Patients, colleagues push Yukon gov't to relent in contract dispute with psychiatrist

For some patients and colleagues of psychiatrist Dr. Leo Elwell, the stakes couldn't be higher.

Without his services, they say, people will die.

Elwell is the Whitehorse psychiatrist locked in a battle with the Yukon government over the way he's paid for his work. 

His clinic, Soulshine Health, works on a fee-for-service model. He wants to move to a contract with the government and says his clinic will have to close if the financial arrangements don't change.

"Patients are devastated by this and the government needs to step up and they need to do the right thing," said Syrena Oswald, who is one of those patients. 

Oswald is organizing Elwell's current and former patients to convince the Yukon government to give the psychiatrist what he's looking for.

"With the mental health crisis that we're having and the fact we're in the Yukon, it's really hard to bring people up here," Oswald said. "And there's this man who has family here and wants to be here and has helped bring other psychiatrists up here.

"I just don't understand what the problem is."

Clinical social worker Jody Studney shares patients in common with Elwell. She said he provides a critical service in the territory and has developed a good reputation among patients and colleagues alike.

"What I appreciate is he provides low-barrier service which means that he can hold space for patients that aren't able to get through the door in other clinics due to their own trauma behaviour," she said. "And I appreciate that he gets past the trauma and he sees the human in front of him."

Studney said with an eight-month waiting list for some psychiatric services already, she's worried about what happens if Elwell leaves.

"This is about life and death, and if Dr. Leo Elwell is not provided fair compensation for his clinic service, which is reasonable, and it closes in March 2024, this will certainly cause significant harm."

In November, Elwell wrote to patients warning that Soulshine could close by the end of March. In the letter, he urged patients to contact Premier Ranj Pillai and Health Minister Tracy-Anne McPhee.  

This week, Elwell's office said in a statement that the Yukon government is planning a review of psychiatric services in the territory. Elwell is scheduled to meet with health officials in late January as part of that review. 

The statement said the plan to close the clinic is now on hold until after that meeting. "We remain hopeful we will secure a contract," it said.  

Elwell's patients are angry at the way he's been treated by the government, in particular by the health minister. Speaking to reporters last month, McPhee, a lawyer by trade, called Elwell's letter to patients "disturbing" and hinted he may have violated his professional oath by urging his patients to advocate for him.

Carolyne Thompson, one of Elwell's patients and a former government employee, is outraged by McPhee's statements. 

"The politicians, especially this government, are too mired in the [health] department's business," Thompson said. "They need to govern. They need to lead."

In a written statement, McPhee said it's common to use both contracts and fee-for-service arrangements with specialists. 

"I understand and I'm concerned for the patients who are impacted by these ongoing discussions, who may be experiencing added stress and trauma," the statement reads. "I want to say to them: we hear you and we are working with Dr. Elwell to find a solution." 

Thompson, a residential school survivor, credits Elwell with literally saving her life by helping her work through issues related to abuse, violence and health problems. 

"He has kept me from offing myself," Thompson said, matter-of-factly.

"He's not fluffy. He gets to the root of it. He doesn't tell you what you want to hear. He says, 'You know what? This is what we need to do.'"