Again the Quebec magazine L’actualitê has an interesting feature article in its April edition dealing with COVID-19 and translated it means what are the steps we can take to ensure we don’t have a year like 2020?
The sixth step to increase access to mental health services.
President of the Quebec Order of Psychologists Christiane Grou offered the following comments.
She said that health care measures increased the amount of distress and anxiety. They have also increased family tension. Problems in the mental health system were building prior to the pandemic where mental issues were the main cause of illness and absenteeism and represented 30-40 % of consultations with family physicians. The mental health system is the poor parent of then general health system where Quebec has allotted 6% of its health budget to mental health compared with 13% in the United Kingdom.
Quebec has the most psychologists in Canada and the greatest per capita representation in North America. There are also 1,000 psychiatrists and 1,800 psychotherapists. In the public system there is a serious problem with waiting lists with waits of 6-24 months if not greater. The problem is that the public system is losing psychologists to the private sector where conditions are better. There remains 2,400 psychologists in the public system and 1,200 in the educational system. This should be corrected as the public system has to deal with more complicated cases which require more resources.
One problem to enter the public mental health system one needs a referral from a physician which bloats the medical system and diminishes access. A simple solution is to open access to public psychologists directly to the public. If you visit community health centres with a prescription for psychotherapy they can only offer group therapy. This is not bad on its own but is not workable if you require some serious needs for psychotherapy. Some community health centres have neither psychotherapists or psychologists.
The Government has decided to purchase mental health services from the public sector. That is an excellent initiative but we need a more durable solution.
Grou is nervous about the offering of on-line mental health services but proposing that alternative to those that require psychotherapy is a bad practice.
In mental health one does not treat troubles but treats persons that are in trouble.