Kids face long waits to see a psychiatrist in province
`I think we're at an absolute crisis level,' doctor says of delays in care
Kariann Emerson's child has been to the emergency room 29 times in approximately three years since their mental health took a turn for the worse.
The Viscount mother said she knows the nurses at the hospital, the best counsellors to speak with, and even how long it takes for an ambulance to arrive in her rural village.
“They are such a strong person. They realize that every day,” Emerson said of her child — but the resources are lacking for kids like hers.
“You can talk all you want, but if the resources aren't there, what good is it?” she said.
Children across Saskatchewan are waiting weeks, months and even years to meet with psychiatrists who are trained to treat them.
Doctors say that the problem means young people can't get treatment until issues become emergencies.
“I think we're at an absolute crisis level,” said child psychiatrist Dr. Randy Zbuk.
Saskatchewan has tried for years to recruit more doctors like Zbuk, currently the only physician manning the child psychiatry unit at Victoria Hospital in Prince Albert.
He came to the city last year to restart the unit after one child psychiatrist retired and the other died, leaving the northern half of Saskatchewan without a single practitioner. Since he's the only doctor, he can only run the 10-bed unit at half capacity.
Zbuk estimated about 400 children and youth are waiting to see him and a team of Saskatoon psychiatrists who make trips to Prince Albert every month.
“I find that we have a whole collection of people who're interested in the well-being of kids,” Zbuk said, speaking about community organizations in Prince Albert, “but as far as what we've done on our end, it's been miserable at best in terms of providing care and shortening that gap. We are not fulfilling our obligations whatsoever.”
In Saskatoon, the Ministry of Health estimates just under 400 children and youth were waiting to see a child psychiatrist in March 2022, with an estimated wait of more than nine months.
That doesn't include private practices, the ministry said. In an unattributed statement, the government noted that people in crisis can go to an emergency room.
Emerson said she thinks there are middle steps missing for when someone is not in a state of crisis but also can't afford to wait weeks. Otherwise, the only recourse is the emergency room, where there is no guarantee of admission for a longer stay.
“I said, `In two days, we're going to be back here.' Just because you can't see it doesn't mean things are OK,” Emerson said.
“You can't measure mental health like a thermometer or an infection. You can't see it.”
Saskatoon child psychiatrist Dr. Tamara Hinz said she believes that if Prince Albert and Saskatoon were evaluated collectively, the wait time might stretch into years.
“I hate that we just have to leave problems to escalate until they sometimes become issues of life and death,” Hinz said.
Those delays also cause logistic hurdles. Hinz said youth who turn 18 while waiting to see a child psychiatrist have to reapply to a different waiting pool to see an adult one, meaning they lose their place in line.
“If a 17-year-old is referred to our list, they're not going to be seen before they turn 18. Yet the practice for most psychiatrist offices is they won't accept a referral for anyone who is not yet 18,” Hinz said.
That was one of the issues Saskatchewan Child and Youth Advocate Lisa Broda highlighted in a report this year on the province's struggling mental health system for children and youth. One of the report's recommendations was to raise the cutoff age from 18 to 25. Another was to continue work on reducing wait times.
“The bottom line is: children shouldn't have to wait weeks, months, years or never get service,” Broda said in an interview.
Broda's report did not stop at child psychiatrists. She noted many clinicians said the problems they were treating likely could have been addressed in the community through counsellors or other supports in schools.
Broda said many problems stemmed from socioeconomic issues like poverty or inadequate housing. The report included recommendations for a central children's mental health plan and an “integrated services delivery model” between different ministries and service providers.
You can't measure mental health like a thermometer or an infection. You can't see it.
Zbuk said that's a common theme in his patients, but he doesn't have the nursing staff to do the outreach needed to follow up.
“I'm happy I came. I've had so much joy. I love my job. But at some point ... if you care about what you're doing and you see this happening, and you see concrete solutions that aren't being looked at, how long can you keep it going for?”