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Canada should expand depression treatments under Medicare: study

New research suggests that roughly half of people with depression don’t even get minimal treatment.

Roughly one in 20 Canadians have major depressive symptoms, but fewer than half get even the minimal treatments for the mental health condition.

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Roughly one in 20 Canadians have major depressive symptoms, but fewer than half get even the minimal treatments for the mental health condition.

Here’s a depressing statistic: one in every 20 Canadians have the symptoms of major depression.

But even worse, fewer than half of them actually get even the most minimal treatment for the condition, according to a new study in the Canadian Journal of Psychiatry.

Its author Joseph Puyat, a researcher at the Centre for Health Evaluation and Outcome Sciences, examined data from Statistics Canada as well as B.C.’s medical billing records and found a huge gap between people’s mental health and getting the help they need.

“People have suspected that we could do so much more to provide support and service,” said the doctoral candidate at the University of British Columbia’s school of population and public health. “But I didn’t realize the magnitude or extent of the gap.

“We found that about 47 per cent of people diagnosable with depression are not getting adequate treatment.”

When it comes to mental health, Canada’s public system Medicare only covers psychiatrists and physicians — not psychologists, psychotherapists or counsellors.

Puyat said many front-line doctors either lack the time or aren’t trained to offer therapy. Psychiatrists, meanwhile, often have long waitlists.

“Antidepressants and counselling or psychotherapy are the first line of treatment for depression,” Puyat said. “But if the treatment preferred is prohibitive, (patients) may forgo treatment altogether, which could lead to the worsening of symptoms.

“Maybe it’s a good time to expand what should be covered by our publicly funded health system — to consider the possibility of covering visits to registered clinical psychologists or counsellors.”

Although those who can afford treatment can pay out-of-pocket to see a psychologist or therapist, financial constraints mean that for 80-90 per cent of patients with diagnosable depression symptoms, he said, a family doctor remains the primary care provided.

It’s not just governments that can help improve Canadians’ mental health, Puyat said. Non-governmental organizations, such as the Canadian Mental Health Association, and workplaces also play a part in offering support and reducing stigma of mental illness.

“We need all the help that we can get from various sectors of our society,” he said. “The problem with depression is not just at the individual level.

“It has a lot of impacts economically and socially. The more sectors are involved in closing the gap, the better for everyone.”

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