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Indicator Metadata

Name

Wait Times for Community Mental Health Counselling

Short/Other Names

Community Mental Health Counselling Wait Times

Description

The median number of calendar days that clients waited for ongoing community mental health counselling services, from the date that the initial referral was received to the date of the first scheduled counselling session.

The first scheduled counselling session refers to the first appointment offered and accepted by the client, regardless of whether they attended the appointment.

This indicator includes only publicly funded services that are scheduled/booked in advance. For the purpose of this indicator, publicly funded means services that are provided, coordinated or overseen by the government. This may include cases where a copay is required.

For the purpose of this indicator, counselling is defined as therapy grounded in a psychological theory or evidence-based practice that uses a set of recognized communication skills, and which is planned to be provided over 1 or more scheduled sessions by trained mental health professionals to promote positive growth, well-being and mental health. Counselling may be individual-, group- or family-based.

Examples of types of counselling included are dialectical behavioural therapy (DBT), cognitive behavioural therapy (CBT), brief low-intensity counselling, interpersonal therapy, solution-focused therapy, narrative therapy, psychoeducational counselling, psychodynamic therapy and mindfulness-based interventions.

Examples of types of counselling not included are crisis, drop-in, self-help, peer-led, clubhouses, residential care, day hospital/day programs, educational counselling, information sharing, specialized consultations and general support.

Interpretation

A low number is desirable for this indicator

HSP Framework Dimension

Health System Outputs: Access to comprehensive, high-quality health services

Areas of Need

Getting Better

Geographic Coverage

Newfoundland and Labrador, Prince Edward Island, New Brunswick, Nova Scotia, Saskatchewan, Alberta, British Columbia, Yukon, Northwest Territories

Reporting Level/Disaggregation

National, Province/Territory

Indicator Results

https://yourhealthsystem.cihi.ca/hsp/inbrief?lang=en

Identifying Information
Name

Wait Times for Community Mental Health Counselling

Short/Other Names

Community Mental Health Counselling Wait Times

Indicator Description and Calculation
Description

The median number of calendar days that clients waited for ongoing community mental health counselling services, from the date that the initial referral was received to the date of the first scheduled counselling session.

The first scheduled counselling session refers to the first appointment offered and accepted by the client, regardless of whether they attended the appointment.

This indicator includes only publicly funded services that are scheduled/booked in advance. For the purpose of this indicator, publicly funded means services that are provided, coordinated or overseen by the government. This may include cases where a copay is required.

For the purpose of this indicator, counselling is defined as therapy grounded in a psychological theory or evidence-based practice that uses a set of recognized communication skills, and which is planned to be provided over 1 or more scheduled sessions by trained mental health professionals to promote positive growth, well-being and mental health. Counselling may be individual-, group- or family-based.

Examples of types of counselling included are dialectical behavioural therapy (DBT), cognitive behavioural therapy (CBT), brief low-intensity counselling, interpersonal therapy, solution-focused therapy, narrative therapy, psychoeducational counselling, psychodynamic therapy and mindfulness-based interventions.

Examples of types of counselling not included are crisis, drop-in, self-help, peer-led, clubhouses, residential care, day hospital/day programs, educational counselling, information sharing, specialized consultations and general support.

Calculation: Description

The number of days that half of the clients waited for their first scheduled appointment for community mental health counselling services and half were still waiting

Start time: The date the initial referral is received for ongoing counselling, regardless of the referral source (e.g., self-referral, doctor’s office, walk-in clinic, emergency department, crisis services)
Note: For clients who are in hospital when the referral is received, the start time will be the date they are discharged from hospital.

Stop time: The date of the first scheduled appointment for ongoing counselling offered and accepted by the client, regardless of whether they attended the appointment

Unit of analysis: Referral for scheduled, ongoing counselling services

Calculation of all-Canada estimates: The pan-Canadian value is calculated using a weighted average of the median wait times submitted by jurisdictions. Weights are calculated using the volumes of referrals submitted by jurisdictions.

Calculation: Geographic Assignment

Place of service

Calculation: Type of Measurement

Number - Median (50th percentile) length of time, in days

Calculation: Adjustment Applied

None

Calculation: Method of Adjustment

Not applicable

Denominator

Description:
Not applicable

Numerator

Description:
The median number of calendar days that clients waited for their first scheduled appointment for ongoing community mental health counselling services
Inclusions:

  1. All ages
  2. All priority/urgency levels, except crisis services
  3. Only new referrals (i.e., referrals for new clients or clients who are being referred for a new episode of care)
  4. All referrals regardless of source (walk-in, family physician, emergency department, crisis services, etc.)
  5. Scheduled, ongoing individual, group and family counselling
  6. Counselling delivered in real time by any mode (in person, phone, videoconference, online)
  7. Client unavailable days (i.e., days when the client was not available to attend the appointment are included)
  8. System delays (i.e., days when the health care provider was not available to offer the service are included)
  9. Only cases where the stop time (i.e., first scheduled appointment) occurred within the reporting fiscal year (April 1 to March 31)

