Paul Kurdyak1, Juveria Zaheer2, André Carvalho2, Claire de Oliveira2, Michael Lebenbaum2, Andrew S Wilton2, Mark Fefergrad2, Vicky Stergiopoulos2, Benoit H Mulsant2. 1. Centre for Addiction and Mental Health (Kurdyak, Zaheer, Carvalho, de Oliveira, Stergiopoulos, Mulsant); Department of Psychiatry (Zaheer, Carvalho, Fefergrad, Stergiopoulos, Mulsant) and Institute for Health Policy, Management and Evaluation (de Oliveira), Faculty of Medicine, University of Toronto; ICES (Kurdyak, Lebenbaum, Wilton), Toronto, Ont. paul.kurdyak@camh.ca. 2. Centre for Addiction and Mental Health (Kurdyak, Zaheer, Carvalho, de Oliveira, Stergiopoulos, Mulsant); Department of Psychiatry (Zaheer, Carvalho, Fefergrad, Stergiopoulos, Mulsant) and Institute for Health Policy, Management and Evaluation (de Oliveira), Faculty of Medicine, University of Toronto; ICES (Kurdyak, Lebenbaum, Wilton), Toronto, Ont.
Abstract
BACKGROUND: Psychotherapy is recommended as a first-line treatment for the management of common psychiatric disorders. The objective of this study was to evaluate the availability of publicly funded psychotherapy provided by physicians in Ontario by describing primary care physicians (PCPs) and psychiatrists whose practices focus on psychotherapy and comparing them to PCPs and psychiatrists whose practices do not. METHODS: This was a population-based retrospective cohort study. We included all PCPs and psychiatrists in Ontario who submitted at least 1 billing claim to the Ontario Health Insurance Plan between Apr. 1, 2015, and Mar. 31, 2016, and categorized them as psychotherapists if at least 50% of their outpatient billings were related to the provision of psychotherapy. We measured practice characteristics such as total number of patients and new patients, and average visit frequency for 4 physician categories: PCP nonpsychotherapists, PCP psychotherapists, psychiatrist nonpsychotherapists and psychiatrist psychotherapists. We also measured access to care for people with urgent need for mental health services. RESULTS: Of 12 772 PCPs, 404 (3.2%) were PCP psychotherapists; of 2150 psychiatrists, 586 (27.3%) were psychotherapists. Primary care physician nonpsychotherapists had the highest number of patients and number of new patients, followed by psychiatrist nonpsychotherapists, PCP psychotherapists and psychiatrist psychotherapists. Primary care physician nonpsychotherapists had the lowest average annual number of visits per patient, whereas both types of psychotherapists had a much greater number of visits per patient. Primary care physician and psychiatrist nonpsychotherapists saw about 25% of patients with urgent needs for mental health services, whereas PCP and psychiatrist psychotherapists saw 1%-3% of these patients. INTERPRETATION: Physicians who provide publicly funded psychotherapy in Ontario see a small number of patients, and they see few of those with urgent need for mental health services. Our findings suggest that improving access to psychotherapy will require the development of alternative strategies. Copyright 2020, Joule Inc. or its licensors.
BACKGROUND: Psychotherapy is recommended as a first-line treatment for the management of common psychiatric disorders. The objective of this study was to evaluate the availability of publicly funded psychotherapy provided by physicians in Ontario by describing primary care physicians (PCPs) and psychiatrists whose practices focus on psychotherapy and comparing them to PCPs and psychiatrists whose practices do not. METHODS: This was a population-based retrospective cohort study. We included all PCPs and psychiatrists in Ontario who submitted at least 1 billing claim to the Ontario Health Insurance Plan between Apr. 1, 2015, and Mar. 31, 2016, and categorized them as psychotherapists if at least 50% of their outpatient billings were related to the provision of psychotherapy. We measured practice characteristics such as total number of patients and new patients, and average visit frequency for 4 physician categories: PCP nonpsychotherapists, PCP psychotherapists, psychiatrist nonpsychotherapists and psychiatrist psychotherapists. We also measured access to care for people with urgent need for mental health services. RESULTS: Of 12 772 PCPs, 404 (3.2%) were PCP psychotherapists; of 2150 psychiatrists, 586 (27.3%) were psychotherapists. Primary care physician nonpsychotherapists had the highest number of patients and number of new patients, followed by psychiatrist nonpsychotherapists, PCP psychotherapists and psychiatrist psychotherapists. Primary care physician nonpsychotherapists had the lowest average annual number of visits per patient, whereas both types of psychotherapists had a much greater number of visits per patient. Primary care physician and psychiatrist nonpsychotherapists saw about 25% of patients with urgent needs for mental health services, whereas PCP and psychiatrist psychotherapists saw 1%-3% of these patients. INTERPRETATION: Physicians who provide publicly funded psychotherapy in Ontario see a small number of patients, and they see few of those with urgent need for mental health services. Our findings suggest that improving access to psychotherapy will require the development of alternative strategies. Copyright 2020, Joule Inc. or its licensors.
Authors: Scott B Patten; Jeanne V A Williams; Dina H Lavorato; Jian Li Wang; Keltie McDonald; Andrew G M Bulloch Journal: Can J Psychiatry Date: 2015-01 Impact factor: 4.356
Authors: Sagar V Parikh; Lena C Quilty; Paula Ravitz; Michael Rosenbluth; Barbara Pavlova; Sophie Grigoriadis; Vytas Velyvis; Sidney H Kennedy; Raymond W Lam; Glenda M MacQueen; Roumen V Milev; Arun V Ravindran; Rudolf Uher Journal: Can J Psychiatry Date: 2016-08-02 Impact factor: 4.356
Authors: Michael Chaiton; Rebecca Billington; Ilana Copeland; Luc Grey; Alex Abramovich Journal: Int J Environ Res Public Health Date: 2022-05-13 Impact factor: 4.614