Psy­chi­a­trist calls doc­tor short­age ‘very un­safe’

The Guardian (Charlottetown) - - FRONT PAGE - BY JIM DAY

A P.E.I. psy­chi­a­trist says the on­go­ing short­age of psy­chi­a­trists in the province is putting men­tal health pa­tients and staff at con­sid­er­able risk.

“It seems like a very un­safe sit­u­a­tion,’’ says Dr. Rob Jay, who works out of a men­tal health out­pa­tient clinic at McGill Cen­tre.

“There is noth­ing that is work­ing prop­erly in this sys­tem…we prob­a­bly need dou­ble the psy­chi­a­trists that we have.’’

Jay says the province does not have the ca­pac­ity to see peo­ple in a timely fash­ion.

As a re­sult, he notes, pa­tients are get­ting frus­trated and they are be­com­ing more ill.

Jay says last month no psy­chi­a­trist was on call for sev­eral days for the men­tal health unit at the Queen El­iz­a­beth Hos­pi­tal or Hills­bor­ough Hos­pi­tal, a psy­chi­atric fa­cil­ity in Char­lot­te­town. Jay an­tic­i­pates at least eight days this month with no psy­chi­a­trist be­ing on call.

To make mat­ters worse, Health P.E.I. is clos­ing five beds in Unit 9 at the QEH, cit­ing lim­ited psy­chi­a­try re­sources.

“We ac­tu­ally have a fair num­ber of beds, but we don’t have enough psy­chi­a­trists to cover them prop­erly,’’ says Jay.

He adds the short­age of psy­chi­a­trists also re­sults in five or 10 men­tal health pa­tients typ­i­cally stay­ing in the emer­gency depart­ment rather than in Unit 9 at the QEH, re­sult­ing in an un­de­sir­able sit­u­a­tion.

“It seems like a very un­safe sit­u­a­tion. There is noth­ing that is work­ing prop­erly in this sys­tem… we prob­a­bly need dou­ble the psy­chi­a­trists that we have.’’

Dr. Rob Jay

“It’s not re­ally care,’’ he notes. “It’s re­ally just hold­ing them un­til the beds be­come avail­able. It’s re­ally just min­i­mal care.’’

Health P.E.I. said in a state­ment that physi­cians, staff and psy­chi­a­trists are work­ing to­gether to sup­port pa­tients al­ready ad­mit­ted to Unit 9 at the QEH or who present to the hos­pi­tal’s emer­gency depart­ment and re­quire in-pa­tient men­tal health ser­vices.

“We rec­og­nize that there is a grow­ing num­ber of Is­lan­ders go­ing to our hos­pi­tals and emer­gency de­part­ments for men­tal health care,’’ said Health P.E.I.

“We con­tinue to iden­tify op­por­tu­ni­ties to im­prove ac­cess to com­mu­nity-based men­tal health ser­vices, such as walk-in clin­ics and pri­mary care providers, know­ing that this will re­duce the reliance on and vis­its to hos­pi­tal emer­gency de­part­ments.’’

Jay, who has worked as a psy­chi­a­trist on P.E.I. for 13 years, says there is al­ways a con­cern that some­one may com­mit sui­cide due to the lack of abil­ity for treat­ment to be pro­vided in a timely fash­ion.

“I have ma­jor con­cerns if some­one comes in sui­ci­dal and there is no one to see them,’’ he says.

Health P.E.I. says emer­gency de­part­ments are ex­pe­ri­enc­ing an in­crease in men­tal health pa­tients who are ex­tremely ag­gres­sive, vi­o­lent or homi­ci­dal.

Fol­low­ing a psy­chi­atric as­sess­ment, these in­di­vid­u­als may be dis­charged from hos­pi­tal to the Provin­cial Cor­rec­tional Cen­tre where, notes Health P.E.I., there are “more ap­pro­pri­ate safety and se­cu­rity re­sources in place.’’

The province’s chief of men­tal health and ad­dic­tions ser­vices had al­ready raised the alarm over emer­gency rooms in P.E.I. be­ing “ex­traor­di­nar­ily short­handed” when it comes to treat­ing pa­tients with acute men­tal ill­ness be­cause of a ma­jor short­age of psy­chi­a­trists in P.E.I.

Dr. Heather Keizer told the leg­isla­tive health com­mit­tee last month the sit­u­a­tion is “ex­tremely oner­ous” for the few psy­chi­a­trists work­ing in emer­gency rooms.

The num­ber of ac­tual full­time-equiv­a­lent (FTE) psy­chi­a­trist po­si­tions in the province’s com­ple­ment is 15 but cur­rently only 9.5 of those po­si­tions are filled and only 4.7 FTE psy­chi­a­trists are avail­able to work on­call in ERs on the Is­land.

This has led to ex­ten­sive wait times for Is­land pa­tients in need of acute men­tal health and ad­dic­tions treat­ment.

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