May 10, 2016 – It is a fallacy to think that only those who have existential issues seek psychotherapy services. In fact, people who consult psychologists do so because of serious mental health problems that have an important impact not only in their personal lives, but also in their work lives.
The Coalition for Access to Psychotherapy (CAP) has been created to work towards the implementation of recommendations made by the Health and Welfare Commissioner of Quebec in his report, published in December 2012. The report includes an assessment of Quebec's mental healthcare services and provides recommendations and actions to improve social and health services in the mental health sector.
Additional Material
CAP seeks to inform the public on issues surrounding access to psychotherapy services. The following resources have been compiled by CAP members to increase awareness surrounding the practice of psychotherapy and to demonstrate its effectiveness in the treatment of mental illness.
Conferences
Improving access to psychotherapy services in Québec and in Canada: thoughts and experiences of Francophone countries
Montréal, Québec—October 29, 2014.
Organised by Helen-Maria Vasiliadis, Alain Lesage, Martin Drapeau and Anne Dezetter
Psychologists, family physicians, psychiatrists and lay people from Québec, other provinces in Canada, France, Belgium, and Switzerland shared their recent findings on different questions relating to psychotherapy services.
Among the subjects that were discussed were: the study being carried out by INESSS in Québec on access to psychotherapy services, the cost-benefits of increased access, introducing psychotherapy services in family medicine clinics, psychologists' views on implementing more psychotherapy services and on how such services could be organized. A panel of CAP members and representatives from other provinces in Canada, France and Switzerland discussed ways in which governments could make psychotherapy services more accessible to the population.
CAP in the News
Press Release: Pilot phase for the new programme on psychotherapy services in mental health
May 7, 2018 - The Québec Minister of Health and Social Services announced the launch of the pilot phase for access to psychotherapy services. The first phase will be implemented in the health services network Alphonse-Desjardins in the Chaudière-Appalaches region and will be aimed at children and adolescents with depressive disorders. The pilot phase will be conducted from June to October 2018.
Click on the link to the press release (French only): http://www.msss.gouv.qc.ca/ministere/salle-de-presse/communique-1594/
Public Programme for Access to Psychotherapy Services
December 3, 2017 – The Québec Ministry of Health and Social Services announced today the creation of a public programme for psychotherapy services for the Québec population. The programme, when fully implemented, will enable more than 240,000 people suffering from mental health problems or psychological distress, to access such services. The cost will be covered by the provincial medical insurance programme.
See the Ministry’s press release and CAP’s response (in French):
Creation of a Public Programme for Psychotherapy Services;
Le Gouvernement du Québec annonce la création d’un programme public de psychothérapie
November 5, 2017 – Sun Life Financial increased the annual amount of insurance coverage for psychological services from $ 1,200 to $ 12, 500 per family for its employees. Sun Life Financial considers that the amount represents an investment in employees’ health and well-being and in helping reducing absenteeism, and not an additional expense for the company.
Click to read the article (in French): 12 500 $ pour voir un psy - Gilbert Leduc (Le Soleil)
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Access to psychotherapy
December 27, 2016 - Chatelaine Magazine published an article advocating for publicly-funded psychotherapy services in order to increase access for the population. Leaders in the mental health care community explain the need and the reasons why this is important. Related articles presenting the experience of people living with mental health problems are also published.
You probably need therapy. Soon, you might event be able to afford it. - Sarah Boesveld (Chatelaine)
Better access to psychotherapy services for all
April 2015 - Following CAP's brief to the Minister of Health and Social Services in March 2015, several articles were published in Québec newspapers on the need for better access to psychotherapy services. Articles available only in French.
Plaidoyer pour le remboursement des traitements en psychothérapie - Ariane Lacoursière (La Presse)
Traitements de psychothérapie - Plaidoyer pour le remboursement - Ariane Lacoursière (La Voix de l’Est)
Psychothérapie hors de prix - Pierre Pelchat (Le Soleil)
Related article: Traitement plus rentable à long terme
Santé mentale : une pilule ne suffit pas - Brigitte Breton (Le Soleil)
L’accès simplifié à la psychothérapie pour vaincre les troubles de santé mentale – Pierre-Luc Trudel (Avantages)
Hundreds of thousands of lives disrupted every year by mental disorders
April 9, 2015—The Coalition for Access to Psychotherapy (CAP) believes that the Government of Québec should implement a publicly insured program that would provide psychotherapy services to those who need them.
