Recommendation pushes for web-based psychotherapy
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.”