Psychiatrist calls doctor shortage ‘very unsafe’
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.