Liberals Propose Practical Solutions To Mental Health Crisis: Bokhari
Manitoba Psychological Society endorses Liberal plan to address mental health issues
Nov 19, 2014—Winnipeg, Manitoba – Unveiling the first plank in the Liberal platform for a Healthier Manitoba, Liberal Leader Rana Bokhari noted, “We all know someone who experiences mental health issues on a daily basis. Whether it is a parent, a child, a sibling or a friend – mental health issues affect us all.”
Jim Hughes Presents Case for Equitable Funding
Apr-2014—Graham Boeckh Foundation President, Jim Hughes, outlines the case for public funding of psychotherapy in Quebec in his interview with Tommy Schnurmacher on CJAD 800 AM.
The Case for Quebec Public Funding for Psychotherapy
Feb-2014—Suburban News op-ed by CAP spokespersons, David Levine and Michael Sheehan.
La psychothérapie : est-ce efficace ?
Nov-2011—Psychologist and CAP member, Martin Drapeau, is interviewed on Une pilule, une petite granule.
Research & Reports
Equitable access to the psychotherapy services in Quebec
January 2018 – INESSS published an update on its findings concerning access to psychotherapy services with respect to effectiveness of interventions, organization of services and costs of providing services. Comparisons are made with Australia and England where increased access to services was instituted more than a decade ago.
Click on the link to read the publication (French only): http://www.inesss.qc.ca/nc/publications/publications/publication/acces-equitable-aux-services-de-psychotherapie-au-quebec.html
Cost-benefit analysis of increased access to psychotherapy services
October 2013 - A cost-benefit analysis conducted by Anne Dezetter et al in 2012 of increased access to psychotherapy services in France concludes that publicly-funded services have a positive impact in terms of quality of life, health and absenteeism and are a cost-efficient investment in the short and long-term for the government, garnering savings overall for society.
Similar studies are being conducted in Canada; the reports will be posted on the CAP website when they become available
Costs and Benefits of Improving Access to Psychotherapies for Common Mental Disorders, by Anne Dezetter, Xavier Briffault, Christian Ben Lakhdar, Viviane Kovess-Masfety, J Ment Health Policy Econ 16, 161-177 (2013)
Sante mentale au Quebec, Volume XL, numéro 4, hiver 2015.
The Québec Health and Welfare Commissioner published its assessment of the basket of insured services.
October 6, 2016 – The report reflects the views and suggestions that were gathered from citizens and different groups interested in healthcare services. The report addresses the question of access to psychotherapy services and reflects the elements presented by the Coalition for Access to Psychotherapy in the brief that it presented to the Commissioner. Three reports are available at www.csbe.gouv.q.ca: the summary, the full report and the report presented in plain French. All reports are available only in French.
The full report is presented here. Entendre la voix citoyenne pour améliorer l’offre de soins et services. Un état des lieux: Rapport d’appréciation thématique de la performance du système de santé et de services sociaux 2016.
Psychotherapy is not a luxury and should be available to all.
Improving access to psychotherapy : strategies from different countries
In October 2014, clinician-researchers affiliated with the Coalition for Access to Psychotherapy held a conference in Montréal on access to psychotherapy in different countries.
Including psychotherapy in the basket of insured services
January 28, 2016 – In the Fall of 2015, Québec’s Health and Welfare Commissioner (QHWC) announced that it would conduct public consultations on the basket of insured health services and social services.
Better access to mental health services
September 28, 2015 – The Union nationale des mutualités libres in Belgium published its latest study entitled « Impact de la dépression sur les coûts de soins de santé et en indemnités ». The study examines the costs associated with depression to the health care system as well as the impact that depression has on workplace absence. Better access to psychotherapy is presented as one of the recommendations.
October 8, 2015 – In relation to the report published by the Union national des mutualités libres, the Belgian newspaper « Le soir » summarizes the results, conclusions and recommendations of the report in an article published on line.
October 9, 2015 – The Québec Ministry of Health and Social Services published its 2015-2020 Action Plan on Mental Health. Reference to the study being carried out by INESSS on access to psychotherapy is mentioned in the introduction to chapter 6 of the Plan.
