A Canadian Perspective on Access to OCD Treatment

Melanie Lefebvre

Melanie Lefebvre

I’m a Canadian living with OCD in a city of just over 150 000. As a Canadian, I have access to free health care, but having OCD means, ideally, access to specialized care. Specialized care can be hard to find. And often, when (or if) you find it, it ain’t cheap.

Let’s reflect back on the 80’s in Canada for a moment. As a child, I wouldn’t allow my mom to use the stove. Perplexed, she asked a public health nurse for guidance:

“Make sandwiches.”

So my mom made sandwiches.

A rare window into the psyche of a child had been revealed: an opportunity missed.

Based on my personal experience searching for specialized help for OCD, it’s likely these opportunities may continue to be overlooked. I can’t speak for other cities across the Great White North. But I would hope that metropolitans like Toronto have more options.

Speaking of options from my experience, here’s the first for review:

Option 1: Counselling (for a fee)

As a young woman in my early twenties, I recognized I needed help. I displayed signs of hit-and-run OCD, but other than that, I only knew the typecast of OCD: checking, hand washing and having things in order.

With time, I learned that my city has counselling agencies with sliding scales for payment based on one’s level of income. Through my career, I learned that if you’re receiving government assistance, the price goes down substantially and can be affordable at around $10 a session.

Option 2: Counselling (Free)

If you’re on social assistance, the government allots you a time limited amount of free counselling sessions. But let’s say you’re not on social assistance. Well, there are still options. We have a couple of short-term counselling agencies for people with limited income free of charge, one of which is specific to the French-speaking population.

If you’re employed with the luxury of an Employee Assistance Program, you’ve got a batch of time-limited sessions of counselling for free.

The catch to counselling? You’re not necessarily going to find an OCD specialist.

That’s what happened with me. The counsellors I’ve had throughout the years, through various means, reassured me countless times, doing more harm than good.

Option 3: Psychologists

If you have benefits through work, your parents, or your spouse, you may get a nice chunk of psychologist fees covered. Otherwise, fees range from $125 to $200.

I’ve been down this road. By the time I was scoping out psychologists, I had more knowledge. The OCD workbooks I’d read suggested interviewing them, ensuring you’re getting the cream of the crop. I couldn’t seem to find much cream specializing in OCD.

I ended up going with the psychologist whose notes I had scribbled on a tissue after running out of paper. Could this have been a premonition for tears to be shed in his office?

I mailed him supplementary literature from my trusty OCD workbooks to ensure he was prepared. I drafted a letter explaining that I was ready to do exposures, that I was hoping he would be my co-pilot, quite literally. We’d take my vehicle and venture onto the pothole ridden roads. But when it came time for this, the letter I had written felt bogus. I wasn’t ready. It was clear that exposures were the answer. I had entered into therapy claiming we would be on the road together. But the road was left untraveled.

Option 4: Skype Therapy

As time went by, my willingness for treatment would wax and wane. I searched for creative ways to obtain therapy and experimented with a few OCD specialists (finally!) from the United States via Skype. But help with funding for the service was not a possibility. And when the Canadian dollar is so low (so, almost always), fees ranging from $125 and upwards of $200, are more like $180 through $240.

So you have to be ready. That’s what’s tough. With fees that drain your pockets, commitment is crucial. I terminated treatment several times before I could commit.

If you’re from a different Canadian city, your menu of treatment options may look entirely different. This is unfortunate. Navigating my city’s menu has taken time, energy and has involved a fair share of frustration. When you need specialized help, ideally there would be a “no wrong door” policy so that wherever you end up, you’ll be guided to the proper help.

Regardless, I recommend patience. Sometimes the government works in your favour. I learned of a free ERP-based group therapy program from the hospital. Now I was getting somewhere.

The group gave me the jump start I needed. It also made me realize that because I was finally doing exposures, I was ready for personalized help. For me, this was important. I’m currently doing therapy Skype style with a specialist in the United States. I’ve found a good fit and it’s worth the investment for my well-being.

What about psychiatric care and medication?

For medication, just because it’s Canada doesn’t mean medication is free. It’s not. It’s expensive. You either need benefits through your employer, spouse or parents to cover a chunk of the cost. Or, if you’re on disability assistance, your medication will be covered. People can also apply for special funding programs if they meet the eligibility criteria.

As for psychiatrists, they are free! But the catch is the wait. If you take the OCD group at the local hospital, you have access to a free consultation with a psychiatrist. This is a start. Otherwise, you may be waiting as long as a year if not more.

A creative loophole (if you have a family doctor, which can be a wait in and of itself) is to request a videoconference with a psychiatrist from a different city. This can often be scheduled in a much shorter amount of time. The psychiatrist can then complete an assessment and provide the doctor with a detailed guide of how to assist the patient through the trial and error process that so often accompanies finding the right psychiatric medication.

You’ve now been given a sample Canadian menu for OCD treatment. My hope for everyone, regardless of where they are from, is that one day someone will bring the menu to us, with more affordable options, and that it won’t feel like we’re playing a game of Where’s Waldo.


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