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Stepped mental health care and services: from self-care to psychotherapy


The Quebec Program for Mental Disorders (PQPTM) is a stepped care and services organization model. It is one of the health services offered by the health and social services network.

The PQPTM relies on a range of services, including self-care, groups, support interventions or psychotherapy. It provides access to specific mental health services offered by a multidisciplinary team.

It is for adults, teenagers and children who present symptoms of the most common mental disorders, such as an anxiety disorder or depression.

Since fall 2020, all public health and social services institutions in Quebec have offered PQPTM services. All Quebec citizens insured by the Régie de l’assurance maladie du Québec have free access to these services.

Adapted service at the right time

Of the care and services offered, self-care is easily accessible and recognized as effective when offered at the right time, in an appropriate and optimal way. These are strategies to improve the individual’s knowledge, tools and skills. The individual will then be better equipped to face difficulties and adopt a proactive role when taking steps to improve his or her quality of life and mental health. Self-care may include:

  • Information on the symptoms or disorder;
  • Suggestions for activities;
  • Lifestyle recommendations.

A person who practices self-care will be accompanied and supported by a care provider, as required.

Psychotherapy refers to the psychological treatment of a person. According to the Ordre des psychologues du Québec, psychotherapy aims to help a person change his or her attitudes, behaviour or ways of thinking or reacting so that they feel better, are able to find answers to their questions, solve problems, make choices or understand themselves better.

In Québec, a permit is required to practise psychotherapy.

In addition to self-care and psychotherapy, the PQPTM provides a framework for services offered to people with common mental health disorders. Many of the following services could meet the needs of these people:

  • Support meetings;
  • Support interventions;
  • Couple and family interventions;
  • Psychoeducation;
  • Rehabilitation;
  • Clinical follow-up;
  • Coaching.

For further information on the above services, see the Treatment and services offered section.


1. Ask for help

If you or a family member or friend are in distress or have signs and symptoms of a mental disorder, ask for help:

  • Call Info-Social 811;
  • Go to your family medicine group (FMG) or see your doctor;
  • See a care provider at a community organization, such as a crisis centre;
  • Contact a care provider you have seen before, where applicable;
  • Contact a care provider at your school or educational establishment if you are a student;
  • Go to a hospital emergency room if the situation is serious and requires immediate intervention.

See the Mental health help and support resources page to find out other resources available to you.

2. Assessment of the situation

The care provider will assess your situation. At the first appointment, you will be asked questions about:

  • Your situation and how often it happens;
  • Your lifestyle;
  • Your family and social network;
  • What you do (work, study, leisure activities, etc.);
  • Your health;
  • Your living conditions.

These questions will help the care provider understand your situation and your needs.

After the assessment, the care provider will be able to refer you to the services that best meet your needs and are the most accessible and effective for you. The care provider will then suggest various treatments to help you feel better.

3. Treatment and services offered

The stepped-care model is an approach where people receive the treatment with the greatest potential for improvement, at the lowest intensity possible. The care provider monitors treatment results and may make the decision with you to increase or decrease the intensity of the treatment or to change treatment.

Treatments include:

  • Directed self-care;
  • Support;
  • Psychoeducation;
  • Group intervention;
  • Family intervention;
  • Individual intervention using techniques from cognitive behavioural therapy;
  • Psychotherapy;
  • Rehabilitation;
  • Taking medication;
  • Treatments offered in hospital.

People consulting for mental health services will find a great deal of information to help them make informed decisions in the information document entitled Obtenir de l’aide et du soutien pour les troubles mentaux fréquents [Getting help and support for common mental disorders] (available in French only) This hyperlink will open in a new window.. This tool covers topics such as:

  • The best time to see care providers;
  • The possibility of accepting or refusing a proposed treatment;
  • The different treatments available;
  • Possible medications;
  • The length of treatment.

Note that this tool offers recommendations and does not replace a professional’s clinical judgment.

See also

Last update: June 21, 2023


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