The report, article and action plan are available only in French.
Report
Impact de la dépression sur les coûts de soins de santé et en indemnités, 28 septembre 2015
Article
Un dépressif sur quatre reste 3 ans sans travailler (Frédéric Soumois, Le Soir. Published on line on Thursday, October 8, 2015)
Québec Action Plan on Mental Health
Faire ensemble et autrement. Plan d’action en santé mentale 2015-2020, Québec
Suicide prevention in youth
October 1, 2015 – The Québec Association for Suicide Prevention (QASP) presented its position paper to the provincial government's Secretariat à la jeunesse as part of public consultations on revisions to the Québec Policy on Youth. In its document, the QASP draws from CAP's position paper to recommend access to psychotherapy as one of the measures that would help prevent suicides among youth who suffer from depression, anxiety or other psychological distress.
Renouvellement de la Politique québécoise de la jeunesse (The report is available only in French)
Access to psychotherapy
June 23, 2015 – The Institut national d’excellence en santé et en services sociaux (INESSS) published two of its much-awaited reports on equitable access to psychotherapy. The first report presents data and information on the effectiveness of psychotherapy in treating common mental disorders. The second report describes the various programs that have been implemented in other countries to increase access to psychotherapy and their costs. The appendices detail the methodology that was used for each aspect as well as some comparative information.
The report is available only in French; a summary is provided in English.
Avis sur l’accès équitable aux services de psychothérapie
Volet I – Examen des données probantes sur l’efficacité et le coût de la psychothérapie comparativement à ceux de la pharmacothérapie dans le traitement des adultes atteints de troubles anxieux et dépressifs
Avis sur l’accès équitable aux services de psychothérapie
Volet II – Analyse des modalités et des conditions d’accès aux services de psychothérapie pour le traitement des adultes atteints de troubles dépressifs et anxieux
Mental health of Québecers and access to treatment
May 6, 2015 – The Institut de la statistique du Québec published its most recent report on the mental health of Québecers. The report draws from studies that have been carried out in recent years and presents, among other information, the services that are used by the Québec population in seeking treatment.
The report is available only in French
Better Access To Psychotherapy Services Through Insured Services
April 2015—The brief that CAP has submitted to the Minister of Health and Social Services argues in favour of such a program given that it would benefit not only individuals but also society as a whole.
The CPA Presidential Task Force on Evidence-Based Practice of Psychological Treatments
Aug 2014—In 2011, the Board of Directors of the Canadian Psychological Association (CPA) launched the Task Force on Evidence-Based Practice of Psychological Treatments to support and guide practice as well as to inform stakeholders. This article describes the work of this task force, outlining its raison d’être, providing a comprehensive definition of evidence-based practice (EBP), and advancing a hierarchy of evidence that is respectful of diverse research methodologies.
The primary objective was to present an overarching methodology or approach to thinking about EBP so that psychologists can provide and implement the best possible psychological treatments. To this end, our intention for this document was to provide a set of guidelines and standards that will foster interest, encourage development, and promote effectiveness in EBP.
Improved access to psychotherapy services: It's time for action!
May-2014—Rita Cavaliere explains the emergence of CAP given the need for greater access to psychotherapy.
Perceived need for mental health care in Canada: Results from the 2012 Canadian Community Health Survey–Mental Health
Sept-2013—Research article by Adam Sunderland and Leanne C. Findlay for Statistics Canada. This article describes the prevalence of perceived mental health care (MHC) needs for information, medication, counselling and other services.
La consultation pour des services sociaux: regard sur l'expérience vécue par les Québécois
Apr-2013—Rapport par l'Institut de la statistique du Québec.
An Imperative for Change: Access to Psychological Services for Canada
Mar-2013—A report to the Canadian Psychological Association by Health Intelligence Inc.
Improving Access to Psychotherapy Delivered Through Primary Care: The Australian Experience
Mar-2013—A presentation by Jane Perkis, Melbourne School of Population Health, University of Melbourne.
Improving Access to Psychological Therapy: Initial Evaluation of Two UK Demonstration Sites
Nov-2009—The evaluation of UK access based on the government's implementation of "Improving Access to Psychological Therapies" (IAPT) initiative.
