Calgary clinic offers 'pay what you can' for clients unable to afford mental health services

With demand for mental health services growing while the economy continues to sputter, a Calgary private psychology practice is offering a pay-what-you-canoption for its patients.

Jessy Roos, executive director of Cultivate, says the economic downturn means more people are struggling and wait lists are growing, both in the publicly funded and non-profit sectors.

"There's just more people out there that need it than there is availability of spaces," she said.

So the clinic is telling its clients to pay what they can even if it's nothing.

Most Alberta psychologists charge about $200 an hour, the rate recommended by the Psychologists' Association of Alberta.

"You can find someone if you're in crisis. You can find someone for six sessions. But if you need more than that, that's really the gap we're trying to cover here, is that ongoing where you can build a relationship, you can learn the skills, you can try out the new hard things and start actually feeling better," Roos said.

Jessy Roos's husband, Joel Roos, a registered psychologist and Cultivate's clinical director, says the downturn in Alberta's economy has forced some agencies in the public and private sectors to trim mental health programs by,for example, putting new caps on the number of sessions a patient can have with a counsellor.

"People have referenced their AHS supports around mental health specifically, where they could previously see a mental health therapist or psychologist as often as they needed through their clinic. Now they were told that because they've seen someone more than six times in the last year, they're no longer eligible for service."

Roos said he has also heard anecdotally that some people in need of specialized mental health services are facing year-long wait times.

Cost can be a barrier

Charmaine Lowe, one of the firm's clients, doesn't have full-time work and has no benefits coverage. She was looking for some help with anxiety associated with the pressure of searching for a job in a new city.

"When you're already under-employed and constantly looking for work, spending $200 an hour to see a counsellor is completely out of the question. So I was really happy when I saw they had a pay-what-you-canservice," she said.

"Who can afford $800 a month to see someone once a week? That's completely inaccessible. I would not have been able to afford mental health services had it not been for 'pay what you can,'" she said.

Roos says he personally reserves 25 per cent of his schedule for pro bono and sliding scale services.

"I'm not looking to puff myself up at all or give myself an extra pat on the back about it, but I do get to feel like I'm doing something effective here," he said.

While "pay what you can" is not common in private practice, there are some other options in the city.

Two years ago, the University of Calgary's psychology department opened a clinic where supervised graduate students provide psychotherapy on a sliding scale based on self-reported household income.

Clinic director Joshua Madsen says a wide variety of services are provided, including child and adolescent psychotherapy and group anxiety counselling and, for adults, cognitive behavioural therapy for social anxiety and for depression.

"We want to fill in any perceived gaps in care in the Calgary community and we want to reach people who we feel wouldn't otherwise have access to high-quality psychological services.

The clinic is a training ground for the doctoral program in clinical psychology at the University of Calgary. The counsellors work under the supervision of registered doctoral psychologists.