Mental health wait times missing targets in P.E.I.
Emergency cases waited average of 48.8 days to see psychiatrist in 2016-17
Wait times for some mental health services in P.E.I. far exceed the targets, according to the most recent data provided by Health PEI. The numbers reflect the 2016-17 fiscal year.
"It's a work in progress. We'd like that to be better. No one should have to wait for services they really, really need — but, real life being what it is, sometimes it takes longer than any of us would like to get appointment times set up," said Bruce Davison, manager of Community Mental Health and Addictions West.
There's no secret that we'd like to be doing better.— Bruce Davison, Community Mental Health and Addictions West
Community Mental Health and Addictions provides front-line service for mental health issues, including counselling.
According to Health PEI, the most common reasons people are referred to Community Mental Health are depression, anxiety, bipolar disorder and trauma.
In 2016-17 Community Mental Health patients classified as emergency waited an average of 22.5 days to receive service while those classified as urgent waited 44.6 days and those classified as semi-urgent waited an average of 53 days.
Davison said the goal is for emergency cases to be seen within a day, urgent cases within a week, and semi-urgent cases within a month.
In 2016-17, both urgent and semi-urgent wait times were down compared to the previous two years.
Wait times 'frustrating' when need is urgent
Sarah Stewart-Clark, founder of the #HowManyWade campaign for better mental health services, said she's heard many stories of "frustrating wait times."
"When somebody has finally come forward to admit that they need help, it's typically not at the beginning of their mental health journey, it's very far along, so they really are at a point where they need help immediately," she said.
She said for many people, the support falls to their family or the community while they are waiting for help, and that she hears from many families who are experiencing burnout as a result.
She also believes that decreasing wait times would be more cost effective for the province.
"What I see in long wait times is that individuals' mental health decreases, so they end up deeper and deeper in crisis so by the time they are eventually seen they are in the phase of their mental illness that is most costly for the province to treat," she said.
Working to reduce waits
Davison said Community Mental Health has been reviewing its workflow, as well as which services could be effectively provided elsewhere, in an effort to cut down the length of time people have to wait.
Davison says for example, Community Mental Health has been partnering with family doctors and nurse practitioners to have them deliver some mental health services directly to patients.
According to Health PEI, 2,695 mental health visits took place in family doctors' offices in 2016-17.
Other initiatives include mental health walk-in clinics, which allow people to see a counsellor for a one-time session with no wait, and the student well-being teams, which are based in two families of schools to deliver mental health services to students.
In 2017, there were 466 visits to the mental health walk-in clinics. In 2016-17 there were 101 active clients on the student well-being teams.
"I think, system-wide we're looking at how we can best work together, how we can best be accessible to people for services, and it's a work in progress, and it's about making any door in our system that somebody enters the right door," he said.
Psychiatry wait times down, but still too high
The average wait times for a patient to see a psychiatrist for mental health reasons also exceeded benchmarks.
The numbers, which do not include patients who see a psychiatrist as part of a visit to an emergency room, show patients classified as an emergency situation waiting an average of 48.8 days in 2016-17. Urgent cases waited an average of 52.9 days, and semi-urgent cases waited 59.4 days on average.
The Canadian Psychiatric Association's recommended benchmarks vary by illness, but are generally within a day for emergent cases, within one or two weeks for urgent cases, and within 28 days for scheduled cases.
"There's no secret that we'd like to be doing better on those," said Davison of P.E.I.'s wait times to see a psychiatrist. "We'd rather nobody have to wait for service longer than they're comfortable waiting, but I think in terms of why — there's been no secret that that our compliment of psychiatrists has been down."
'We're learning to work better with the resources we have'
Wait times in some categories were down slightly in 2016-17 compared to the two previous years, and Davison is hopeful that now that Health PEI has brought on more psychiatrists, those wait times will continue to decrease.
"The encouraging thing about the numbers ... is that most of that predates the last round of hiring, so my hope is — and my explanation for at least some of that — is that we're learning to work better with the resources we have," he said.
That could include, he said, triaging patients to ensure those who are referred to psychiatry are the ones who need it most.
Hospital admissions down, community referrals up
Another trend shown in the data provided by Health PEI is that while hospital admissions have decreased over the last ten years, referrals to Community Mental Health have gone up.
Davison said the two may be linked — that more people are seeking earlier intervention through Community Mental Health, with that reducing the number of hospital admissions.
He said he believes people are more willing to seek help for mental health at an earlier stage and Community Mental Health services are becoming more accessible.
The most common reasons for hospital admission have been fairly consistent over the past decade, and include a depressive episode, a stress reaction or adjustment disorder, bipolar disorder, anxiety disorder and psychoactive substance use dependence syndrome.
Davison said many of these can benefit by early intervention.
"One of the things that jumps out for me is that it speaks to the importance of intervention at the earliest point as possible," he said.
"We all have crises and somebody may need to go to [the emergency department] to be assessed for risk of harming themselves, but a lot of that work, a lot of that support can be delivered in our agencies, or in other places."
This story is part of an ongoing series CBC P.E.I. is doing on mental health services in the province. You can share your experiences with us here.
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