Mental Healthcare in Quebec: Analyzing the Policy Waves

With mental health at the forefront of the media and increasingly becoming destigmatized, policymakers are seeking to catch up. Recently, the Quebec government has demonstrated exemplary initiative by introducing the Quebec Program for Mental Disorders: from Self-Care to Psychotherapy (PQPTM). This is part of a new mental health program in Quebec which aims to improve access to mental health services. Its two main components are self-care and psychotherapy. 

This program, which began in the Fall of 2019, is currently being deployed in numerous Integrated Health and Social Services Centres (CISSS) around Montreal. In the same way that medical professionals and researchers advise people to exercise and eat healthy to improve physical health, positive coping strategies must also be given to improve mental health. This is precisely the aim of the self-care component of the program, which encourages individuals to regain control over their mental well-being, be aware of available resources and when to use them, and play a proactive role in improving their quality of life and mental health. The approach taken by the program is a holistic one, encompassing both personal strategies and resources available. This has been shown by researchers to be an effective way to improve mental health. This method of modulating thinking is relatively new, having only entered mental health practice in the second half of the 20th century, but has been proven to be successful. For individuals who need an additional source of support after being equipped in this way, psychotherapy will also be available. The psychotherapy component of the program is primarily targeted towards people with mental disorders, behavioural disturbances or in psychological distress. Its purpose is to positively impact cognitive and emotional functioning, as well as personality and relationships. Clinical follow-up, coaching, rehabilitation and involvement of the family in various ways are all possible courses of action for individuals in need of long term support. 

The provision of these services in the way that the program is suggesting is a big improvement over the previous program in place. In fact, Quebec’s long and tumultuous history with mental healthcare has seen several displays of apparent disregard for people with mental illness. For example, in the 1960s, the downsizing of psychiatric hospitals became common in Quebec. This resulted in some ex-psychiatric patients struggling to access the follow-up care they needed, and in some cases, even becoming homeless. Due to decentralized data gathering in Quebec, there is also no data demonstrating average wait times for mental health services. However, long wait times is a chronic complaint among Quebec residents; one particular patient had to wait 13 months for a psychiatric follow-up.  

The implementation of this new policy thus represents an improvement over the old attitudes towards mental healthcare in that it takes a more holistic approach to mental illness. It does not see mental health solely as a doctor’s responsibility but rather seeks to equip both individuals suffering from mental illness and their loved ones with the tools necessary to manage the situation while waiting to see a professional. It remains unclear how much wait times will change, but an emphasis on different forms of therapy such as psychotherapy as an alternative to traditional medicating represents an effort on the part of the government to address concerns about accessibility. This being said, the number of mental healthcare professionals per 1000 people in Quebec remains at a low 14, based on data gathered in 2019. This makes a big difference in the long run. While the program underway is a good short-term measure, the fact remains that too many people who are affected by mental illness still face barriers in accessing treatment.

Overall, this policy treats mental illness as a condition that can affect anyone and empowers individuals by providing them with proactive coping strategies in order to mitigate the negative effects of long wait times. However, in order to effectively promote both physical and mental health, there should be a continued emphasis placed on programs that increase awareness of mental illnesses and equip at-risk individuals with tools to best manage symptoms as they await treatment. Treatment for physical illnesses begins as soon as a person tests positive for it. In the same way, diagnostic tools and measures must also be developed so that the early symptoms of mental illness are identified. Ultimately, as health is multidimensional and includes both physical and mental health, it is imperative that both of these aspects are addressed by health policies. The PQPTM is a step forward in this direction.