Half of P.E.I. psychiatrist positions filled by actively working doctors, province says

Only half of P.E.I.'s psychiatrist positions are filled by actively working doctors — leaving 7.5 psychiatrists working, while the provincial complement is 15 full-time positions, according to Health PEI. 

It's greatly concerning to us to discover that our acting psychiatrists in the province have reached such a low level of numbers.— Sarah Stewart-Clark

Recent attrition, retirements and sick leaves have temporarily reduced the active doctors to 7.5, of whom 4.7 are able to provide after-hours calls to the emergency department at the Queen Elizabeth Hospital in Charlottetown said a statement on behalf of Dr. Heather Keizer, P.E.I.'s chief of mental health and addictions.

Earlier this year, Health PEI said the number of psychiatrists would be at least 11 by August. As well, Dr. Mahesh Nachnani, who was recruited from England, was supposed to be on P.E.I. by August, but Health PEI said there has been a delay and the process of him arriving has been longer than was expected.  

"This understandably creates a significant challenge in ensuring coverage for inpatient beds in Charlottetown and for ready-access to psychiatry in community," said Keizer in the statement.  

'Challenging situation'

"In response to this challenging situation, an urgent action plan is being developed by Mental Health and Addictions and the Department of Health and Wellness, alongside the ongoing diligent long term recruitment efforts of the past 12 months" said Keizer.

She said part of the province's plan going forward is to hire doctors who can mentor interns and students, and recruit them to stay on P.E.I. She said this is the first year that training Canadian psychiatrists have been recruited directly from the University of Ottawa, Dalhousie University and Memorial University.

"As a result, over the next year, two senior psychiatry trainees will be coming to P.E.I. to do community electives with a potential to settle in P.E.I. long term," said Keizer. 

She also said a submission has been made to the Physician Resource Planning Committee to add to the complement of psychiatrists on P.E.I.  

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Island Mothers Helping Mothers, which advocates for mental health resources and started the #HowManyWade campaign, believes the shortage has reached a critical level and is concerned with what the plan is if patients arrive at emergency rooms or are admitted to the psychiatric unit.

'Lost trust'

In response to hearing about the province's urgent action plan development,  Sarah Stewart-Clark, founding member and administrator for the group said she wants to see action.

"At this point, I have to say that I've lost trust in the health minister and Health PEI to manage our mental health care system. We've heard many times in the past that they have a plan and so we're tired of hearing that message without seeing the results," she said. 

"It's greatly concerning to us to discover that our acting psychiatrists in the province have reached such a low level of numbers."

Stewart-Clark, who hears many personal stories of Islanders and their mental health through her group, said the impact is that it takes longer for people to get in to see their doctors and their health deteriorates, leading some people to go to the emergency room.

"It's having a really severe impact on our population who have a mental illness, but can function very normally under the appropriate treatment," said Stewart-Clark. "I've seen time and time again where individuals are not able to see their psychiatrist when they need to because the psychiatrists who are currently here are trying to cover so much from the psychiatrists who have already left."

Focus on treatment before crises

She said it's important to have a sufficient number of psychiatrists so people can be treated before they are in crisis.

"If you think about it in terms of heart disease, it would be the same as if you were not able to see a cardiologist until you are actually having a heart attack," said Stewart-Clark.

She said the group agrees that psychiatrists are not the answer for everyone, "but the reality is we do have a proportion of our population who has a medical, serious mental illness that require the treatment of a medical psychiatrist."

"I completely agree that psychiatrists aren't the only piece of this puzzle, but they are an important piece for specific patients in the system and I'm concerned that we're at such a low level that we are now seeing both patients and public safety concerns arise from this situation," said Stewart-Clark. 

Comprehensive health care planning coming from province

Keizer and Verna Ryan, CAO of Mental Health and Addictions, will be doing a presentation to the standing committee on health and wellness next week on a comprehensive accountability action strategy for mental health and addictions for the province. 

Keizer said the focus of the mental health and addictions leadership is on comprehensive services for Islanders throughout their lives and the program will encourage cooperation between government departments, "particularly in addressing social determinants of health like stable housing, employment, food security and timely access to medical care."

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