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Canadians suffering from a major depression should be able to schedule a visit with a psychiatrist within four weeks, and not endure waits of six months or more as they do now.

Mothers suffering from postpartum mood disorder, teenagers with hypomania, and seniors who have a bout of psychosis should be entitled to equally speedy care.

That is the position laid out yesterday by the Canadian Psychiatric Association in the latest volley of a growing movement to establish maximum wait times for a host of health services.

To date, the provinces have agreed to establish maximum medically acceptable wait times in five areas: joint replacement (hips and knees), sight restoration (cataracts), cancer care, cardiac surgery and diagnostic imaging.

Dr. Donald Milliken, president of the CPA and a psychiatrist in the affective-disorders clinic at Royal Jubilee Hospital in Victoria, said prompt treatment for mental-health issues should be a an essential component of delivering good health care and a priority for governments. "The focus on access to certain types of surgical procedures has hidden the fact that access to care for the most serious psychiatric illnesses is actually much more difficult for many, many Canadians," he said.

In a position paper published in the Canadian Journal of Psychiatry, the group argues that prompt treatment is essential because of the stigma associated with mental illness, and the disabling nature of conditions such as depression, schizophrenia, panic disorder and mood disorders.

"For most of us, the worry of 'losing your mind' is the most disabling thing that can happen to us," the paper states. It establishes maximum wait times for five "sentinel" mental illnesses: psychosis, mania, hypomania, postpartum mood disorder, major depression.

According to Health Canada, more than four million Canadians are suffering from an identifiable mental illness at any given time. Only one-third of them are getting treatment.

While there are no good data on the number of patients actually waiting for psychiatric care, anecdotally, the situation appears grim.

"Most psychiatrists don't even keep wait lists because they would be too long," said Dr. Blake Woodside, chairman of the Canadian Psychiatric Association and director of the eating-disorders program at Toronto General Hospital.

Waits are longest for children, and in rural communities, particularly remote aboriginal communities.

Dr. Woodside said what is truly tragic is that delays in treatment routinely result in a worsening of a person's condition and worse outcomes -- at great cost to individuals and the health system.

"Right now, if you show up in ER suicidal, you will get care, but if you want a consultation for a serious mental-health problem, it will take many months to be seen," Dr. Woodside said.

He said it is important to bear in mind that, while people are waiting for care, patients "are often not leading productive lives -- they can't work, they can't function well, they are getting sicker."

There are about 4,000 psychiatrists and 6,000 psychologists in Canada. Family doctors also commonly treat mental illness.

In the September, 2004, health accord, the provinces vowed to establish benchmarks by the end of 2005 and achieve "meaningful reductions" in wait times by April of 2007.

Ottawa provided the provinces with $41-billion in new money, including $5-billion earmarked for wait-time reductions in the five designated areas.