Quebec health institute calls on province to cover psychotherapy

A Quebec report concludes psychotherapy is as effective as drugs for treating depression and moderate anxiety — and cheaper, with longer lasting results.

• Listen to Michael Sheehan: Speaking out for psychotherapy
• Access to psychotherapy: A patient's perspective

The new report, prepared by Quebec's National Institute for Excellence in Health and Social Science (INESSS), draws on literature and expertise from around the world, including Australia and the United Kingdom, where psychotherapy is already considered frontline care and provided free by the state. 

Psychotherapy 'is not a vaccine...but it's as close as we can get to a vaccine,- Michael Sheehan, retired Quebec judge and mental health advocate

The INESSS research team found that for people with moderate anxiety or depressive disorders, there is no significant difference between psychotherapy and drug therapy when it comes to reducing symptoms.  

However, it concluded, psychotherapy's benefits are longer lasting — even after as few as five or six sessions —providing better protection from relapse.

"That puts to rest the thinking that psychotherapy is the road to never ending treatment," retired Quebec judge Michael Sheehan told CBC Quebec AM host Susan Campbell in an interview. 

Sheehan lost a son to suicide, and he now leads a Quebec coalition aimed at improving access to psychotherapy.

"It's not a vaccine, but...it's as close as we can get to a vaccine," Sheehan said.

"If we did have a vaccine for most common mental illnesses, such as depression and anxiety, don't you think we would be screaming to have access to it, and it would be scandalous if we didn't?"

Mental illness strikes one in five

The INESSS study says one in five people are affected by a mental health disorder in their lifetime, the most common being depression and anxiety disorders such as panic attacks.

However, with just one in three psychotherapists practising in the public sector, by far the majority of those benefiting from talk therapy either have private insurance or the financial means to pay for it themselves.

Quebec's commissioner for health and social welfare recommended in 2012 the government should insure more mental health services and offer more equitable access to psychotherapy. The health ministry mandated INESSS to undertake the assessment of the costs and effectiveness of psychotherapy compared to psychopharmaceuticals at that time.

Languishing on waiting lists

Jason Gilmour's story is far too common. A resident of Danville, in Quebec's Eastern Townships, he has grappled with depression and occasional panic attacks most of his adult life. Yet for a decade, he didn't even have a family doctor, despite being told for years that he was near the top of waiting lists in the region.

"A lot of the stuff I've done has been on my own, searching online, reading a lot of books on the subject," he said. "At a certain point, no matter how hard you're trying on your own, you still need a professional — an objective opinion to try to help you to see some issues that maybe you don't see on your own."

"You just have to hold out hope that one day these things are going to change."