Counselling therapists expect surge in clients when public billing starts

As Nova Scotia moves toward the provision of universal mental health care, private therapists are preparing for the change.

Local members of the Canadian Counselling and Psychotherapy Association, which represents registered counselling therapists, met in Wolfville, N.S., this weekend to discuss the province's plan to allow private mental health-care providers to bill the public health-care system.

Jean Blackler, president of the association's Nova Scotia chapter, said the introduction of public billing is welcome. 

She said counsellors are concerned that many Nova Scotians are in need of mental health care but cannot afford it.

Blackler said that even those who have private insurance often reach their plan's limit before they complete their treatment.

"We need another mechanism in which people can access that care that they need over the length of time needed in order to come to a maintenance level in their wellness," she said.

Prepared for surge in clients

Last October, the provincial government passed legislation making a public billing model possible.

In November, it launched a pilot program that will run for a year before the details of the model are finalized and the service becomes more widely available. It will start with psychologists, registered counselling therapists and social workers.

Some private health-care providers have said they're worried about their capacity to meet demand. Blackler said she, too, is thinking about a potential onslaught of new clients, but she said her profession is ready for it.

"We will have a surge in clients," she said. "That's absolutely true. But I think that we have the infrastructure in place to accommodate the surge as it becomes known and as people are needing it and becoming comfortable that it's available."

The number of registered counselling therapists in Nova Scotia has more than doubled in the past three years, now numbering about 750.

Blackler said she expects some people who are trained as counsellors but who are not registered will do so once public billing comes online.

Questions remain to be answered

Counsellors raised questions at the meeting this weekend about what the province will pay and which services will be covered. 

The province has not said what rates it will pay therapists, but Blackler said the association is asking for a range of $150 to $190 per hour, depending on the service.

The services to be covered by the province have not been finalized. But association member Derrick McEachern, who has been meeting with provincial officials, said there are five broad categories being considered: assessment, intervention, consultation, supervision and administration. 

A spokesperson for the Department of Health and Wellness said the first pilot program for the new billing model includes eight private psychologists who are doing assessments of children and youth with autism and ADHD. Those assessments have long waitlists in the public system. 

"Findings from this and other pilot projects will inform the design of future programs under legislation for Universal Mental Health and Addictions," said Khalehla Perrault in an email.

She said the pilot is testing the integration of private-public services and payment mechanisms.