Let’s do something about it.

Abstract

I have worked on this special issue of Canadian Psychology for quite some time now and am very pleased to finally see it in print. Clearly, the topic-access to services in psychology-is an important one. I have received more submissions for this special issue than for any other special issue of CP. Because of this enthusiasm and because so many manuscripts received were of high quality and, more importantly, because the topic covered here deserves our full attention, I have accepted more papers than I normally would for a single issue. Unlike previous issues, this one also includes many more commentaries than what readers may be accustomed to with the journal. Sure, I wanted data, and I wanted it published and available for anyone who still wonders whether greater access to services in psychology is needed, as well as for anyone who may need such data to make the case for greater access to services in their jurisdiction.It is for these reasons that this issue includes a study by Talbot and colleagues (2014, pp. 75-79) that shows that only a minority of physicians routinely refer patients with anxiety or depression for specialized mental health care; instead, these patients are often treated with a combination of pharmacotherapy and simple advice giving. In another paper, Roberge and colleagues (2014, pp. 60 - 67) report the findings of a study on 740 adults who were diagnosed with Panic Disorder, Generalised Anxiety Disorder, or Social Anxiety Disorder. Their findings show that less than half of the respondents received psychotherapy for their condition; furthermore, only a minority of respondents reported that they could receive the sessions they needed from the same health care professional. Some of the key variables that explained greater access to psychotherapy included having access to supplementary insurance, age, a university level education, and being a woman. Some of these variables are also discussed in other papers in this special issue. For example, using data from the 2009 -2010 Canadian Community Health Survey, Cox (2014, pp. 68 -74) showed that overall, women more frequently consulted all types of health professionals for a mental health reason. However, gender differences on mental health consultation have been found to vary depending on the type of service provider and the mental health concern. In another paper, it is the issue of supplementary coverage that is addressed; Walker and colleagues (2014, pp. 101-109) report the results of their survey on the extended health insurance plans available to undergraduate students at Canadian colleges and universities with regard to coverage for prescription medication and for psychotherapy. Their findings show that although the coverage for medication is adequate, this is not the case for psychotherapy. In addition, for institutions with coverage for psychotherapy services, the modal level of total coverage varied between a mere $300 and $500 per year.Sadly, access to adequate services for children and teenagers is not much better. Lee and colleagues (2014, pp. 110 -116) conducted a large survey of Canadian parents and found that few of the services offered to parents were evidence based and that access to parenting programs was often difficult. Hunsley and colleagues (2014, pp. 117-125) surveyed Canadian psychological practitioners who offer services to children and youth. Their findings indicate that approximately one third of service users had been prescribed psychotropic medication and that it was not unusual for them to receive services from multiple health care practitioners for the same problem. In another study of services offered to children and youth with anxiety disorders, Eichstedt and colleagues (2014, pp. 90 -100) found that access to evidence-based treatments is moderate, at best.All the data presented in this special issue and elsewhere (e.g., Commissaire a la sante et au bien-etre du Quebec, 2012; Mental Health Commission of Canada, 2012; Peachey, Hicks, & Adams, 2013; Sunderland & Findlay, 2013) converge: access to services is simply not adequate, and a number of different variables, including poor coverage for psychotherapy and other services in psychology in both basic and extended health insurance plans, can explain this. …