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Evidence to Improve Care

Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder

Ontario Health Technology Advisory Committee Recommendation

  • The Ontario Health Technology Advisory Committee recommends that evidence-based, structured, individual and group psychotherapy provided by nonphysicians be publicly funded for patients with major depressive disorder and/or generalized anxiety disorder

Read the Full Ontario Health Technology Advisory Committee Recommendation Report Here

Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada. People with major depressive disorder experience sadness and loss of interest or pleasure in activities they once found rewarding. People with generalized anxiety disorder experience persistent, excessive, and difficult-to-control worry. It is not uncommon for someone with major depressive disorder to also suffer from generalized anxiety disorder or vice versa. 

Three common psychological treatments for major depressive disorder and generalized anxiety disorder in Ontario are cognitive behavioural therapy, interpersonal therapy, and supportive therapy. They are also known as psychotherapy, or “talk therapy,” and can be provided by physicians or regulated nonphysicians such as a psychotherapists or psychologists, and can be delivered in individual or group settings.

In Canada, approximately 11% of the population will have major depressive disorder at some point in their life, and 6% will have generalized anxiety disorder. Compared with usual care (for example, drug therapy), treatment with psychotherapy, or “talk therapy,” represents good value for money.

The most affordable option is group psychotherapy provided by regulated nonphysicians, with individual psychotherapy made available where group psychotherapy is not possible or inappropriate. Public funding for structured psychotherapy may result in extra spending of $11 million to $529 million per year for the next 5 years, depending on the type of treatment (group vs. individual), type of provider (nonphysician vs. physician), and the number of patients who are treated.

Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment
August 2017

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The Ministry of Health and Long-Term Care is currently reviewing this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry has a standardized process in place to review Health Quality Ontario recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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