Advertisement

Canadian Journal of Public Health

, Volume 100, Issue 2, pp 145–147 | Cite as

Integrating Psychologists into the Canadian Health Care System: The Example of Australia

  • Richard Moulding
  • Jean Grenier
  • Grant BlashkiEmail author
  • Pierre Ritchie
  • Jane Pirkis
  • Marie-Hélène Chomienne
Commentary
  • 2 Downloads

Abstract

Canada and Australia share many similarities in terms of demographics and the structure of their health systems; however, there has been a divergence in policy approaches to public funding of psychological care. Recent policy reforms in Australia have substantially increased community access to psychologists for evidence-based treatment for high prevalence disorders. In Canada, access remains limited with the vast majority of consultations occurring in the private sector, which is beyond the reach of many individuals due to cost considerations. With the recent launch of the Mental Health Commission of Canada, it is timely to reflect on the context of the current Canadian and Australian systems of psychological care. We argue that integrating psychologists into the publicly-funded primary care system in Canada would be feasible, beneficial for consumers, and cost-effective.

Key words

Mental health services psychotherapy mood disorders anxiety disorders primary health care 

Résumé

En termes de démographie et de structure de leurs systèmes de santé, le Canada et l’Australie partagent de nombreuses similitudes; cependant, on note une divergence dans leur approche et leurs politiques en ce qui concerne le financement des services psychologiques. Les réformes récentes des politiques en Australie ont considérablement augmenté l’accès de la population aux psychologues pour des traitements fondés sur les preuves dans le contexte des troubles mentaux de forte prévalence. Au Canada, l’accès aux psychologues demeure limité, la grande majorité des consultations se produisant dans le secteur privé; la majeure partie de la population ne pouvant avoir accès à ces services pour des raisons économiques. Le lancement récent de la Commission de la santé mentale du Canada suggère que le moment est opportun et qu’il est pertinent de se pencher sur le contexte actuel des systèmes canadiens et australiens en ce qui concerne les soins psychologiques. Nous suggérons que d’intégrer les psychologues dans le système de soins de santé primaires au Canada est réalisable, bénéfique pour les consommateurs, et coût-efficace.

