Men­tal health wait times and so­lu­tions

The Compass - - Editorial - Pat Cullen So­cial Af­fairs

We have all heard of lengthy wait times in the prov­ince’s men­tal health ser­vices and the Trin­ity-Con­cep­tion re­gion is no ex­cep­tion.

How­ever, the num­ber of some ex­ist­ing pro­grams will be in­creased and oth­ers will be in­tro­duced to lessen these wait times, ac­cord­ing to David Kielly, pro­gram man­ager for men­tal health and ad­dic­tions with Eastern Health. Kielly says 1,000 to 1,050 peo­ple cur­rently need help in this re­gion and the health author­ity is do­ing its best to keep pace with these num­bers by adding to ex­ist­ing ser­vices and in­tro­duc­ing oth­ers.

The main of­fices of Eastern Health in this area are lo­cated at Har­bour Grace and Bay Roberts. Out­reach clin­ics are done at other sites, in­clud­ing Old Per­li­can. There are around 11 clin­i­cians, two of whom work from Bay Roberts.

Wait times have been re­duced through the in­tro­duc­tion of walk-in clin­ics where peo­ple get the help they need and leave, group-ther­apy ses­sions and new pro­grams such as the Ther­a­pist As­sisted On­line ser­vices where the client and clin­i­cian in­ter­act through com­puter or sim­i­lar tech­nol­ogy.

The in­take process has also been stream­lined with a client now find­ing out within 48 hours to which ser­vice they have been re­ferred.

The in­take per­son is a so­cial worker at Har­bour Grace who does re­fer­rals for the en­tire Trin­ity-Con­cep­tion area and de­cides,

at times with the help of other clin­i­cians, the risk level of the client and the ser­vice most ap­pro­pri­ate. So the first point of con­tact for the 1,000 or so peo­ple seek­ing men­tal health ser­vices through­out Trin­ity-Con­cep­tion is the Tay­lor Build­ing, where as­sess­ments are done. Small won­der that Kristyn Drover, a clin­i­cal psy­chol­o­gist who prac­tises there, says she and the other clin­i­cians feel taxed. “I can’t speak to other of­fices, but this of­fice alone gets about (1,000) peo­ple”, she said. “And that’s been a steady in­crease for the last five years with no in­crease in staff.” Drover has worked from the Har­bour Grace of­fice for about 10 years.

While she can­not say defini­tively what caused the in­crease, she thinks gov­ern­ment’s cam­paign of des­tigma­ti­za­tion around men­tal ill­ness about five years ago could be a fac­tor.

“They had lo­cal and prom­i­nent

celebri­ties (par­tic­i­pat­ing)” she said. “It was a won­der­ful ad (but) at the same time they didn’t put in place the re­sources for the in­flux of re­quests we were go­ing to get.”

David Kielly says wait times ex­ist be­cause of the back­log that arose be­fore new pro­grams were in­tro­duced and re­fer­rals were ris­ing.

“I think part of the wait list that you see now, you’ll con­tinue to see de­crease be­cause of the re­sponses we’ve brought in ,”he said. “It’s just that we haven’t had new pro­grams in place long enough to re­ally sort of trim down the back­log that oc­curred as things were con­tin­u­ously grow­ing.” Kielly ex­pects de­mand to re­main con­stant at roughly 1,050 next year.

At present, men­tal health and ad­dic­tion ser­vices at Eastern Health in this area, like psy­chi­a­try, are han­dled at Car­bon­ear

Gen­eral Hospi­tal. Ac­cord­ing to Drover, ur­gent cases are seen im­me­di­ately, while clients at least risk of sui­cide can wait up to 10 or 12 months to see her or a men­tal health nurse or so­cial worker (hope­fully this will de­crease as new pro­grams come on stream and walk-in clin­ics are in­creased). She would like to see money al­lo­cated to hire more clin­i­cians, but given the prov­ince’s fis­cal sit­u­a­tion, she is not op­ti­mistic.

Ado­les­cents from 12 to 18 are seen more quickly than adults, per­haps be­cause in this ag­ing pop­u­la­tion there are less of them. There is also an ado­les­cent coun­sel­lor at Har­bour Grace and youth can tap into pro­grams es­pe­cially geared to them. An email from Kielly a few weeks ago said 11 ado­les­cents were on the wait list for men­tal health ser­vices.

As to psy­chi­atric ser­vices at the lo­cal hospi­tal, it is de­bat­able as to how many psy­chi­a­trists we have. Drover puts it at two to­gether with oth­ers who may of­fer week­end clin­ics. A spokesper­son for Eastern Health said in a rather con­fus­ing email “there is cur­rently one per­ma­nent psy­chi­a­trist and one tem­po­rary locum 3/4 po­si­tion psy­chi­a­trist at Car­bon­ear Gen­eral Hospi­tal.” The email fur­ther states the health author­ity “…is cur­rently work­ing on strate­gies to im­prove wait times for men­tal health ser­vices in­clud­ing psy­chi­a­try.”

To Drover’s knowl­edge, the psy­chi­a­trist(s) presently em­ployed there are get­ting more than 600 re­fer­rals a year. A woman whose in­ter­view ap­peared in The Com­pass last month said she has been wait­ing a year to see a psy­chi­a­trist there. She suf­fers from de­pres­sion and while she is get­ting pre­scrip­tions from her fam­ily doc­tor, she also says she has “no sup­ports.” She goes on to speak of “nu­mer­ous friends and fam­ily mem­bers” but her state­ments of “no sup­ports” and “there’s days I’m lucky to get out of bed” are dis­turb­ing. If she has not al­ready seen a psy­chi­a­trist since the ar­ti­cle ap­peared both on­line and in-print in Fe­bru­ary, then her case should be given more con­sid­er­a­tion. Re­gret­tably, no psy­chi­a­trist(s) at Car­bon­ear Gen­eral would agree to an in­ter­view.

Mean­while, Bell is out there with a lot of money to give to men­tal health projects through its Let’s Talk cam­paign, so for any­one work­ing in the field that’s an op­tion-and a good one. In some cases trans­porta­tion is al­ready paid to bring peo­ple re­ceiv­ing gov­ern­ment ben­e­fits to the clin­i­cian’s of­fice. Money from that Let’s Talk cam­paign could be used to help more.

If you’re wait­ing to see a psy­chi­a­trist or ther­a­pist or just not feel­ing well, David Kielly ad­vises you to go to the walkin clinic, call or “get your doc­tor to send some­thing to our in­take worker.” His mes­sage is “Reach Out” so don’t let talk of pro­tracted wait times pre­vent you from find­ing as­sis­tance. For your sake and that of your loved ones please let them find a ser­vice to help you. The men­tal health cri­sis line is open 24 hours a day, seven days a week. Its num­ber is 1-888-737-4668.

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