When it comes to accessing mental healthcare in Canada, therapists say prohibitive costs create a “two-tier system.”GETTY IMAGES
Therapy can be transformational, says therapist Roxanne Francis. Take one of her former patients, a woman we’ll call Nina. When she started therapy, she was at a low point in her life. As a child, she had experienced severe trauma and as an adult, it was impacting her ability to parent her own children. Child protective services had become involved, and there was the chance that she might lose custody.
“At the point that she came to me, she said, ‘I don’t even know why I’m here,’” Francis says. “We put in a safety plan to ensure that she called me the next morning, because she didn’t really see herself living through the night.”
But Nina did call, and Francis was able to help her find a way forward. They began to work through the childhood trauma that was at the root of Nina’s current situation, but they also explored practical strategies and solutions, like re-connecting with some relatives who could help with childcare or figuring out how to get into a better paying field of work.
“At the time that she stopped seeing me, she had started school and was working at night, and her cousin was helping her with childcare,” says Francis. “Things had turned around, and she was no longer thinking about ending her life.”
A crucial point? Nina was able to get some of the help she needed because she had access to free therapy through the community agency that Francis worked for at the time.
“I met so many wonderful people who needed therapy. I met people who were contemplating suicide and figured out that life was worth it. I met people who were diagnosed with bipolar disorder and figured out how to live a regular life. I met people who were trying to leave abusive relationships and were able to leave and find support because accessible therapy was there for them,” says Francis, who worked in community-based care for over a decade before opening her own private practice, which offers a sliding fee-scale to support those who may not be able to afford the full rate. “It really makes a world of difference.”
As Francis explains, there is a “two-tier system” when it comes to access to therapy in Canada:
Those who are able to afford it and those who can’t — who also are often the people who need this service the most. (Private therapy can cost between $150 to $250 per session, which is out of reach for many people.)
Helping to bridge some of that gap is EveryMind, a not-for-profit funded by the Ontario government that offers free mental health services to children, youth and families in Peel region. This includes a crisis line and single session counselling services, with appointments often available within a day or two through their Tangerine program.
“Just last week, one of our clinicians met with a young person struggling with auditory hallucinations,” says Karen Anslow, director of clinical services at EveryMind. “This young person had the experience of people not taking him seriously. But through this process, he expressed to the clinician that he felt heard and not judged.”
As a result of a single session, this young man received a report that he could show to his family doctor and get the kind of follow-up care that he needed.
“For children and young people who are struggling with their mental health, or maybe feeling alone and isolated, this is a safe space where they don’t feel judged, and [to] get actionable resources to walk away with,” says Anslow. “A lot of young people, children and families really struggle to find the help to meet their needs. If we or other community partners weren’t an option, it just shuts another door on them.”
The spectrum of need is as diverse as the growing population EveryMind serves: Since the pandemic, they’re noticing an “explosion” in anxiety, alongside eating disorders, obsessive compulsive disorder, depression, selective mutism, and ADHD and caregiver burnout.
And while these free or low-fee offerings are imperfect — there can be months-long waitlists in some areas, and some services may cap the number of sessions — access to public therapy services can profoundly improve both individuals and their communities.
“The therapist isn’t just there to catch your tears and be a ‘yes’ person, but to also hold you accountable and challenge you,” says Francis. “What would happen if you actually applied for this thing you’re so scared of? What would happen if you put things in place and left this person that’s no good for you? We help you actually make steps so you can climb the ladder and make your life better.”
