SUPPORT ALBERTANS TO ACCESS FUNDED PSYCHOLOGICAL SERVICES

Physicians are specialists in medical illness and physical disease. Psychiatrists are medical doctors who treat severe mental illness (with the majority using medication regimens as their primary treatment intervention).

Psychologists are the experts in mental and emotional health.

Alberta currently has a medical care, rather than a full health care system. There are ample studies confirming that mental and behavioural health have a direct and significant impact on both quality of life, and on physical health. The distress and costly outcomes of untreated mental health issues for the families in Alberta is staggering.

We are at a time where mental health concerns and access to mental health support is in the forefront of people’s minds. In any given year, 1 in 5 people in Canada (i.e. 7.5 million Canadians in 2018) will personally experience a mental health problem, with the most common being depression or anxiety. By age 40, approximately 50% of Canadians will have or have had a serious mental health crisis or a mental illness. Annual cost of mental illness to the economy runs in the billions.

According to Statistics Canada, young adults aged 15–24 experience the highest incidence of mental disorders of any age group in Canada. It is estimated that 10–20% of Canadian youth are affected by a mental illness or disorder, with suicide being one of the leading causes of death, accounting for 24% of all deaths among 15–24-year-olds and 16% among 25–44-year-olds.

Research has consistently demonstrated that access to psychological services is the number one reported unmet need in addiction and mental health reform. The Mental Health Commission of Canada reported that, almost half (49%) of Canadians who have suffered from issues such as depression or anxiety have never accessed help. Further, they explained that the economic cost to Canada for untreated mental health issues is formidable. In 2010 these costs were estimated to be at least $50 billion per year, with health care, social services, and income support costs making up the biggest proportion of these costs. Research indicates that if we reduce the number of people experiencing a new mental illness in a given year by 10%, the Canadian economy could save at least $4 billion annually. Access to psychological intervention has significant health outcome and cost-recovery benefit.

Currently mental health funding is primarily routed through and centralized within the medical care system. In Alberta, unless an individual or family can afford a private psychologist or has coverage through an insurance plan, those who need mental health or family crisis supports often must access these through their physician.

The medical care system is designed for acute physical or psychiatric crises; not timely and/or preventative mental and behavioural health interventions. In most cases, family doctors and hospitals are not adequately equipped to deal with escalating mental health issues. Psychologists within the centralized Alberta Health system are significantly over extended and unable to meet the rapidly growing demand for services. Related to the overburdened medical system, PCN’s, hospitals, and physicians currently need to triage individuals and focus both their diagnosis and interventions through the lens of the medical model.

In short, this means that many Albertans only qualify for psychological intervention and support after substantial suffering or crisis. To access intervention, the person's issues or dysfunction must, in most cases, be extreme. When Albertans deteriorate to the point where mental health issues present as severe anxiety, depression, suicidality, addiction, family violence, crime, and increasingly critical and complex levels of mental illness, they may then qualify for intervention.

Solely funding a centralized medical system to support Albertans with mental and behavioural health issues is neither cost efficient nor effective. The waiting lists for programs in the centralized medical system can be long and of course, by then the issues have often become more extreme and entrenched.

Facilitating access to treatment before it is a big problem (primary prevention) and working on the issues as they are presenting (secondary treatment) followed by support for ongoing maintenance (tertiary services) is in order. Decentralized funding for psychologists will provide for a well-rounded treatment model, that is less reactive, more proactive, and much more cost effective in the long run than dealing with crises which may involve hospitals, Children’s Services, and the criminal justice system.

Albertans are demonstrating increased awareness and understanding of mental health issues, as well as increased acceptance of people talking about their mental health challenges. With this comes the increased recognition of the importance of timely intervention and support to effectively address these challenges. Albertans expect the same recognition and sensitivity from their employers, politicians, and government.

Despite psychologists being registered professionals under the Health Care Act, mental health care is excluded from the standard list of para-medical services subsidized by the Alberta Government. Unfortunately, many individuals and families are still not able to access needed mental health interventions and support because they cannot afford to see a psychologist. Consider if Albertans were not able to access medical care because they cannot afford to see a doctor. One does not need to imagine the detrimental outcome of that.

Despite the availability of dedicated psychologists, financial barriers to mental health access and intervention continue. Mental health care rendered by psychologists is long overdue for decentralized funding/subsidy, as is provided for physiotherapy, speech therapy, optometry, dental services, and chiropractic care.

By diverting some funds from the centralized medical stream directly to psychologists across Alberta, timely and expert intervention could be realized without increasing costs and without adding to the pressures on the already backlogged medical system and infrastructure.

With the current public sentiment on mental health concerns and the increasing need for accessible and expert mental health support, it is very timely for the new Alberta Government to support all Albertans by directly funding mental health interventions by psychologists.

Given that:

The new Alberta Provincial Government is setting priorities and formulating their first budget.

Mental health is a priority for this new Alberta government, as evidenced by the creation of an Associate Minister position for Mental Health and Addictions.

Psychologists are the experts in assisting individuals and families to manage mild to complex behavioural, psychological, and mental health issues related to family function, situational challenges, and/or mental illness.

Accessing mental health supports through a centralized medical system has not proven to be successful in providing accessible, timely, or pro-active interventions for mental health prior to crisis .

Hospitals and family physicians are inundated with mental health issues which interfere with their ability to focus on medical needs and physical health.

It is not the most effective use of Albertan’s tax dollars to fund mental health needs through a centralized physical health medical system.

Cost remains the primary barrier who most need access to psychological health services.

Other registered health service providers receive partial or full funding through AHS (e.g. dental, chiropractic, physiotherapy, podiatry, and optometry).

This is an area that requires action rather than further study.

As Alberta taxpayers we PETITION THE GOVERNMENT TO:

Redirect some mental health funding from the centralized medical system and allow Registered Psychologists to bill AHS directly for psychological interventions.

Incorporate a partial funding model for treatment or fund up to 10 sessions annually for intervention services with a Registered Psychologist for qualified Albertans.

This petition has been initiated by the Edmonton Psychologists Interagency Committee. Please visit us online for more details and contact information. Our founding agencies include Kells Counselling, Insight Psychological, Dreamcatcher Nature-Assisted Therapy, and Cornerstone Counselling Centre; however, we are only a few of the organizations that support this mental health initiative.

The Edmonton Psychologists Interagency Committee professionals are available for further comment and can be reached through mh.access.ab@gmail.com.

Further information about how Alberta’s mental health tax dollars could be more effectively utilized can be accessed through the Psychologists' Association of Alberta.