P.E.I. Nurses' Union calls for more transparency, review of mobile mental health teams

The president of the P.E.I. Nurses' Union is calling on the province to review its mobile mental health service and 24/7 mental health and addictions phone line. 

"We've been running with one to three RNs [registered nurses] in the program as well as the … social worker positions," Barbara Brookins said. "We just want to know what the follow-up is and who actually knows whether or not there have been RNs and social workers performing the tasks." 

The province launched the mobile mental health response service back in October 2021, contracting Medavie Health Services Inc. to operate the program. 

The service includes three mobile mental health units that respond to people in need of mental health care, as well as operating a 24-hour phone line people can call to speak to a registered nurse or social worker. 

Brookins said that under that contract, there should be six full- and part-time nursing positions and six social workers assigned to the project. 

She said many of those positions have been vacant since the program started.

Three vacant positions to fill 

The province says that as of May 26, nine of the nursing and social worker positions on the teams were filled and recruitment was underway to fill three vacant positions — two for social workers in Montague and Charlottetown and one for a nursing role in Montague.

Donna Galloway, manager of the mobile mental health program, said all staff members rotate working shifts, answering calls on the mental health phone line or going out in the mobile mental health vehicles.

Since the program began, she acknowledges the team hasn't been staffed to a full complement. 

"You're kind of stuck trying to create a new program where there isn't an abundance of people to fill those positions," she said.

Galloway started working with the mobile mental health team when it first launched in 2021. Back then, she said it was harder to recruit new staff because people were still unsure about the stability of the service.

But in the last four months, she said, interest in the program has grown.

All mobile units not on road yet

The province's contract with Medavie states there should be a mobile mental health unit stationed in each of P.E.I.'s three counties.

When the program launched in 2021, two of the units were placed in Summerside and Charlottetown. Ernie Hudson, health minister at the time, said the third would launch at a later date. 

Galloway said while all three are now operational, they're not yet all out on the road at the same time because of the staffing crunch. Two new staff members were hired this week and are being trained, so "definitely by the end of the summer we should be consistently having two — and in the fall potentially three."   

Volume not what was anticipated 

Galloway said the teams have been able to keep up with demand for services even though not all three vehicles are deployed.

"The volume is not, I think, what people had initially anticipated, partly because of how much we are able to address on the phone where people aren't wanting a visit or needing a visit," she said.

Medavie Health Services data shows more than 4,000 people have called the mental health phone line, and about 90 per cent of those were treated within their own communities without having to go to an emergency room. 

On average, Galloway said mobile teams are dispatched to treat people twice a day, adding: "We are definitely servicing the entire Island with the resources we do have."

Premier gives statistics

Speaking in the legislature on May 24, Premier Dennis King presented data on use of the service in 2022. He said more than 2,300 calls came in to the hotline, and the mobile units were dispatched 479 times — which means about 20 per cent of calls led to a mental health team visit.

Galloway confirmed that in about 80 per cent of cases, nurses and social workers are able to help clients over the phone without dispatching the vehicles. 

King also provided a breakdown of where calls came from last year. 

He said Charlottetown made up the largest number of calls at 65 per cent, followed by Summerside at 19 per cent of calls. Next was Montague, which accounted for 8 per cent of calls, followed by O'Leary at 4 per cent, Alberton at 3 per cent and Souris at 2 per cent. 

We've certainly been – myself included – in Tignish in the morning and Souris in the afternoon, so we certainly are covering the entire Island every day.— Donna Galloway

This is one of the benefits of being able to travel to where the need is, Galloway said. 

"If Montague is showing there's less volume there, we might use them to cover off in Queens County and make some adjustments as needed, she said.

"We've certainly been — myself included — in Tignish in the morning and Souris in the afternoon, so we certainly are covering the entire Island every day." 

Phone line concerns 

Brookins said she'd also like to see a review of the 24-hour mental health phone line, which is supposed to be staffed by a mental health nurse or social worker at all times. 

A Department of Health and Wellness spokesperson told CBC News the only time a nurse or social worker would not answer is if the person on duty were currently on a phone call with another client.

In that case, calls would be sent to Medacom, which provides dispatch for Island EMS, and the 911 system would take the call. If it wasn't an emergency, the nurse or social worker on shift would call the person back when they're off the phone.

"Prior to our existence, that's exactly where those calls would have gone, and they would have fielded those calls and not even had us available to them," Galloway said. 

She said this January, the program also took over operation of the Island Helpline, another phone resource for people in mental health crisis.

Galloway said that when the lines merged, the call volume doubled. The program just added and filled another social worker position and plans to post an additional nursing position to handle any overflow. 

Being able to speak directly with a person in crisis and address their concerns on the phone has made a big difference, she said.

She believes the program is meeting the needs and demands of the province "despite the staffing complement," and adds: "I think it's a fantastic program that is certainly [making] a difference for the community."

Minister open to review

The leader of P.E.I.'s Official Opposition, Hal Perry, also has concerns about the program and the fact that it hasn't yet been fully staffed.

"It's a $3 million contract, but they're not meeting their contractual obligations in this," the provincial Liberal leader told CBC News. 

In 2021, the government provided media with copies of the contract the province has entered into with Medavie Health Services Inc.

That contract shows the service would have an annual cost of nearly $3 million, with $1.7 million of that going to Health P.E.I. to pay the salaries of registered nurses, social workers and the clinical lead of the program.

According to that contract, Medavie would receive $1.2 million per year, including management fees worth $107,700 per year.

Perry said he wants to know how much of that budget has been spent — specifically on salaries for positions that have been vacant. 

CBC News requested updated information from the Department of Health and Wellness and Medavie about how much money the government has spent on the program so far, but that information wasn't provided before deadline.

Health Minister Mark McLane told CBC News he receives metrics from Medavie regularly, but he agrees it's time to take a closer look at how things are going.

"With any program, I think we should reach back to the people we serve and those that provide the service, so I think it's a very valid point," McLane said, adding: "At the two-year mark, or as we near it, it's a very valid question and something we should do."

In a statement, a spokesperson with Medavie said they "would certainly like to extend the program" and "we believe it has demonstrated great value to the province and we look forward to continuing to support Islanders."

The province's contract with Medavie also says the agency will need to provide a final report of the program by Sept. 2024, once the contract has expired.