• Linda Nguyen

Psychological Services: Public vs Private



The Mental Health Commission of Canada (MHCC) estimates that 66% of adults and 75% of children and youth do not access services and support to address their mental health concerns. Research has shown that psychological treatment and support are highly effective for many conditions and people. It is essential to address these concerns early, as the longer things go untreated, the more difficult it is to treat.


Mental health concerns do not go away on their own and can negatively affect our physical health. There are two forms of treatments: psychopharmacological treatment (medication) and non-pharmacological treatments (counselling, psychotherapy, and psychological services). By addressing mental health care using the biopsychosocial model, we look at the effects of biology, psychology, and socio-environmental factors. Therefore, for some, a combination of pharmacological and non-pharmacological treatments is most effective towards their improvements and recovery.


This article will explain how mental health care is offered in Canada and consider the potential benefits and drawbacks of different service delivery methods. In Canada, most of our access to medical care is through the universal health care system. Therefore, there are no out-of-pocket expenses for the use of services covered, which can vary between provinces and territories. However, public funding is usually limited to essential physician services and hospital care. Conversely, both optical and dental care is completely privatized. These services are paid for by the individual, their insurance or a combination of both.


Psychological services are unique as it is offered both in the public and private health care system. Both of the systems have their potential benefits and drawbacks. In some cases, private psychological services can supplement those offered in public mental health care. Ultimately, the choice of which services to use depends on your concerns, needs and preferences.


Public Psychological Services

Family physicians are usually the first point of contact for nearly 80% of people with common mental health problems. The most frequent method of treatment is often pharmacological, meaning using medication to address mental health needs. Some physicians offer psychotherapy, assessments and counselling. However, it is important to note that these non-pharmacological interventions are often emotional support and counselling. This type of therapy involves listening and giving advice and not formal psychological treatment.


At the discretion of the family physician, they can refer you to other services such as counselling, psychotherapy and psychological services. Referrals may be for a counsellor, psychologist, social worker, occupational therapist or psychiatrist. These services are publicly funded and require no out-of-pocket expense. However, except for psychiatric services and treatment, they do have potential limitations and drawbacks.


When you should utilize the public health care system:

  1. If you require the use of medication to treat your mental health symptoms or illness. Only physicians are allowed to prescribe medication. There are two options: working with your family doctor or with a psychiatrist. For more complex and severe cases, it is best to work with a psychiatrist. Your family doctor will have to make a referral on your behalf.

  2. If you or someone you know have an immediate psychiatric need or have suicidal ideation. Contact your mental health professional. If this is not possible, call a distress line, dial 911 or proceed to the nearest hospital emergency room. Click here to learn more about suicide prevention and resources.

  3. If, due to financial constraints, you are unable to pay for private psychological treatments and services. Public psychological services are free, but they do come with limitations. Some health insurance plans will have some coverage for psychological therapies, which can significantly decrease the cost. Also, some private practice clinicians offer a sliding scale option based on your income.


Private psychological services

While there is some availability of public health services, it certainly comes with some drawbacks. The public psychological health care system has limited accessibility and is not an ideal option for some individuals. Private psychological services fill this gap by providing personalized, effective and timely care. There is a cost associated with private treatment and services, which may discourage some from seeking treatment through this route. However, there are a few things to consider,


Counselling, psychotherapy and psychological services are highly effective. Around 75-80% of people who received treatment experienced significant improvements and benefits. Non-pharmacological treatments have no side effects and are the preferred method of treatment for some. Furthermore, some conditions are treated best with a combination of both medication and psychotherapy. Psychological treatments offer value for money spent and can positively impact your health, functioning, and general life satisfaction.


What are some drawbacks of the public health care system?

  1. Public psychological services are generalized. Its purpose is to serve the general public. Individual needs and preferences are not a priority, especially considering limited treatment options and resources available. Sometimes, the most effective treatment for a particular individual or condition is just not offered.

  2. There is a long wait time. Typical wait periods from referrals can take several months, up to over a year. There are usually far more individuals seeking treatments than publicly-funded clinicians and resources available.

  3. Treatment can be limited. Most programs have limitations on the number of sessions. This limit is typically usually around 5-10 sessions. In some cases, an extension may be granted. However, due to the public health care system's constraints, some individuals' needs and concerns are not fully resolved during this time limit.

  4. There is a limited choice over your care provider. Your referral from your physician determines your provider. Even then, sometimes, it is not your doctor who makes the decision. Who your provider is dependent on the program or agency providing the service.

If any of the above factors concern you, consider working with a clinician in private practice. A skilled mental health professional can offer you specialized psychological treatment unique to your concerns, needs and preference. In private practice, referrals are typically not needed. Wait times are significantly shorter, ranging from several days to weeks. The treatment length can be any duration you require. If you and your clinician are not a good fit for any reason, you can easily switch to someone else. Most psychologists are more than happy to refer you to someone else, especially if they feel that your concerns are outside their practice area.


Summary:

  • There are two types of psychological treatments: psychopharmacological (medication) and non-pharmacological (counselling, psychotherapy and psychological services)

  • Mental health care is provided through two systems: public and private

  • The public system is recommended if you: -require the use of medication (family physician or psychiatrist) -are in immediate danger of hurting yourself or suicidal ideation -have severe and debilitating symptoms or conditions, and require hospitalization or inpatient psychiatric services. -have financial constraints or no insurance coverage

  • The public system has its drawbacks: -Generalized service designed for the general public -Long wait times -Limitations on duration and number of treatment sessions -No choice over your care provider

  • The private system fills in the gaps and can supplement services provided by the public system. It can provide: -Specialized treatment unique to the individual -Access to most effective and efficient treatments -Shorter wait times -No limitations on duration or number of treatment sessions -You decide who your treatment provider is.



17 views0 comments