July 15, 2016

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Half of patients with depression are inadequately treated

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New UBC research shows that about 50 per cent of British Columbians with depression are not receiving even the most basic level of care. Authors say the findings highlight the challenges of accessing mental health services across Canada.

"In a country with a publicly-funded care system, many people have untreated depression or do not get adequate care," said Joseph Puyat, a PhD candidate in UBC's school of population and public health. "Our findings highlight the need to keep the conversation going about how to close the gap in treating mental illness."

It's estimated that one in 20 people experience depression each year. Puyat and his colleagues reviewed from almost 110,000 British Columbians diagnosed with depression by physicians between 2010 and 2011. They examined whether these individuals received either one of the two recommended treatment options: antidepressants or psychotherapy.

They found that only 13 per cent of people received at least four psychotherapy or counselling sessions and 47 per cent received antidepressant medication for at least 12 weeks. Overall, about 53 per cent received the minimum threshold of treatment.

The researchers believe that their findings underestimate the full extent of the problem since many people do not seek or receive a diagnosis for their depression because of issues around stigma or access to a physician.

Puyat, who is also a research methodologist at the Centre for Health Evaluation and Outcome Sciences (CHÉOS), compared these findings to results from the Statistics Canada's 2012 Canadian Community Health Survey and found that the B.C. data is comparable. In the national survey, four out of ten Canadians who struggle with depression indicate they are not accessing any services to treat depression.

He suggests that provinces need to take a look at the services covered for mental health and how patients access care. For example, Canadians only receive coverage for counselling from medical doctors yet many family physicians don't have the time or training to provide counselling services.

"We need to evaluate, on an on-going basis, the existing structures, policies, and practices to further understand why almost half of the individuals diagnosed with do not receive the minimum amount of treatment," said Puyat.

More information: J. H. Puyat et al. How Often Do Individuals with Major Depression Receive Minimally Adequate Treatment? A Population-Based, Data Linkage Study, The Canadian Journal of Psychiatry (2016). DOI: 10.1177/0706743716640288

Journal information: Canadian Journal of Psychiatry

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