Mental illness is highly prevalent in Canada and costs the Canadian economy and health care system billions each year. Yet, Canadians generally do not have access to evidence-based psychotherapy that is considered a frontline treatment in countries such as the United Kingdom and Australia. Family health teams (FHTs) have been proposed as a way to improve access to mental health treatment. Yet, limited research has been conducted on the inclusion of Psychology into FHTs or the training of graduate students in this emerging field. To address this research gap, the novel treatment delivery and student training model at the Ryerson University Psychology Training Clinic (PTC) and St. Michael’s Hospital’s FHTs was examined in two studies. First, a pilot study examined the effectiveness of individual CBT provided by graduate students to patients with a primary anxiety or depressive disorder. Eighty percent of participants either no longer met diagnostic criteria for their primary mental disorder or were in partial remission. They experienced a significant reduction in symptoms of overall mental health, depression, and anxiety. As well, participants expressed a high level of satisfaction with the services received and reported having a positive working alliance with their student psychotherapist. Results indicate that student-delivered psychotherapy in a FHT setting is an effective treatment delivery model. Second, a two-part mixed methods study was conducted evaluating perspectives on patient care, interprofessionalism, and student training through an online study and individual interviews with health care providers, clinical supervisors, graduate students, and patients. Results from this study indicate that the PTC was a positive addition to the FHTs that improved access and provided patients with high quality mental health services. Generally, high levels of interprofessionalism were reported, though some drawbacks and individual differences were noted. The PTC was described as a valuable training experience. The importance of supervision and specific interprofessional and FHT training was highlighted. Findings from these studies represent a worthwhile contribution to the FHT and primary care psychology literature. Furthermore, the inclusion of Psychology and student trainees into a FHT appears to be a successful, viable option to improve access to effective mental health services.
Mental health services in Canada: Barriers and cost-effective solutions to increase access
