Half of depression patients receive inadequate care in B.C., says UBC study

Almost half of those who seek treatment for depression in B.C. are receiving inadequate care, according to a new UBC study published in the Canadian Journal of Psychiatry.

The study's authors found that, of all British Columbians diagnosed with depression, only 53 per cent received the minimum baseline of treatment.

"We were surprised," said Joseph Puyat, a PhD candidate at UBC's School of Population and Public Health and lead author of the study.

"We certainly didn't expect that in a developed country such as Canada, where healthcare is publicly funded, that a situation like this would show up in our data."

Undertreated and underdiagnosed

"Adequate care" is a concept that will vary greatly from person to person, he noted, but for the purposes of the study, Puyat and his team defined "inadequate care" as a course of treatment that did not meet the minimum guidelines for that form of treatment.

That meant at least 12 weeks of antidepressant treatment, or at least four counselling or psychotherapy sessions.

The researchers looked at data from hospitals, physician claims and prescription dispensation to determine the level of care depression patients were receiving.

They found that only 47 per cent of those prescribed antidepressants received them for 12 weeks, and only 13 per cent received four therapy sessions.

Puyat said the actual number of depressed people receiving inadequate care is likely much higher than the study found, since the study only considered patients who sought treatment, and many people do not.

According to Statistics Canada, about five per cent of Canadians suffer from symptoms that meet the criteria for clinical depression.

Care difficult to access

Puyat suspects the widespread under treatment has to do with the way mental healthcare is funded. Right now, antidepressants are publicly covered but counselling is not.

"The use of counselling or psychotherapy, that can be accessed, but there are substantial barriers to getting that," Puyat said.

"If you want to get that from private practitioners, you're going to have to pay out of pocket for it."

The solution, Puyat said, is to change the way mental healthcare is funded to make it more accessible, and also to continue to work to reduce the stigma around mental illness, which keeps many from seeking treatment in the first place.

"We need to reexamine our current policies in our practices, and even our attitudes towards mental illness and seeking mental health care," he said.

With files from CBC Radio One's The Early Edition.