Cross Country Record1:53:00FULL EPISODE: How accessible are mental health services in Canada?
After what her family has endured, Christine Hodge says she sympathizes with Canadian families who do not have access to essential medication and treatment for mental illness.
The Ottawa woman’s daughter, now 21, was diagnosed with bipolar I disorder before the pandemic began; however, it took more than two years – and a lot of advocacy – to find a psychiatrist willing to take her.
“This diagnosis, and all that it entails, made it impossible to find him a psychiatrist for over two years, which would be the basis of his treatment,” Hodge said. “If she hasn’t been able to go for more than two years, then what is available for others less fortunate?”
In a Statistics Canada study released in 2021, nearly one in five Canadians aged 12 and older said they needed help with their mental health. About 45 percent of respondents said they felt their needs were unmet or only partially met.
And, according to the Canadian Institute for Health Information, wait times in some jurisdictions for community mental health counseling are longer for children and youth up to age 18, compared to adults. For all ages, the average wait time in Canada is 22 days.
Even if the entire waiting list was magically cleared today, it wouldn’t take long for us to fall back behind because we can’t even keep up with the continued demand.– Tamara Hinz, child and adolescent psychiatrist
Saskatchewan psychiatrist Dr. Tamara Hinz says the child and adolescent psychiatry waiting list in Saskatoon currently has more than 300 referrals, and the longest-waiting patient was discharged in January 2020.
Demand for mental health care services is on the rise, according to Hinz, as is the shortage of psychiatrists and psychologists, she said.
“We drive ourselves crazy sometimes trying to figure out how to reorganize or redistribute the services we provide,” Hinz said. “But at the end of the day, there just isn’t enough pie there.”
“Every month we are falling further and further behind. We are getting more new referrals than our practice group has the capacity to see. not long for us to start falling behind again because we can’t even meet the current demand.”
A big part of the problem, Hinz said, is that psychiatrists are covered by state funding, but psychologists generally aren’t — and the few state-funded positions are quickly taken.
“It creates an additional backlog for our services because there are still some parts of the assessment and treatment that a psychologist cannot do compared to a psychiatrist.”
Hinz, who is also an assistant professor of psychiatry at the University of Saskatchewan, says it continually strikes her how long people wait to see mental health specialists and the effects it might have on them.
“I met a teenager who should be in 11th grade, and is enrolled in 10th grade but isn’t going, and is sort of suffering from mental health symptoms and undertreated ADHD while he had been on our waiting list for over two years.”
“We are constantly faced with these kinds of scenarios where we see it all as a waste of time and opportunity.”
Shortage of accessible and affordable psychologists
Dr. David Dozois says he advocates for Canadian psychologists to be covered by provincial and territorial health insurance plans.
The psychology professor at Western University says he believes mental health care should be universal, like physical health care.
“Psychologists are only covered as long as they are in a government-funded hospital agency or clinic,” Dozois said. “If not, the cost of a psychologist is considered extraneous to the public health system.”
Either people pay to see psychologists with their own funds, he said, or they have an insurance plan through their employer.
Dozois says there is a “huge shortage” of psychologists in Canada’s public hospital system because many are leaving for better pay in the private sector.
“There are often waiting lists, but people can certainly see a psychologist in private practice much, much faster than they can in the public system,” he said.
“If you have the [financial] resources, the result is a health care system that is inequitable in many ways. In the public system, often people wait at least six months, often a year or 18 months. »
There are approximately 19,500 psychologists in Canada, according to Statistics Canada.
Unifying Access to Mental Health and Addictions Services
A BC psychiatrist says there also needs to be a unification of mental health with addictions treatment in all provinces and territories.
Bill MacEwan of the Downtown Vancouver Community Court Mental Health Team said the people he sees need sites that will treat you for both, at the same time.
“If you don’t have that, they’ll never be able to help the person the moment they walk through the door,” he said. “You have to do what you can in that moment and then try to make a meaningful impact. In Ontario, I know some centers do that. There are better systems. We don’t have to reinvent the wheel. “
When it comes to someone with psychosis, bipolar disorder or depression, MacEwan said the biggest hurdle is also managing their drug use and preventing them from overdosing. The two often go hand in hand, he says.
Hodge said her family was lucky enough to find a psychiatrist and put her daughter on a stabilizing mixture of drugs.
She called her daughter’s psychologist in tears asking for help, Hodge said.
Hodge said she told him, “‘She’s about to stop coming to you because the psychological help you’re giving her isn’t really helping much.'”
“He then contacted his entire network and found us a psychiatrist willing to take her, based on his words. That’s what it took.”
Hodge said her family was incredibly lucky and her daughter “dodged a bullet”.
“She’s doing so well and she’s been working really, really, really hard because she has the cornerstone of proper medication.”