Quality Standard Details
Obsessive-Compulsive Disorder: Care in All Settings
- Publication Date
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2020-January-01
- Status
- Published
- Topic Area
- Mental Health and Addictions
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Obsessive-compulsive disorder (OCD) is characterized by the presence of obsessions (recurrent, persistent, intrusive thoughts, urges, or images) and/or compulsions (repetitive behaviours). It is estimated that 1.6 to 2.3% of adults (1 in 50) have had OCD at some time in their life.
The disabling symptoms of OCD contribute to a poorer quality of life, not only for people with OCD, but also for their families. And OCD also contributes to the considerable economic burden that mental health and addictions have on society.
There are substantial gaps in the health care system when it comes to treating people with OCD. Clinicians do not always recognize the different ways OCD can present or know what the appropriate treatments are; this represents a knowledge gap and opportunity for education.
This quality standard addresses care for people with OCD. It applies to care for people in all settings but focuses on primary and community care. This quality standard focuses on care for adults (age 18 years and older), but it includes content that is relevant for children and adolescents. It does not address care for some disorders that are related to obsessive-compulsive disorder (e.g., body dysmorphic disorder, hoarding disorder, excoriation disorder, or trichotillomania) because these are separate disorders that require different treatment.
For information about anxiety disorders, please see Anxiety Disorders: Care in All Settings.
Quality Standard in Brief
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Quality Statement 1: Identification
People with suspected OCD are identified early using recognized screening questions and validated severity-rating scales.
Quality Statement 2: Comprehensive Assessment
People with suspected OCD, or who have had a positive screening result for OCD, receive a timely comprehensive assessment to determine whether they have OCD, the severity of their symptoms, whether they have any comorbid conditions, and whether they have any associated functional impairment.
Quality Statement 3: Support for Family
People with OCD are encouraged to involve their family during their assessment and treatment, considering individual needs and preferences. Family members are connected to available resources and supports and provided with psychoeducation that includes how to avoid accommodation behaviours.
Quality Statement 4: Stepped-Care Approach for OCD
People with OCD receive treatment that follows a stepped-care approach, providing the least intensive, most effective intervention first, based on symptom severity, level of functional impairment, and individual needs and preferences.
Quality Statement 5: Self-Help
People with OCD are informed about and supported in accessing self-help resources, such as self-help books, Internet-based educational resources, and support groups, considering their individual needs and preferences and in alignment with a stepped-care approach.
Quality Statement 6: Cognitive Behavioural Therapy for OCD
People with OCD have timely access to cognitive behavioural therapy with exposure and response prevention, considering their individual needs and preferences and in alignment with a stepped-care approach. Cognitive behavioural therapy with exposure and response prevention is delivered by a health care professional with expertise in OCD.
Quality Statement 7: OCD-Specific Pharmacological Treatment
People with moderate to severe OCD, or people who are not responding to psychological treatment, are offered a selective serotonin reuptake inhibitor (SSRI) at an OCD-specific dose and duration, considering their individual needs and preferences and in alignment with a stepped-care approach.
Quality Statement 8: Monitoring
People with OCD have their response to treatment (effectiveness and tolerability) monitored regularly over the course of treatment using validated tools in conjunction with an assessment of their clinical presentation.
Quality Statement 9: Support During Initial Treatment Response
People with OCD are informed about what to expect and supported during their initial treatment response. When initial treatment is not working, people with OCD are reassessed. They are offered other treatment options, considering their individual needs and preferences and in alignment with a stepped-care approach.
Quality Statement 10: Intensive Treatment
When psychological or pharmacological treatment is not working, or in cases of severe OCD, people are referred for intensive treatment, in alignment with a stepped-care approach.
Quality Statement 11: Relapse Prevention
People with OCD who are receiving treatment are provided with information and education about how to prevent relapse and manage symptoms if they re-emerge.
Quality Statement 12: Transitions in Care
People with OCD are given appropriate care throughout their lifespan and experience seamless transitions between services and health care professionals, including between care settings and from child and adolescent services to adult services.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
If you would like to receive these resources, please send us a message using our contact form:
- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
