Psychotherapy in Canada: the question is not whether we can afford to make it more accessible, but whether we can afford not to.

The World Health Organization estimates that depression is the leading cause of disability and that it contributes greatly to the global burden of disease. It is also estimated that in Canada, approximately 20% of the population will be affected by a mental disorder, including depression. Such disorders are associated with a marked deterioration in the functioning of individuals, with poorer quality of life and death by suicide, in addition to representing considerable costs both in direct costs for care and in indirect costs related for example to a drop in productivity. Again in Canada, it is estimated that the costs associated with mental health problems amounted to $ 52 Billion in 2006. That's a lot. Can we therefore imagine that we could recuperate the costs of making psychotherapy accessible to all, free of cost or at low cost, which of course means paying more professionals to offer this service?

As a result of our work with Quebec’s National Institute of Health and Social Services (INESSS) following a request from the Minister of Health, we have already established, via a systematic review, that the costs of psychotherapy for treating anxiety and mood disorders is equivalent to that of medication in the short term (and lower when the therapy is given in a group format), and significantly lower than pharmacotherapy in the long run. It's a good start, but can we be more specific?

This is the question that my colleagues H. Vasiliadis, A. Lesage, E. Latimer and myself recently decided to look into. In a socio-economic modeling study that will be released soon, we calculated the consequences –including the financial implications- of depression and its treatment over a 40 year period. Unsurprisingly (others have previously found similar results), out model showed that better access to psychotherapy led to a significant decrease in suffering and to increased health-related quality of life. That in itself should suffice to make the case for greater access to psychotherapy. But let’s imagine for a moment that it is not enough, and that it all comes down to money. Can we expect a return on our investment?

Simply put: yes. IN CANADA, FOR EVERY DOLLAR ($ 1) INVESTED IN PROMOTING GREATER ACCESS TO, AND IN OFFERING PYCHOTHERAPY, OUR MODEL INDICATED THAT THERE WOULD BE ON AVERAGE A $2 SAVING FOR SOCIETY.

Not bad. Obviously, the question is no longer whether we can afford to provide psychotherapy in Canada, but whether we can afford not to.

Dr. Martin Drapeau, Clinical Psychologist
Professor at McGill University

Martin Drapeau is a professor of counselling psychology and psychiatry at McGill University and a clinical psychologist at Medipsy Psychological Services. The opinions expressed here are those of the author only and not necessarily those of Medipsy Psychological Services. Medipsy is  a private psychology clinic located in Westmount, Quebec.