Lakeshore General Hospital patient still awaits psychiatric follow-up 13 months after discharge

Thirteen months after a serious mental health relapse put her in hospital for an extended stay, a Rosemère, Que., woman is still waiting for a psychiatric follow-up and is getting the runaround over where to turn for care.

"It's like living with a time bomb," says Janet. CBC News is withholding her full name to protect her privacy.

Janet's story is all too common, says a Montreal advocate for people living with mental illness: long wait times to initially see a psychiatrist or to get follow-up care are chronic complaints.

Janet, 58, who was diagnosed with bipolar disorder 30 years ago, can spot the warning signs when she's on the brink of a relapse. So when she found herself struggling with anxiety and insomnia and consumed by negative thoughts in the summer of 2016, she knew she needed help.

She contacted her psychiatrist in Sainte-Thérèse, suspecting her medication had to be adjusted. She was shocked to discover her file had been closed because it had been inactive for more than six months.

She needed a new psychiatric referral, but her family doctor was away on medical leave.

Full-blown crisis

It took Janet three months to get a new family doctor, who tinkered with her medications and prescribed a leave from work.

However, by then, she says, she'd fallen into such a deep depression that she went into a "vegetable state."

There has to be more options than the psych ward.

Desperately worried, her daughter took her to the Lakeshore General Hospital in Montreal's West Island, where she ended up on the psychiatric ward for three and a half weeks in December 2016.

She thinks her relapse and hospitalization could have been avoided, had she been able to see a psychiatrist as soon as she started to feel unwell.

"There has to be more options than the psych ward," she said.

Yet even after that costly hospitalization, five months after she felt the first warning signs of a relapse, she is still falling between the cracks.

No timely follow-up

When she was released from the Lakeshore, the woman was told her follow-up care would be provided by a psychiatrist at her local community health clinic, the CSSS de Thérèse-De Blainville.

That didn't happen.

Instead, the CSSS offered 12 weeks of group therapy, which she said was inappropriate given her fragile condition.

"I was too weak," she said. "I was just starting to walk again and function a little better."

She said she needed one-on-one care from a psychiatrist, to make sure her recovery was on track.

Months went by without an appointment. When she called to find out what was taking so long, she was told the clinic's psychiatrists only accepted one or two new patients a month and had long waiting lists.

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Finally, last July, an opening came up, but she was out of town and missed the call. By the time she got the message and phoned back, the spot had been filled.

She was back on the waiting list.

It's now been more than a year since her release from the Lakeshore, and she still hasn't seen a psychiatrist. She doesn't even know if she should still be taking the medication prescribed to her 13 months ago.

"It's infuriating," she said. "You feel frustrated. You want to get help."

Average wait 6 months

The CISSS des Laurentides, the regional health authority that manages her clinic, says it can't comment on her case.

However, it acknowledges the average wait to be seen by someone at its outpatient psychiatric clinic is about six months.

Janet's experience is, unfortunately, not unique, says Alice Charasse, the executive director of RACOR, a network of alternative and community mental health organizations on the island of Montreal.

Long wait times to both see a psychiatrist or get follow-up care are common complaints, Charasse said.

It's almost like the government assumes once a crisis is over, they can be out of the system.- Alice Charasse, executive director of RACOR 

Unlike a broken foot or a short-term illness, Charasse says, mental illness doesn't follow such a predictable trajectory. People can be stable for years and then have a crisis. 

Due to that unpredictability, Charasse says the system has to be able to respond immediately — and not wait for people to become so ill that they end up in hospital.

"It's almost like the government assumes once a crisis is over, they can be out of the system," said Charasse. "We know that many patients will have multiple episodes during their life time."

'No patient can be denied follow-up': CIUSSS

CBC contacted the Montreal West Island CIUSSS, the regional health care agency which administers the Lakeshore Hospital, to find out how psychiatric patients released from the hospital can get follow-up care.

The regional agency said anyone can get a follow-up: they just have to phone to make an appointment.

This was news Janet, who then called the Lakeshore — and got a completely different answer. She tried to reach the psychiatrist who had treated her during her hospital stay, but that doctor's secretary told her that her file had been closed.

She suggested Janet go to the emergency room in Saint-Eustache, which is the regional hospital closest to her home.

After Janet was turned away for follow-up care by the Lakeshore Hospital a second time, CBC checked back with the regional health agency, as well as the provincial Health Ministry.

"No patient can be denied a follow-up," said a spokesperson for the CIUSSS.

The ministry confirmed that, indeed, patients have the right to choose where to go to receive care, anywhere in the province.

Shortly after our inquiries, Janet got a new call from the Lakeshore, informing her she has an appointment with the head of psychiatry there next week.

Janet is relieved she'll finally have her medication reviewed, but she says she never should have been denied access to psychiatric care — not when she needed it as she started to relapse, and not when she needed follow-up care.

What she's needed all along, she says, is to be heard, "not feeling that you're left out, and that you're not important." 

"My life means something. It means something to me."​

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