Private mental health practitioners welcome the chance to be paid by public health system

The Nova Scotia government is working toward allowing private mental health practitioners to provide publicly insured services and some professional representatives say that should be the beginning of further reforms.

Mental Health and Addictions Minister Brian Comer tabled a bill last week intended to allow private practitioners — starting with psychologists, social workers and registered counselling therapists — to provide some services through the publicly funded health-care system.

The executive director of the Association of Psychologists of Nova Scotia said she was pleased by the news because it recognizes that "mental health is of supreme importance to any health."

But Susan Marsh said her association still needs more details. And when it comes to psychologists in the province, right now there is little capacity among those in private practice to take on more work even if they could bill the public system, she said.

"I think we need to consider all of the things that they are considering with doctors and nurses," Marsh said in an interview Thursday.

"How to ensure that there are more seats in universities and more funding to universities to produce more masters- and PhD-level psychologists, and I would say looking outside the province to attract people to come in, although I know that all provinces are dealing with this."

Recruitment is a subject Marsh said her association is hoping to hear more about from the provincial government, but overall she said she's been pleased with the level of communication coming from the province since the creation of a dedicated department for mental health and addictions.

"They have been responsive, they have included us in a lot of their meetings," she said. "I do feel that they have been listening."

The executive director of the Nova Scotia College of Social Workers said the number of people in the field is not a problem right now — there are 2,800 social workers in the province compared to 1,800 in 2016 — but there are other issues needing action.

Alec Stratford said it's probably good to get private practitioners involved in the public health-care system, but he said he'd like to see less reliance on the medical side of mental health and addictions and more emphasis on treating the roots of people's challenges.

"Of course talk therapy is part of that provision, but there are a range of social policies that need to be in place, as well," he said.

That means that along with opening up MSI billing and expanding not-for-profit supports, there needs to be clear direction from the government to create a cohesive system.

"So the real challenge that we see at this point in time with moving forward with the approach the minister is moving forward with is what does it do to the rest of the systems that are needed to cover off the whole spectrum of mental health and addictions services."

Rather than waiting for someone to present with symptoms, diagnosing them and providing treatment, Stratford said there is "an overwhelming amount of evidence" pointing to the need to focus on housing, adequate income levels and social connections — also called the social determinants of health — because of their effect on mental wellness.

A spokesperson for Comer said work is underway on a strategy to guide retention and recruitment of mental health professionals and that the social determinants of health would factor into health-care planning.