Original Title: État des connaissances: accès équitable aux services de psychothérapie au Québec

Authors' objectives: The magnitude of mental health problems and mental disorders in society incite the health authorities in many countries to address the issue of accessibility of psychological care and services. In fact, it is considered that more than one in five people will have to deal with a mental disorder during his lifetime. Anxiety disorders and depressive disorders, being the most common, account for nearly two-thirds of all mental disorders. Less than half of those with common mental problems or disorders affected will seek professional help. The fear of stigma and the presence of factors that restrict access to psychological interventions in the public network are among the obstacles observed. In order to address the concerns raised by this reality, the MSSS (Ministry of Health and Social Services) have mandated the National Institute of Excellence in Health and Social Services (INESSS) to inquire into the organizational and economic issues related to the improvement of access to psychotherapy services for the Quebec population .

Authors' results and conclusions: RESULT: In Quebec, in addition to the legal distinction between psychotherapy and related practices, there are two broad categories of psychological intervention mentioned in the literature, namely: low-intensity interventions and high-intensity interventions. The low-intensity interventions, generally based on cognitive-behavioral theoretical models, are provided by professionals who do not necessarily have specific professional training in mental health. Guided self-help, psychological education, healthy lifestyle habits training, problem solving and structured physical activity programs fall into this category. High-intensity interventions, for their part, involve weekly sessions in the presence of a properly trained professional according to the standards established in each jurisdiction. Training in social or parenting skills, various cognitive-behavioral interventions, group therapies and brief therapies, as well as psychotherapy as defined in Quebec are some examples of this type of high-intensity interventions. 1. Who should have access to psychotherapy? People of all age groups who have mental health problems or disorders may benefit from psychological interventions. 2. When psychotherapy is indicated, which types and modalities of therapies should be favoured? The efficacy of various psychological interventions, including psychotherapy, is generally comparable. The observed differences are small, and they are more closely tied to the age group and type of mental disorder than to the therapeutic approach itself. The efficacy of psychological interventions also depends on the personal characteristics of the therapist and the user, as well as on the factors common to all psychological interventions. 3. At which stage of treatment should psychotherapy be considered? Most clinical practice guidelines recommend that psychological interventions for people with common mental disorders be offered as part of a stepped-care model and integrated into primary health care services. 4. What are the costs and benefits of psychotherapy? The work of INESSS confirm that health benefits as well as economic gains resulting from the treatment of common mental disorders have been consistently observed in the jurisdictions studied. CONCLUSION: The state of knowledge carried out by INESSS confirms the efficiency and cost-effectiveness of psychological interventions, including psychotherapy, in the treatment of mental health problems and common mental disorders. We hope that these studies will inform the decision-makers as to the orientations to be pursued in order to respond to the needs of people with such problems, for their own benefit, that of their loved ones and that of the Quebec society.

Authors' methods: The magnitude of mental health problems and mental disorders in society incite the health authorities in many countries to address the issue of accessibility of psychological care and services. In fact, it is considered that more than one in five people will have to deal with a mental disorder during his lifetime. Anxiety disorders and depressive disorders, being the most common, account for nearly two-thirds of all mental disorders. Less than half of those with common mental problems or disorders affected will seek professional help. The fear of stigma and the presence of factors that restrict access to psychological interventions in the public network are among the obstacles observed. In order to address the concerns raised by this reality, the MSSS (Ministry of Health and Social Services) have mandated the National Institute of Excellence in Health and Social Services (INESSS) to inquire into the organizational and economic issues related to the improvement of access to psychotherapy services for the Quebec population .

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/acces-equitable-aux-services-de-psychotherapie-au-quebec.html

Year Published: 2018

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/acces-equitable-aux-services-de-psychotherapie-au-quebec.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: Gouvernement du Québec