Integrating Psychologists into the Canadian Health Care System: The Example of Australia
Mar-2009—An assessment of Canada's need for the integration of psychologists into the publicly-funded health care system, drawing from Australia's recent initiatives.
Additional Resources
L’exercice de la psychothérapie et des interventions qui s’y apparentent
May 2018 - Resulting from a collaborative effort by several professional orders of Quebec, the document "L’exercice de la psychothérapie et des interventions qui s’y apparentent" has just been published. This document clarifies the practice of psychotherapy and illustrates the difference between psychotherapy and other interventions carried out by clinicians working in mental health services and human relations. The document promotes better collaboration among professionals from different disciplines and helps the reader understand the specific role of each professional in the provision of mental health services.
Click on the link to obtain the document. (French only): ordrepsy.qc.ca/psychotherapieautresinterventions
Support for Universal Access to Psychotherapy
April 2017 – The Forum de la relève étudiante pour la santé au Québec (FRESQue), a group of 30 university associations representing students in the healthcare professions, held its 2017 Summit Meeting on the theme of improving public access to mental healthcare services. During the meeting, FRESQue adopted 17 of the 60 recommendations that it had taken under consideration and presented them to the Minister of Health and Social Services, Gaétan Barrette. Two of the three principal recommendations advocate for universal coverage of psychotherapy services (thereby making them reimbursable through medicare) and a revision of services offered under the public sector, including in increase in the number of psychologists and a revision of the provincial Mental Health Action Plan.
For more information on FRESQue, see https://www.lefresque.com/
SOMMET DU FRESQue. Entrevue Fresque- Michel Dongois, Profession santé, Avril 2017, page 11
EDITORIAL: Argument for a federal transition fund for increased mental health services in the community
January 2017 – In the editorial appearing in The Canadian Journal of Psychiatry/ La Revue Canadienne de Psychiatrie (Vol. 62(1), pages 4-7), the authors argue for the allocation, by the Federal Government as part of its healthcare transfer payments to the provinces, of a transition fund for mental health services in the community such as psychotherapy, assertive community treatment teams or intensive case management teams. Increased access to these services, which are proven to be cost-effective, evidenced-based interventions, should be part of an integrated approach to the provision of quality, patient outcomes-based services in mental health.
Authors: Alain Lesage, MD, Roger Bland, MD, Ian Musgrave, MD, Egon Jonsson, PhD, Mike Kirby, PhD, LLD (Hon), and Helen-Maria Vasiliadis, PhD
The Canadian Journal of Psychiatry / La Revue Canadienne de Psyciatrie, 2017, Vol. 62(1)4-7
Access to psychotherapy
December 27, 2016 – Chatelaine Magazine published an article advocating for publicly-funded psychotherapy services in order to increase access for the population. Leaders in the mental health care community explain the need and the reasons why this is important. Related articles presenting the experience of people living with mental health problems are also published.
You probably need therapy. Soon, you might be able to afford it (Sarah Boesveld, published in Chatelaine magazine)
- With the stigma around mental illness finally crumbling, advocates have a new goal: a publicly funded path to the couch.
Investment in mental health therapy matters
October 13, 2016 – Roberto-Lewis Fernandez, professor at the Columbia University Department of Psychiatry and the New York State Psychiatric Institute, reminds us that funding in mental health research focuses primarily on basic research – research for tomorrow’s solutions - and less on research on treatments and services that could help people today. Dr. Fernandez invites the new director of the National Institute of Mental Health to seek a balance in mental health research activities so that effective treatments, such as therapy for depression, are made available today to people who live with mental health problems.
In mental health research, NIH needs to focus less on tomorrow and more on today (Roberto-Lewis Fernandez, published in The Washington Post).
October 6, 2016 – The Globe and Mail examines the importance of Starbucks’ decision to increase insurance coverage for psychotherapy for its employees from $ 400 a year to $ 5000 a year. By doing so, Starbucks is not only helping to decrease costs related to absenteeism and disability claims, but also to correct an inequity in access to mental health services for young people who need treatment at a time when it would help them most.
