Thank you to Patrick for her recent editorial1 on depression. Her statement that “the fact that we don’t have widely accessible and effective treatments for depression is a serious problem” is an understatement. Canada is capable of doing much better.
The way forward is through:
a massive effort to make evidence-supported behavioural treatments accessible to all Canadians
better integration of primary care with mental health care
more research into strategies to improve behavioural treatment outcomes such as mindfulness to improve the outcomes of cognitive behavioural therapy
new models for delivery of mental health care such as the Mood Disorders Association of BC Psychiatric Urgent Care Program to replace the inefficient and costly private-practice model that so many psychiatrists use2
more research into why some individuals with depression drop out of treatment or do not respond (each individual with depression needs a thorough psychiatric assessment to identify comorbid conditions such as anxiety or personality disorder that contribute to drop out or treatment failure if not addressed)
boosting community programs.
The need is urgent and action is required at all levels: federally, provincially and locally.