title: Moving Out of the Office: Removing Barriers to Access to Psychiatrists.
abstract: Our paper offers a perspective on barriers to access to psychiatric care. Research shows that access depends not simply on the total number of trained specialists but also on their kind of practice. In some large cities, some practitioners follow a small number of patients in long-term psychotherapy, a practice supported by government insurance, which places no limits on the number of sessions or treatment duration. The problem is that long-term psychotherapy, despite a rich tradition in psychiatry, is not an evidence-based treatment. This review recommends a model in which psychiatrists spend more time in consultation with primary care professionals, in acute care for patients with severe mental illness, and in briefer, more cost-effective forms of psychotherapy.
authors.affiliation: Research Associate, Institute of Community and Family Psychiatry, Sir Mortimer B Davis-Jewish General Hospital, Montreal, Quebec; Professor, Department of Psychiatry, McGill University, Montreal, Quebec.
authors.forename: Joel
authors.initials: J
authors.lastname: Paris
authors.affiliation: Senior Medical Advisor, Centre for Addiction and Mental Health, Toronto, Ontario; Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario.
authors.forename: David
authors.initials: D
authors.lastname: Goldbloom
authors.affiliation: Director of Health Systems Research, Centre for Addiction and Mental Health, Toronto, Ontario; Assistant Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario.\
authors.forename: Paul
authors.initials: P
authors.lastname: Kurdyak
mesh_terms: D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000706:statistics & numerical data*