Why Starbucks Canada's investment in mental health therapy matters (Erin Anderssen, The Globe and Mail)
September 28, 2016 – In a blog published by The Huffington Post, Doris Provencher, Executive Director of AGIDD-SMQ argues for free access to psychotherapy services for youth as a proven alternative to prescription medication.
Santé mentale des ados: au-delà de la pilule, la psychothérapie - article available in French (Doris Provencher, The Huffington Post).
September 11, 2016 – Gilles Simard, who has benefited from psychotherapy, advocates for universal and free access to psychotherapy services.
Osons la psychothérapie gratuite! - article in French (Gilles Simard, journalist and peer-helper, published in French in Le Soleil, pages 28-29, September 11, 2016)
September 9, 2016 – In an article published in Notre santé, Jérôme Gaudreault, Executive Director of the Association québécoise pour la prevention du suicide and member of the Coalition for Access to Psychotherapy, outlines different measures that can help prevent suicides. Timely access to psychotherapy is one of these measures.
Moderniser la prévention du suicide - article in French (Jérôme Gaudreault, Notre santé – Le portail de la santé au Québec)
June 17, 2016 – Véronique Hivon, member of Québec’s National Assembly, speaks out in favour of including psychotherapy in the basket of insured healthcare services.
Hivon veut une « révolution » en santé - article in French (Jean-Marc Salvet, Le Soleil, published June 17, 2016, pages 6-7)
May 10, 2016 – La Presse published an opinion piece written by Charles-Albert Morin and co-signed by the spokesmen for the Coalition for Access to Psychotherapy (CAP) and Christine Grou, the President of the Ordre des psychologues du Québec, also a member of CAP. In this publication, Charles-Albert Morin emphasizes that rendering psychotherapy more accessible - that is, including it in the basket of insured services - would help decrease the direct and indirect costs of mental health services.
La psychothérapie n'est pas un luxe - article in French
Better access to mental health services
September 21, 2015 – Le Soleil published an article by Brigitte Breton on the Ministry of Health and Social Services’ upcoming Mental Health Action Plan. Ms. Breton expresses hope that this plan will address much-needed mental health services for children and youth, including access to psychotherapy, as has been noted by the Quebec Ombudsman (Protecteur du citoyen) and the Québec Health and Welfare Commissioner.
The article is available only in French.
Access to psychotherapy and a better mental health care system
May 23-28, 2015 – The Globe and Mail has published a series of articles, both print and on-line, on improving access to mental health care services, including psychotherapy. The opening article addresses the need for publicly funded therapy and generated an initial response from the federal Liberal and NDP parties.
The Globe and Mail also published a commentary from the Coalition for Access to Psychotherapy.
Articles
Open Minds: Better Mental Health Care : The case for publicly funded therapy
(E. Anderssen, The Globe and Mail, May 23, 2015)
Opposition parties urge co-operation with provinces on mental-health services
(K. Mackrael, The Globe and Mail, May 24, 2015)
Commentary
Rather than argue that government cannot afford to provide psychotherapy services, we should argue that it can’t afford not to
(D. Levine and M. Sheehan, published on-line in The Globe and Mail, May 25, 2015)
Reducing the stigma associated with mental illness and improving access to treatment
April 25, 2015 – The Economist’s article talks about the stigma that people with mental illness must face as well as the services that some countries have put in place to better provide treatment and to improve the public’s perception of mental illness.
Better Treatment for Depression (letter to the Editor of CMAJ)
April 7, 2015 - Dr. Alain Lesage, a CAP member, argues in favour of increased access to psychotherapy as an effective treatment for depression in response to an editorial in the Canadian Medical Association Journal (CMAJ)
Qualaxia Blog
Qualaxia is a network of researchers, experts, decision-makers, managers and clinicians. The network's goal is making documents believed to be particularly important on the subject of public mental health easily accessible. Use the blog to give your opinion, ask questions, describe your experiences or recommend documents or tools of interest geared towards decision-makers, managers and clinicians.
- La psychothérapie, c’est pour les bien-portants anxieux! – Avec les propos de Dr Martin Drapeau, psychologue
- La psychothérapie, c’est pour les bien-portants anxieux! : 1re partie
- La psychothérapie, c’est pour les bien-portants anxieux! : 2e partie
- Les conditions de pratique en psychotherapie: La situation actuelle et la remuneration demandee