THUNDER BAY — Two psychology professors from Lakehead University say the Ontario government should integrate registered mental health providers into the public health insurance system.
Drs. Deborah Scharf and Kirsten Oinonen, who are both registered clinical psychologists, make the argument in a paper published this month in the Canadian Journal of Public Health.
In the article, they said Ontario's COVID-19 response has pointed out shortcomings in the physician-only public health-care system, "which limits access to appropriate and sustainable mental health care."
"The fear, grief, social isolation, and financial and occupational losses from COVID-19 have created a mental health crisis," Scharf said.
The researchers note that the province's efforts to rapidly expand mental health-care access due to the pandemic include new OHIP billing codes that allow physicians to provide trauma conselling over the phone, as well as patient self-serve online tools, but psychologists and other registered mental health provider services have largely been left out of the provincial response.
Oinonen said non-physician mental health providers operate outside the provincial health-care infrastructure, including the OHIP provincial payer system that facilitated the provincial physician response.
"A physician-centric mental health-care system limits public access to quality, sustainable, evidence-based mental health services because most physicians do not have the capacity, training, or desire to provide mental health services," she said.
The two psychologists described some problems with the physician-centric response to COVID-19, including:
- physicians do not typically provide psychotherapy
- payment incentives in medicine have not typically increased public access to mental health-care
- shortages of psychiatrists and other public mental health-care services mean that physicians have nowhere within the public system to refer their patients with severe or emergency mental health issues
Scharf maintained that a physician-centric approach puts patients at risk from inadequate or inappropriate care while increasing stress on primary care providers whose services are needed elsewhere during COVID-19.
The researchers advocate for the creation of trial-billing mechanisms through OHIP for registered mental health providers, and for the introduction of standardized provincial-required reporting of registered mental health providers including their capacities.
Last May, the federal government announced $240 million to support online mental health-care and medical services.
Oinonen said the federal and Ontario governments should leverage psychologists and other registered mental health practitioners in their response.