Shortage of psychiatrists being felt in Cape Breton
Unhealthy situation in mental health resources unacceptable, says MLA
A memo outlining what local doctors and nurse practitioners should do in the face of a worsening psychiatrist shortage in Cape Breton has upset a local MLA who is demanding an immediate solution to the problem.
“This is unacceptable. Cape Breton is in desperate need for mental health care and this memo shows the centralized team in Halifax isn’t helping,” said Cape Breton Centre MLA Tammy Martin.
Dr. Warren Wilkes, executive director of medicine for the Nova Scotia Health Authority’s eastern zone, said the authority is continuing its efforts to bring more doctors to the area, adding it takes time to hire specialized medical personnel.
“I am optimistic that the numbers will increase. We’ve had a number of recruitment fairs that we’ve attended across the region and internationally and there’s been a lot of interest,” said Wilkes, adding it does take time to go through the process. “I am optimistic that the numbers will improve but it does take time.”
The memo in question was sent out on Oct. 30 to family physicians and nurse practitioners in Cape Breton by Dr. Scott Milligan, site lead, department of psychiatry for the Cape Breton site, Eastern Zone, and Dr. Faisal Rahman, chief of the Department of Psychiatry for the Eastern Zone of the Nova Scotia Health Authority.
The memo states that while local health professionals have asked for help, the island is now down to seven adult psychiatrists and one part-time child psychiatrist, down from a usual complement of 16. The memo further indicates there are 122 psychiatrists currently working in Halifax and for more pay.
Wilkes did not dispute the figures outlined in the memo.
“Well, the numbers that they’re speaking of with respect to physician supply and recruitment are correct,” said Wilkes, “and you can definitely feel some of the challenges because of the need for more physicians in the region.
“There’s always recruitment challenges in this region and across the province. There’s always physicians coming and going for various reasons. Psychiatry is one of the main priorities for recruitment across the province … we’re constantly recruiting more physicians and continually reaching out to find physicians of all specialties in trying to build up the numbers.”
For Martin, it may amount to the provincial government spending a bit more money to get what is needed now.
“I think it’s unacceptable and disgraceful,” said the MLA. “Spend that surplus budget and give us the health care that will save our lives and give us the services that we deserve.”
The doctors remaining have to cover everything including taking calls and covering inpatient consults on medical floors, the inpatient units, outpatient clinics, seniors’ mental health, the neurodevelopment clinic, consultations to Breton Ability Centre, clinics in North Sydney and Inverness and a travelling clinic to Neil’s Harbour. According to the memo, there are also pay differences for practising in a more rural area such as Cape Breton.
“We face barriers on several fronts, not least the fact that psychiatrists in Halifax earn more than their rural colleagues and they practise in a heavily resourced area. Why come to an under-serviced area only to work harder, take first call (one in seven or less) only to be paid significantly less?” the memo asks.
The memo recommends that doctors keep following and renewing prescriptions for patients seen in local clinics who are stable.
“If we do not have to follow so many stable patients, we will have more availability to see unstable patients on an urgent basis.”
If the patient becomes unstable, the doctor is asked to contact the clinic or a psychiatrist directly.
The memo also states that psychiatric services from the New Waterford and Glace Bay clinics will be moved to the Regional Hospital site although patients attending the Depot and Clozapine clinics in those noted sites will continue to be seen there. All other mental health and addiction services will still be offered at the New Waterford and Glace Bay clinics.
New psychiatric referrals and follow up will be transferred to Sydney to be shared amongst the psychiatrists there and transportation support will be available to those who need it to help ease the burden of travel for some patients.