Suicide Prevention | Psychotherapy needs to be more accessible, says psychiatrist

(Montreal) Psychotherapy services should be easily accessible to the entire population and not just to people with private insurance, argues a psychiatrist.

The D^r Alain D. Lesage put the idea of ​​equitable access to psychotherapy back on the table among his recommendations presented, Wednesday, at the public inquiry of the Coroner’s Office on the theme of suicide.

“When drug insurance was created, those who were not insured became insured. But we did not create two types of pharmacies; one for the poor and one for the rich”, he illustrated in front of the coroner M^e Julie-Kim Godin, at the Trois-Rivières courthouse.

Last October, in an open letter published in “Le Devoir”, he argued that “only half of Quebec men can quickly and inexpensively access therapy through their employee assistance programs or private insurance”.

Uninsured citizens must instead “wait in the very long queue offered by the public plan,” mentioned the full professor at the Research Center of the University Institute in Mental Health of Montreal.

“In our society, it is unfair,” lamented the D^r Lesage, Wednesday, to the recommendations and representations of the coroner’s inquest.

The D^r Lesage gave the example of Manitoba and Ontario, which during the pandemic offered privately managed distance psychotherapy programs to people without insurance.

In response to his suggestion, a senior official from the Ministry of Health and Social Services (MSSS) specified that Quebec had announced the deployment of a strategy for the acceleration and integration of digital mental health. This aims to promote access to mental health care and services by increasing the number of digital tools, such as mobile or online applications.

The national director of mental health and forensic psychiatry services at the MSSS, D^r Pierre Bleau, mentioned the imminent arrival of a support program “Find your spirit”, by which the participants acquire skills “via a cognitive behavioral therapy scheme”.

In-depth investigations

The D^r Lesage also reiterated his proposal to the MSSS and the Ministry of Public Security to carry out systematic audits on suicide. This approach aims to deepen and analyze 100 deaths by suicide drawn at random from the approximately 1,000 cases that occur on average each year in Quebec.

The exercise would be carried out by a panel including representatives of bereaved families and a psychologist or social worker. A questionnaire would also be sent to treating physicians and families.

The objective of carrying out such in-depth investigations is to see possible improvements in the quality of the services offered to prevent this type of tragedy and then make recommendations. A practice that has been tested on the territory of the CIUSSS de l’Est-de-l’île-de-Montréal, underlined the D^r The wise.

If the coroner M^e Godin is keeping this proposal in its final report, the MSSS could look into how to set up this avenue, indicated the D^r Blue.

The idea of ​​having a uniform “tool” to assess suicide risk was also discussed. Several means exist to measure the degree, but they do not replace clinical judgment, according to Dr.^r Blue.

A standardized assessment should “demonstrate its effectiveness” in recognizing “false positives and false negatives”. “I haven’t seen tools like that,” he said.

The coroner’s inquest on the theme of suicide covers the deaths of Mikhaël Ryan, Joceline Lamothe, Suzie Aubé, Jean-François Lussier, Marc Boudreau and Dave Murray.

The hearings on the recommendations and representations sections, which will feed Ms.^e Godin on solutions to prevent suicide, are due to end this week.

This article was produced with the financial support of the Meta Fellowships and The Canadian Press for News.