Online support: E-mental health services can help reduce wait times

For all the talk about the importance of mental health, it can be hard to access help in Canada. Anyone who has ever sought provincially-funded therapy knows that long wait times are simply part of the package.

But several Canadian organizations and researchers are finding ways to cut through these wait times and offer help to more Canadians by harnessing the power of the Internet.

Through different kinds of web-based delivery, they are using technology to enhance traditional forms of mental health care, opening more Canadians to help in a cost-effective way.

These are solutions that are badly needed in Canada. Waits for therapy covered by medicare range anywhere from weeks to a year, depending on where you live in Canada.

That’s despite the fact that psychotherapy, or “talk therapy,” has been shown effective at treating several mental health conditions, including the two most common in Canada: depression and anxiety.

Of course, Canadians have the option to see a private psychologist or therapist, but at $150 to $200 a session or more, it’s not an option for everybody. Some Canadians are lucky enough to have mental health coverage under their group health plans at work or school. But the unemployed, the self-employed, and those who have used up all their benefits are left to pay out of pocket.

For mental health professionals such as Dr. David Gratzer, a psychiatrist at Toronto Scarborough Hospital, it makes no sense that Canadians can't easily access treatments such as cognitive behavioural therapy that have been shown time and time again to work.

“Can you imagine if we were talking about cancer care, and I said to a cancer patient at my hospital, you will have no access to radiation services; you can only get chemo?” he told CTVNews.ca in an interview.

All Canadians should be able to access psychotherapy treatments but the reality is, like many aspects of Canadian health care, that means waiting, despite the work of such programs as Bell Let’s Talk.

But Internet-delivered care is offering hope for change.

“E-mental health,” as it’s sometimes called, lets patients get professional help using the Internet, phone apps, and other technologies.

Progress is slow, but Canada is starting to catch up with several other countries that adopted Internet-supported mental health programs years ago. Sweden was one of the first. Britain and Australia have also gotten on board, launching ambitious e-mental health programs to try to cut wait times.

Dr. Gratzer is helping to lead the charge here in Canada. His hospital was the first in Canada to offer Internet-based cognitive behavioural therapy through an outpatient clinic. Many patients are choosing to skip the wait times for group therapy and doing treatment at home with the help of trained therapists online. He says the results for patients are as good as traditional face-to-face talk therapy, and the dropout rate is even lower.

Patricia Lingley-Pottie is taking a somewhat different approach. She’s the president of Strongest Families Institute in Halifax and has helped develop an educational program to help parents learn how to work with their children mental health challenges, such as anxiety, ADHD (attention deficit hyperactivity disorder), and behaviour problems including oppositional defiance disorder.

If access to mental health care is bad for adults, it’s even worse for kids. About 15 per cent of kids and adolescents in Canada experience mental illness that is serious enough to impair their functioning, yet less than a third of these kids and their families receive help in a timely manner.

The Strongest Families Institute is helping to change that by providing a program parents and kids can do from home, so they don’t have to wait for one-on-one care with a therapist.

The program is ideal for parents who find it difficult to attend therapy or parenting support sessions in the middle of the workday, because they can work on their treatment from the comfort of their home, at a time that is convenient to them.

As exciting as many e-mental health programs are, they are not meant to replace traditional psychological therapy. Some patients prefer to work face-to-face with therapists; others don’t have good access to the Internet; still others are simply not interested in learning the technology.

And that’s fine, say Gratzer and Lingley-Pottie; e-mental health is just another tool to offer help to those who wouldn’t otherwise receive it.

Their concern though is that many programs already initiated in Canada may not get the funding they need to continue or to expand.

Lingley-Pottie says her group has taken the models they created for their behaviour and anxiety treatment programs and expanded them for everything from postpartum depression, to PTSD, to nighttime bedwetting. But she says some of these programs are still waiting for provinces or jurisdictions to fund them.

Dr. Gratzer says lots of great, innovative mental health initiatives get launched in Canada but they often die on the vine because they fail to get funding to keep expanding. He says the federal government should look to all the mental health initiatives that Canadian researchers have already created and scale them up.

“If the federal government wants to invest more in mental health as they say they do, I would say, start with these programs,” he said. “Don’t spend more money paying doctors more. Use these evidence-based ideas.”