Exclusions:

  1. Stand-alone addictions counselling
  2. Crisis counselling services
  3. Drop-in/walk-in counselling services
Background, Interpretation and Benchmarks
Rationale

Indicators of wait times are of high interest to both the Canadian public and system managers, as they reflect important aspects of experiences of care and of the responsiveness of the health system. Measuring wait times provides an indication of whether Canadians are getting timely access to mental health counselling services in the community.

Many factors affect wait times, such as availability of mental health professionals, the number of people requiring counselling services, urgency of the client’s condition and client choice.

This indicator can be used to understand access to mental health care in the community and to know how jurisdictions are performing in terms of providing timely access to mental health counselling services.

Interpretation

A low number is desirable for this indicator

HSP Framework Dimension

Health System Outputs: Access to comprehensive, high-quality health services

Areas of Need

Getting Better

Targets/Benchmarks

Not applicable

References

Not applicable

Availability of Data Sources and Results
Data Sources

Provincial and territorial data collection systems

Available Data Years

Type of Year:
Fiscal
First Available Year:
2019
Last Available Year:
2019

Geographic Coverage

Newfoundland and Labrador, Prince Edward Island, New Brunswick, Nova Scotia, Saskatchewan, Alberta, British Columbia, Yukon, Northwest Territories

Reporting Level/Disaggregation

National, Province/Territory

Result Updates
Update Frequency

Every year

Indicator Results

Web Tool:
Your Health System: In Brief
URL: https://yourhealthsystem.cihi.ca/hsp/inbrief?lang=en

Updates

Not applicable

Quality Statement
Caveats and Limitations
  • Caution should be used when interpreting this data. The data comes from independent provincial and territorial systems, which have known variations in definitions. There is a commitment among jurisdictions to work toward harmonizing definitions and improving comparability of results.
  • Data coverage varies across Canada.
  • Differences in the organization, funding and availability of services and care providers will influence wait times across provinces and territories.
  • Differences across jurisdictions in terms of which clients qualify to receive publicly funded counselling services can influence wait times.
  • There is no standard urgency classification or common benchmark wait time across the country, and clients of all urgency levels have been included. Differences in the mix of acuity levels across jurisdictions may result in differences in wait times.
  • Days where the client is unavailable are included.

Jurisdiction-specific challenges

  • In Newfoundland and Labrador, the start time is the date of intake in some regions and the stop time is the date of the first appointment attended. Age was collected partway through the year in 1 of 4 regions, and data was reported by sex instead of gender. Wait time data reported is for integrated mental health and addictions services.
  • In Prince Edward Island, the stop time is the date of the first appointment attended.
  • Nova Scotia reported wait time data by sex instead of gender. Data reported includes integrated mental health and addictions services.
  • For clients in New Brunswick who are in hospital when the referral is received, the start time is the date of initial referral instead of the date of discharge from the hospital. For all clients, the stop time is the date the case was opened (i.e., assigned to a service provider). Wait times are reported by sex instead of gender and include integrated mental health and addictions services for the children and youth population.
  • In Saskatchewan, the start time in one of the larger regions is the date of intake. The data excludes subsequent new referrals for the same client in some health regions. No data was available by gender or sex. The wait time data may include walk-in services in some regions, but these are estimated to be small. Data is missing for about 35% of the population.
  • British Columbia is unable to identify whether the first service was for counselling or for other types of interventions for the adult population. The stop time is the date of the first recorded clinical note for children and youth and the date of the first clinical interaction for adults. Data is missing for 12% of the province. Wait time data includes integrated mental health and addictions services for adults. Data is recorded by sex for the adult population instead of gender. Data also includes some crisis services for the children and youth population.
  • In Yukon, the start time is the date the client agrees to receive services. Data is missing for approximately 50% of the territory because of the transition to a new electronic data collection system. There were some data quality challenges in the first 3 quarters of the fiscal year as referrals were missing key dates. Data by sex or gender is unavailable at this time.
  • For Alberta and the Northwest Territories, results are not shown due to insufficient data coverage, but they are included in the Canada value. For more information, see the 2021 Shared Health Priorities companion report.
  • No data is available at this time for Quebec, Ontario, Manitoba and Nunavut.
Trending Issues

Not applicable

Comments

This indicator belongs to the Shared Health Priorities portfolio measuring access to mental health and addictions services and to home and community care.

More information on this indicator will be available in the 2021 companion report on the Shared Health Priorities page.