The provincial election has come and gone, and now the new government must roll up their sleeves and get to work improving a number of critical issues dear to the hearts of British Columbians. Top of mind for many: healthcare, healthcare, healthcare.
The BC Family Doctors recently released a report that summarized what doctors told them would improve healthcare in the province. Creating team-based primary care was a central theme – and should be a top priority for the new government.
Part of their call to action is also a recommendation for the government to fund and support the integration of doctoral-level trained clinical psychologists into primary care clinics. This would be an essential step forward.
Primary care should include mental and behavioural health treatment. Mental and behavioural healthcare should not just be a luxury for those who can afford it, but part of our foundational primary care system.
The estimated cost associated with untreated anxiety and depression in Canada sits at $130 billion. The true cost of failing to address mental and behavioural health in Canada is likely to be far greater. This number does not include the broader burden of other mental illnesses or behavioural health conditions, including the health and economic costs associated with chronic diseases such as obesity, diabetes and cardiovascular disease.
Access to mental and behavioural health treatment for the majority of people living in B.C. and across Canada currently consists of an emergency crisis line, online “resources” or access to care provided by mental health clinicians.
These clinicians – no matter how good some of them may be – remain largely unregulated, exempt from regulation or without the advanced skills and competencies to complete diagnostic assessments or provide evidence-based treatment for people’s mental or behavioural health.
The result: wide variability in clinician skill and expertise, and people’s personal suffering that is no longer contained within individual homes but spilling out into our streets and communities.
Such suffering creates a cycle of escalating demand on primary care and emergency room services, while the people most in need continue to face delays in accessing appropriate care, placing them at the greatest risk of harm to themselves or others.
This is not normal or standard practice across the globe.
In other countries such as the U.S., the UK, Norway, Sweden, Australia and New Zealand, different models already publicly fund psychological treatment, seen as a necessary part of primary care. While these systems vary in how care is funded and delivered, they provide mechanisms for patients to access evidence-based mental and behavioural health treatment as part of healthcare.
The main difference between their system and ours?
Psychologists are covered providers in the public systems. There are over 17,000 psychologists across Canada, yet fewer than 15 per cent of them are in the public health system.
Internationally, the countries that make mental health universally accessible are seeing lower rates of the chronic physical diseases that mental distress feeds: diabetes, heart disease and obesity. Decades of data across the world have shown that when patients have timely access to effective mental and behavioural health services, outcomes improve.
There’s some recent good news: the federal Health Minister recently announced a one-year extension of funding for mental health, addictions and home care.
So, what do we need in B.C.? A primary care strategy that includes mental and behavioural health treatment as a core component.
Properly delivered publicly funded psychological care – assessment, diagnosis and treatment, all measured for effectiveness – can return $4 for every $1 invested. Effective treatment up front means fewer repeat visits, fewer crises and lower downstream costs in emergency rooms and hospital beds.
Primary care that includes effective mental and behavioural treatment should be a top priority for our new government.
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