People in Saskatchewan with serious mental illness do not have access to timely help.
Dozens of beds at the province’s main inpatient mental health facility in North Battleford, Saskatchewan, are not open.
The facility is supposed to have 188 open psychiatric rehabilitation beds and 96 beds available in a separate, secure wing for people charged with a crime living with mental health issues. Government data from April 1 shows that 48 of 96 correctional beds and 166 of 188 non-correctional rehabilitation beds were operational.
A Saskatchewan couple said their son, who burned down their home and was charged with arson, needed an assessment at the secure facility but was told he couldn’t get in due to shortage. They say their son who needs immediate psychiatric care is stuck in a jail on hold.
The Registered Psychiatric Nurses Association of Saskatchewan said beds are closed at the psychiatric hospital because the province cannot staff them. A spokesperson for the Saskatchewan Health Authority said it was “working with many partners to recruit staff to help open additional beds” and the numbers fluctuated from day to day.
Long waiting lists for outpatient care
Adult and adolescent patients also wait months or years in Saskatchewan for outpatient psychiatric help. These wait times can create bigger problems down the line.
“Delayed care means disease progression to a more serious level that could have been prevented,” said Dr. Doug Urness, president of the Canadian Psychiatric Association.
They also have a broader impact on patient support networks and the healthcare system, he said.
There were 120 licensed psychiatrists in Saskatchewan as of March 2021. The government funds 64.7 full-time equivalent contract positions, and the remainder are “fee-for-service physicians.”
Urness said there was no clear answer on the optimal psychiatrist-to-population ratio, but some estimates pinned it as one psychiatrist for 6,500 to 10,000 people.
He said that even if a field reaches this ratio, it will still not be enough to meet the demand, because many psychiatrists spend their time dealing with administration, education or research in addition to see patients.
The delays reverberate
The long waiting list for adults referred to psychiatrists also creates backlogs in the field of child psychiatry.
“I will continue to treat patients who are 18, sometimes 19 or 20 years old,” said Dr. Tamara Hinz, a child and adolescent psychiatrist. “Given the crisis in adult psychiatry, sometimes there just aren’t any adult psychiatrists willing to take some of these patients out of my practice, which of course affects our ability to bring in new children.”
Hinz said that further complicates the child psychiatry system, which has long faced its own long waiting lists and inability to meet demand.
“It’s extremely frustrating,” Hinz said. “To know that as a system we are failing so many children. It’s hard to think – it’s hard to know – how a child who is hurting now will have to wait 18 months before they can see someone like me. “
Hinz said children with mental health issues that go untreated can develop more complex and difficult-to-treat mental health issues as adults.
Urness said shortages of psychiatrists are widespread across Canada, and said a key way to address it is also to expand education programs, increasing training places in psychiatric programs.
The Saskatchewan Health Authority (SHA) would not coordinate an interview with the provincial head of the department of psychiatry or another member to discuss the pressures, but wrote that the SHA “recognizes the difficulties in recruiting and retaining psychiatrists in Province. The demand for psychiatrists in Canada and abroad is great. »
The SHA said there were 38 residents in the University of Saskatchewan College of Medicine’s psychiatry residency program in residency years one through five as of January 1, 2022.
He added that the Ministry of Health also provides funds to the medical school for subspecialty training in child and adolescent psychiatry. Currently, two residents obtain this sub-specialty.
Shortage of psychiatric nurses is also a ‘crisis’
Beverly Balaski, executive director of the Registered Psychiatric Nurses Association of Saskatchewan, said the North Battleford facility isn’t the only one affected by a shortage of psychiatric nurses.
She said there are at least 165 unfilled registered psychiatric nursing positions in the province. These are nurses who undergo specialized training related to mental illnesses, psychiatric emergencies, overdoses, suicidal crises and psychoses.
Balaski said these professionals can lighten the load on the mental health system. However, psychiatric nurses are retiring much faster than new people are being trained.
“The impact is a reduction or closure of services,” she said, noting the long waiting lists, the situation at North Battleford Hospital, as well as the reduction of services in small towns like Yorkton and Prince Albert. “If nothing is done and these people are allowed to retire without restocking, we simply cannot sustain the profession in the province at a time when we are going through multiple mental health crises.”
She said the shortage is expected to increase significantly over the next decade as half of current members are expected to retire.
The province recently announced the construction of a new Urgent Care Center in Regina intended to relieve some of the pressures in the city’s emergency rooms, including issues related to mental illness and addictions. The government has said psychiatric nurses will provide care at the centre.
Balaski wondered where these psychiatric nurses would come from, as the government was unable to staff the existing facilities. She said the recent government budget had increased the number of training places to 80 from 56, but that was not enough.
“We need 120 immediately, for at least three years, to get out of this crisis.”