in short, a large bureaucratic apparatus.
A digital general assembly would not incur significant additional expenses and could lead to medium-term savings.

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Question 36: What are the advantages of democratising the SGPP? 

Answer: Long-term benefits—such as greater transparency, increased member engagement, and stronger legitimacy of the professional association—would far outweigh the one-time adjustment costs.

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Question 37: Would democratization affect the notably low member participation in the SGPP/SSPP?

Answer: The increased engagement of all SGPP/SSPP members as a result of democratization would enhance the association’s visibility and appeal.
A more democratically organized SGPP/SSPP would attract more members, potentially allowing the currently high membership fee of CHF 600 per year to be reduced.

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Question 38: What advantages would a more democratic SGPP/SSPP offer to Swiss psychiatry?

Answer: Democratic structures would encourage the participation of all SGPP/SSPP members, ensure transparency in decision-making processes, and prevent key decisions from being made in the interests of a small elite minority.
A democratized SGPP/SSPP would gain credibility and legitimacy as an official professional association at both the federal and international levels.

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Question 39: Why is it socially important for the SGPP/SSPP to be democratically organized?

Answer: The SGPP/SSPP officially represents all Swiss psychiatrists, including those who are not members of the association.
Psychiatric work has a direct impact on both the health and the rights of patients, for example, in cases of involuntary commitment.
It is essential that decisions made by a professional association of such significant health policy relevance are based on democratic and transparent structures.

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Question 40: What would be the consequences of a court ruling in favor of the initiators or the board?

Answer: If the court rules in favor of the initiators, the board must conduct the vote in its version signed by 349 colleagues within six months.
What happens if the court rules in favor of the board is still unclear.

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Question 41: What happens if the initiative for democratization fails?

Answer: If the initiative for democratization of the SGPP/SSPP fails, the current autocratic and opaque organizational structure of Swiss psychiatry will remain in place.
Professional functionaries, who cannot be elected or removed by SGPP/SSPP members, will continue to control the association.
Without reforms, the SGPP/SSPP will completely lose its legitimacy.

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Question 42: What happens if the ballot vote succeeds?

Answer: After a successful ballot vote, all SGPP/SSPP members will be able to decide whether they prefer a general assembly (which could also be digital) or automatic membership in an SGPP/SSPP section without additional costs.
These sections would democratically and transparently elect delegates.
Both systems ensure member participation, making the SGPP/SSPP more democratic, transparent, and future-proof.

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Ways to support the democratization of the SGPP/SSPP:

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Question 43: How can I support the initiative for democratization of the SGPP/SSPP in non-material ways?

Answer: You can support the initiative to democratize the official professional representation of Swiss psychiatry by informing yourself about it and discussing the necessity of democratizing the Swiss Psychiatric Society with others.

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Question 44: Why does the initiative for democratization of the SGPP/SSPP need donations?

Answer: All initiators advocating for SGPP/SSPP democratization work on a voluntary basis and are not paid for their efforts.
In contrast, the SGPP/SSPP leadership is compensated for blocking the ballot vote, using membership fees to pay themselves by the hour. Their financial resources are virtually unlimited.
To cover essential expenses such as legal consultation, website maintenance, etc., the supporters of democratization urgently need donations.

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Question 45: How can I donate?

- Donations can be paid or transferred to the account CH56 0900 0000 1578 2948 7

- You can also go directly to https://www.psychiatria.ch/spenden 

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- and support us directly by credit- or debitcard or Twint.