Provincially and territorially funded psychotherapy

October 5, 2017

For the most part, the services of psychologists, social workers, and psychotherapists are not covered by Medicare. Provincial and territorial health plans pay for some mental health professionals. These include psychiatrists and the services of therapists in a hospital setting (for example, a social worker at an outpatient clinic).

People who want to access therapy generally without paying have to see family doctors – who may or may not be properly trained in mental illness – wait a long time to see someone in the public system, or make an appointment privately with a counsellor. That is, if they can afford it: The cost of a counsellor can easily run from $80-$250 per hour.

Other countries, like Britain, Germany, and Australia offer some form of public coverage for psychotherapy. In Quebec, the Coalition for Access to Psychotherapy, which includes doctors, advocates and researchers, has been calling for a public insurance plan that would cover the costs of therapy.

A 2015 article in the Globe and Mail made the case for publicly funded therapy, stating “Research has found that psychotherapy is as effective as medication—and in some cases works better. It also often does a better job of preventing or forestalling relapse, reducing doctor’s appointments and emergency-room visits, and making it more cost-effective in the long run.”

We also know that a good relationship between health care clients and practitioners plays an important role in recovery from mental illness. According to the Centre for Addiction and Mental Health (CAMH), that relationship accounts for 30 percent of the process. A CAMH document says that “the warmth, empathy, caring and non-judgmental attitude that the counsellor brings to the relationship with a client” is critical.

We can lobby to expand health benefits for workers so that they cover psychotherapy. However, most health plans cover only a very limited number of sessions or have limited fee coverage. Even expanded benefits are unlikely to dramatically increase that. To ensure true access, we need to lobby for access to therapy for all.

Mental health and mental illness are complicated. Drugs can have a role to play, and so can therapy. Canadians spend about a billion dollars a year on private psychologists, with nearly a third of that being paid for out of pocket. Therapy is an important treatment for improving and maintaining good mental health, and it should not be available only to those with generous health plans or those who can afford to pay for it.