Rec­om­men­da­tion pushes for web-based psy­chother­apy

Tillsonburg News - - SPORTS - JEN­NIFER BIEMAN

Gov­ern­ment-funded ther­apy that’s just a click away?

The prov­ince’s health-care watch­dog thinks it’s a great idea.

Health Qual­ity On­tario has re­leased a draft rec­om­men­da­tion urg­ing the prov­ince to con­sider of­fer­ing pub­licly funded cog­ni­tive be­havioural ther­apy to On­tar­i­ans over the in­ter­net.

The web-based cog­ni­tive be­havioural ther­apy — a com­mon type of psy­chother­apy — would be geared to­wards On­tar­i­ans strug­gling with mild to mod­er­ate clin­i­cal de­pres­sion or anx­i­ety dis­or­ders.

“We’ve known for awhile that peo­ple with de­pres­sion or anx­i­ety can ben­e­fit from psy­chother­apy,” said Dr. Ir­fan Dhalla, vi­cepres­i­dent of ev­i­dence de­vel­op­ment and stan­dards at Health Qual­ity On­tario. “(It can) help them re­frame the way they think some­times and re­think­ing the way they think can change feel­ings and ac­tions.”

Health Qual­ity On­tario — the prov­ince’s health-care ad­viser tasked with mea­sur­ing and col­lect­ing sys­tem sta­tis­tics — is seek­ing pub­lic in­put on the draft rec­om­men­da­tion un­til Nov. 6.

Once the agency com­piles pub­lic in­put on its draft rec­om­men­da­tion, the fi­nal doc­u­ment will need to get ap­proval from the Health Qual­ity On­tario board of di­rec­tors. If all goes as planned, the fi­nal rec­om­men­da­tion will be sub­mit­ted to the Min­is­ter of Health and Long-term Care in early 2019, Dhalla said.

The on­line men­tal health pro­gram would be based around a se­ries of struc­tured ses­sions. A health-care pro­fes­sional could guide peo­ple through the on­line pro­gram, or in­di­vid­u­als could work through the se­ries on their own.

While web-based cog­ni­tive be­havioural ther­apy won’t be right for ev­ery per­son, Dhalla said there’s ev­i­dence that it’s ef­fec­tive — and cost-ef­fec­tive too.

Though the ex­act for­mat of the on­line ther­apy is up for de­bate, Health Qual­ity On­tario found that for pa­tients, the cy­ber in­ter­ven­tion was bet­ter at im­prov­ing symp­toms of mild to mod­er­ate de­pres­sion and anx­i­ety dis­or­ders than lan­guish­ing on a wait­ing list for other ther­a­pies.

There are fre­quently bar­ri­ers for pa­tients who want to ac­cess face-to-face ther­apy, Dhalla said. Pa­tients with­out work­place ben­e­fits or pri­vate in­sur­ance of­ten pay out of pocket for the help psy­chol­o­gists or so­cial work­ers can pro­vide.

“In On­tario, these kinds of treat­ments can be very dif­fi­cult for peo­ple to ac­cess, par­tic­u­larly peo­ple who can’t af­ford to pay for these treat­ments pri­vately,” Dhalla said.

The Health Qual­ity On­tario draft rec­om­men­da­tion es­ti­mates pub­licly funded in­ter­net-de­liv­ered cog­ni­tive be­havioural ther­apy would cost be­tween $10 mil­lion and $40 mil­lion for treat­ing adults with mild to mod­er­ate de­pres­sion and be­tween $16 mil­lion and $40 mil­lion to treat adults with anx­i­ety dis­or­ders. The es­ti­mates fac­tor in a three per cent an­nual in­crease in us­age each year.

Web- and phone-based cog­ni­tive be­havioural ther­apy is al­ready of­fered by the On­tario di­vi­sion of the Cana­dian Men­tal Health As­so­ci­a­tion (CMHA). Pri­mary care doc­tors can re­fer pa­tients with mild to mod­er­ate de­pres­sion and anx­i­ety to its on­line and tele­phone BounceBack pro­gram, which was launched in the spring.

“It’s a fan­tas­tic model that is based in health eq­uity. It’s avail­able in mul­ti­ple lan­guages and is re­ally driven by the con­sumer,” said CMHA On­tario chief ex­ec­u­tive Camille Quen­neville. “The con­sumer can go on­line and book when they wish to have their tele­phone ap­point­ments. It is across the prov­ince and it’s free of charge. It’s avail­able to any­one 15 years old and older.”

The pro­gram has been op­er­at­ing suc­cess­fully in Bri­tish Columbia for nine years, Quen­neville said. Clients re­ferred to the pro­gram are given tele­phone coach­ing ses­sions and have ac­cess to on­line videos and work­books be­tween phone ap­point­ments.

“We’re very proud of it,” Quen­neville said, adding the Health Qual­ity On­tario draft rec­om­men­da­tion is pos­i­tive news.

“I’m in favour of peo­ple not hav­ing to wait for ser­vice. I’m in favour of peo­ple be­ing able to ac­cess to ser­vice and I’m most in favour of peo­ple get­ting the help they need when they need it.”

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