A solution for the mental health therapy referral dilemma facing family doctors

According to a 2025 study by the Canadian Institute for Health Information, 41% of Canadian adults and 36% of children with a diagnosed mental health condition had mental healthcare needs that were only partially or completely unmet.Patients with concerns about anxiety, depression, ADHD, substance use, addiction and stress related to marital breakdown will often confide in their family doctor, but if a referral for counselling by a psychologist or therapist is required, some family doctors may not be much help. Some may know a provider they can refer to. Others may have little more than a few business cards in their drawer, but they probably don’t know much about the quality of care the individual offers, what they specialize in and whether they’re a good match.Alternatively, a family doctor can advise counselling but leave it to the patient to do their own research, which may mean relying on a Google search or reaching out to family or friends.Another option available to doctors is Layla, a Toronto-based company that accepts referrals from more than 1,000 family doctors and matches them to a mental health provider. Founded in 2019, Layla started off small with a roster of 10 or so therapists in Toronto and now has more than 550 fully vetted mental health clinicians rostered in Ontario, British Columbia, Alberta and Nova Scotia.According to co-founder and CEO Samer Abughannam, Layla is managing referrals for approximately 10,000 new patients per year and facilitating around 300 appointments per weekday.The mental healthcare sector has a number of issues that make it difficult to navigate, including a variation in quality and licensing from one jurisdiction to another, complained Abughannam. Layla addresses these issues first by rigorously vetting the therapists it contracts with and then by carefully matching patients based on clinical expertise, interpersonal fit and logistics.Layla performs due diligence by checking college registration, insurance and credentials, said Abughannam. “Beyond that we do a simulated consult using a patient AI agent to see how they perform in different scenarios. That’s followed by an hour-long meeting with our clinical team where we do a deep dive into their strengths and weaknesses. Typically, the process results in less than a 20% acceptance rate.”The matching of patients to therapists is equally rigorous, including an online intake form patients are required to fill out and a subsequent intake call with a Layla care co-ordinator. In addition to clinical fit, care co-ordinators consider shared lived experience, personality and style, shared cultural heritage, language and scheduling. Layla care co-ordinators stay in touch with patients, reaching out to them following the second and fourth session with a therapist to see how things are going.Using Layla for mental health referrals provides doctors with a referral destination they can trust to take good care of their patients, said Abughannam.Layla notifies referring doctors that a patient has been seen by a therapist and offers them the option of receiving progress notes if they want to stay in touch with their patient’s journey.Patients can also self-refer through Layla’s website, but Layla has a bias for working with primary care, said Abughannam. “Patients who are referred to us by primary care have a higher percentage of having only recently started developing symptoms compared to self-referred patients, so earlier intervention is a definite benefit. Referrals from doctors also help us reach populations that are typically not self-referring. As an example, older adults account for only 2% of our self-referring patients but 10% of our GP-referred population. Additionally, patients referred by their family doctor are less likely to experience early drop-off.”To keep in touch with family doctors and address the lack of CME courses on mental health, Layla sponsors 10 online CME events per year. A course in October, for example, focused on strategies to combat burnout and stress while one scheduled for Nov. 17 is on understanding the diagnostic difference between BPD and bipolar (teens). Courses are led by psychiatrists affiliated with academic hospitals and are usually well-attended by 60 to 100 doctors.To assist patients lacking extended health insurance and facing affordability barriers to care, Layla offers lower cost therapy by trainees under the supervision of a Masters-level clinician for $35 per session.While service is currently limited to four provinces where Layla has a critical mass of therapist registereds, Abughannam says there are plans to extend coverage to additional provinces in 2027.Ideally positioned to monitor trends in mental health, Layla ranks anxiety and depression as the two most common mental health conditions with ADHD increasing from the high single digits to 15% of referrals and then plateauing in 2024. Layla also reports the median age of clients increasing by approximately 10%, reflecting the growing number of Gen Xers and older adults now seeking care.

A solution for the mental health therapy referral dilemma facing family doctors

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