The Quebec Program for Mental Disorders (PQPTM) is meant to be a mental health service transformation based on the stepped care model and is aimed at people with symptoms of the most common mental disorders. Its goal is to promote access to the right service, at the right time, by providers with the right expertise. To better guide individuals to the most effective treatments, the PQPTM provides recommendations from expert committees based on the best available scientific evidence, which is the first of the three pillars of the program (link in French only). Another pillar of the PQPTM is the training and clinical support that is available to mental health providers to promote the diversity of recommended treatments at each step of the program.
The continuous clinical measurement is the element that completes the core principles of the PQPTM. This approach relies on scientifically supported questionnaires, which are filled by service users, and allow providers to determine if current treatments are beneficial. This allows for quicker adjustments when necessary. For comparison purposes, it is a bit like in physical health where a doctor measures a person’s blood pressure at each visit to see if a prescription for antihypertensive medication is effective.
The PQPTM is an adaptation of the Improving Access to Psychological Therapies program (IAPT), whose experience over the past 14 years in England has shown that telehealth solutions for continuous clinical measurement should be favored in order to offer the service user the possibility of filling out questionnaires electronically. This has the advantages of avoiding transcription, facilitating data analysis by the providers and maximizing the clinical time offered directly to the person.
A successful first experience in the Outaouais
To achieve this goal, the PQPTM is benefiting from the Virtual Care Platform (VCP), a technological tool developed for the Ministry of Health and Social Services. It is a user-friendly web platform that was tested in the general social services of CLSCs in the Outaouais region during the summer and fall of 2022. The encouraging results now make it possible to gradually extend the deployment of the PQPTM VCP assessment questionnaires to all institutions in the province starting in January 2023.
A mental health professional from the CISSS de l’Outaouais speaks about this experience:
Since the Virtual Care Platform was introduced, we have been able to register a person and send an e-mail invitation so that he or she can fill out their questionnaires online. When the user submits his or her questionnaire, I receive an email notification and I can look at the results. I usually have apprehensions about computers, but using the VCP is easy and has greatly facilitated the use of the PQPTM questionnaires.
Another provider from the Outaouais region notes the benefits for people who use this service:
Having the possibility of filling out the questionnaires at home, at a time when the person is feeling most comfortable, allows him or her to take the time to reflect on the evolution of his or her symptoms, for example, by distinguishing between depressive symptoms and anxiety symptoms. Furthermore, having a standardized and objective tool to follow one’s condition is part of the good comments I receive.
A stepped deployment
The PQPTM currently uses a VCP functionality that allows the person to fill out questionnaires at home prior to his or her appointments with the provider. Eventually, the platform will also allow for real-time virtual care, a “patient” portal as well as tools to manage a person’s trajectory through the PQPTM stepped care. Other medical specialties will be added to mental health to complete the virtual care offer throughout Quebec. It is important to note that Teledermatology is the first provincial service to be deployed with the VCP since the spring of 2022.
Mental health workers concerned by this service will be able to consult the “Soins virtuels en santé mentale” page, soon to be available on the Réseau québécois de la télésanté portal (telesantequebec.ca/en/). Communications are planned for the managers of the clinical teams involved. Professionals will therefore be notified in a timely manner when this modality becomes available to them. Training sessions are also planned in order to help them become familiar with the VCP and its functionalities.
To learn more about the Quebec Program for Mental Disorders (PQPTM), visit the following page on the Quebec.ca government website: Stepped mental health care and services: from self-care to psychotherapy.