Mots clés

Services de santé mentale psychothérapie troubles de l’humeur troubles d’anxiété soins de santé primaires 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Stephens T, Joubert N. The economic burden of mental health problems in Canada. Chron Dis Can 2001;22(1):18–23.Google Scholar
  2. 2.
    Begg SJ, Vos T, Barker B, Stevenson CE, Stanley L, Lopez AD. The burden of disease and injury in Australia 2003. PHE 82. Canberra: Australian Institute of Health and Welfare, 2007.Google Scholar
  3. 3.
    Roth A, Fonagy P. What Works for Whom? A Critical Review of Psychotherapy Research. New York, NY: Guildford, 2005.Google Scholar
  4. 4.
    Schulberg HC, Raue PJ, Rollman BL. The effectiveness of psychotherapy in treating depressive disorders in primary care practice: Clinical and cost perspectives. Gen Hosp Psychiat 2002;24(4):203–12.CrossRefGoogle Scholar
  5. 5.
    Arnett JL, Nicholson IR, Breault L. Psychology’s role in health in Canada: Reaction to Romanow and Marchildon. Can Psychol 2004;45:228–32.CrossRefGoogle Scholar
  6. 6.
    National Institute for Health and Clinical Excellence (NICE). Published clinical guidelines. Updated 2007. Available online at https://doi.org/www.nice.org.uk/guidance/index.jsp?action= ByType&type=2&status=3&p=off (Accessed August 22, 2008).Google Scholar
  7. 7.
    Mental Health Commission of Canada. Key Initiatives. Available online at: https://doi.org/www.mentalhealthcommission.ca/keyinitiatives.html (Accessed May 11, 2007).Google Scholar
  8. 8.
    Starfield B, Shi L. Policy relevant determinants of health: An international perspective. Health Policy 2002;60:201–18.CrossRefGoogle Scholar
  9. 9.
    Hutchison B, Abelson J, Lavis J. Primary care in Canada: So much innovation, so little change. Health Affair 2001;20:116–31.CrossRefGoogle Scholar
  10. 10.
    Deber RB. Health care reform: Lessons from Canada. Am J Public Health 2003;93:20–24.CrossRefGoogle Scholar
  11. 11.
    Marchildon GP. Health Systems in Transition: Canada. Toronto, ON: University of Toronto Press, 2006.Google Scholar
  12. 12.
    Grenier J, Chomienne MH, Gaboury I, Ritchie P, Hogg W. Collaboration between family physicians and psychologists: What do family physicians know about psychologists’ work? Can Fam Phys 2008;54:232–33.Google Scholar
  13. 13.
    Romanow RJ, Marchildon GP. Psychological services and the future of health care in Canada. Can Psychol 2003;44:283–95.CrossRefGoogle Scholar
  14. 14.
    Dobson KS. A national imperative: Public funding of psychological services. Can Psychol 2002;43:65–75.CrossRefGoogle Scholar
  15. 15.
    Craven M, Cohen M, Campbell D, Williams J, Kates N. Mental health practices of Ontario family physicians: A study using qualitative methodology. Can J Psychiat 1997;42:943–49.CrossRefGoogle Scholar
  16. 16.
    Canadian Psychological Association. Putting human behaviour at the heart of health care in Canada. Written submission to the Commission on the Future of Health Care in Canada. November 1, 2001.Google Scholar
  17. 17.
    Hamilton Family Health Team. Shared mental health care in Canada. Available online at: https://doi.org/www.shared-care.ca/index.shtml (Accessed November 26, 2007).Google Scholar
  18. 18.
    Nickels MW, McIntyre JS. A model for psychiatric services in primary care settings. Psychiatr Serv 1996;47:522–26.CrossRefGoogle Scholar
  19. 19.
    Ontario Ministry of Health and Long-Term Care. Family Health Teams: Advancing primary care. Bulletin No 1. December 2004. Available online at: https://doi.org/www.health.gov.on.ca/transformation/fht/fht_bul/fht_bul_1_120604.pdf (Accessed September 21, 2007).Google Scholar
  20. 20.
    Turcotte V. L’intégration de psychologues dans les équipes multidisciplinaires de première ligne; facteurs facilitants et obstacles. Mémoire présenté à la Faculté des études supérieures de l’Université Laval dans le cadre du programme de maîtrise en santé communautaire pour l’obtention du grade de maître ès sciences (M.Sc.). Québec, QC: Université Laval, 2005.Google Scholar
  21. 21.
    Canadian Institute for Health Information. Health and Personnel Trends in Canada (1995 to 2004). Updated 2006. Available online at: https://doi.org/secure.cihi.ca/cihiweb/dispPage.jsp?cw_page= PG_399_E&cw_topic=399&cw_rel=AR_21_E. Accessed 11/4/2008 (Accessed July 2006).Google Scholar
  22. 22.
    Morley B, Pirkis J, Sanderson K, Burgess P, Kohn F, Nacarella L, Blashki G. Evaluating the Access to Allied Psychological Services Component of the Better Outcomes in Mental Health Care Program (Eighth Interim Evaluation Report): Consumer outcomes: The impact of different models of psychological service provision. Melbourne: Program Evaluation Unit, University of Melbourne, 2006.Google Scholar
  23. 23.
    Mental Health Council of Australia. ‘Out of Hospital, Out of Mind!’ A Report Detailing Mental Health Services in Australia in 2002 and Community Priorities for National Mental Health Policy for 2003–2008. Canberra, Australia: Mental Health Council of Australia, 2003.Google Scholar
  24. 24.
    Mental Health Council of Australia. Not for Service: Experiences of injustice and despair in mental health care in Australia. Canberra: Author, 2005.Google Scholar
  25. 25.
    Mathers CD, Vos ET, Stevenson CE, Begg SJ. The Australian Burden of Disease Study: Measuring the loss of health from diseases, injuries and risk factors. Med J Australia 2000;172:592–96.PubMedGoogle Scholar
  26. 26.
    Vos T, Corry J, Haby MM, Carter R, Andrews G. Cost-effectiveness of cognitive-behavioural therapy and drug interventions for major depression. Aust N Z J Psychiat 2005;39(8):683–92.Google Scholar
  27. 27.
    Hickie I, Groom GL. Primary care-led mental health service reform: An outline of the Better Outcomes in Mental Health Care initiative. Australas Psychiat 2002;10:376–82.CrossRefGoogle Scholar
  28. 28.
    Pirkis J, Blashki G, Murphy AW, Hickie I, Ciechomski L. The contribution of general practice based research to the development of national policy: Case studies from Ireland and Australia. Aust NZ Health Policy 2006;3(4):doi:10.1186/1743-8462-3-4.Google Scholar
  29. 29.
    The Senate Select Committee on Mental Health. A national approach to mental health from crisis to community: First report. Canberra: Commonwealth of Australia, 2006.Google Scholar
  30. 30.
    van Gool K. National Mental Health Action Plan: One year on. Health Policy Monitor 2007; April 2007. Available online at: https://doi.org/www.hpm.org/survey/au/a9/2 (Accessed September 20, 2007).Google Scholar

Copyright information

© The Canadian Public Health Association 2009

Authors and Affiliations

  • Richard Moulding
    • 1
    • 2
  • Jean Grenier
    • 3
    • 4
    • 5
  • Grant Blashki
    • 6
    Email author
  • Pierre Ritchie
    • 3
  • Jane Pirkis
    • 7
  • Marie-Hélène Chomienne
    • 4
    • 5
  1. 1.Primary Care Research Unit, Department of General PracticeUniversity of MelbourneAustralia
  2. 2.Swin-PsyCHE Research UnitSwinburne University of TechnologyMelbourneAustralia
  3. 3.School of Psychology, Faculty of Social SciencesUniversity of OttawaOttawaCanada
  4. 4.Montfort HospitalOttawaCanada
  5. 5.Department of Family MedicineUniversity of OttawaOttawaCanada
  6. 6.Nossal Institute for Global HealthCarlton VictoriaAustralia
  7. 7.Centre for Health Policy, Programs and Economics, School of Population HealthUniversity of MelbourneAustralia

Personalised recommendations