Health care: Shortage of psychiatrists in London hits wait times for kids

By Jennifer Bieman, The London Free Press

 

Kids who need mental health services in London face a dire shortage of psychiatrists, a bottleneck critics warn could make already months-long wait times even worse.

Federal Health Minister Jane Philpott said this week youth mental health should be a priority for doctors, a huge hurdle since the governing body for Ontario doctors lists fewer than 100 child and youth psychiatrists in the entire province.

London has eight, but only two have practices outside of hospitals.

While mental health awareness has grown dramatically in recent years, fuelled partly by high-­profile campaigns encouraging people to talk, service for the youngest segment of the population can’t meet demand.

The situation is so bad, a London psychiatrist recently took to twitter to decry the shortage of specialists.

Child and youth psychiatrists are under pressure, not only by their limited numbers but also by a 43-per-cent spike in the number of children and youth seeing a psychiatrist between 2006 and 2014.

Kids who need mental health services in London face a dire shortage of psychiatrists, a bottleneck critics warn could make already months-long wait times even worse.

Federal Health Minister Jane Philpott said this week youth mental health should be a priority for doctors, a huge hurdle since the governing body for Ontario doctors lists fewer than 100 child and youth psychiatrists in the entire province.“The supply needs to improve,” said Desi Brownstone, a London psychiatrist and president of the Ontario Psychiatric Association.

“It’s a crucial time to intervene because a lot of psychiatric problems show up in childhood and adolescence.”

Brownstone said there are political and practical reasons why child and youth psychiatrists are in such short supply. It begins with the limited number of training spots in medical schools for students who want to pursue psychiatry.

“Those are decisions within med schools based on the funding that they get from the government,” he said.

“There’s competition amongst all the training programs. Psychiatry has long been neglected, there and in other ways as well.”

Psychiatrist pay is one of them. Brownstone said the profession is one of the lower-paid medical specialties.

The average gross annual pay for a psychiatrist in Canada was $255,745 in 2014-15, according to the Canadian Institute for Health Information’s national physician database.

Psychiatrist earnings are well below medical specialists such as internal medicine, dermatology, neurosurgery or gynecology and obstetrics, which all average gross pay above $400,000 a year.

It’s a reality of which medical students graduating with six-figure debts are only too aware, Brownstone said, especially since pursuing a sub-specialty like child and adolescent psychiatry also requires a year or two of extra study and another exam. Though he’s pleased the provincial government is focusing on youth mental health more, and said London is fortunate to have several services specifically for children, Brownstone said more needs to be done.

“The problems remain,” he said.

One of the problems is wait times. Ontario’s auditor general last year reported children and youth waited an average 67 days for mental health services in 2013, the last year data was available.

At more than one in five of the agencies providing service in Ontario, the average wait time was more than 100 days.

In London, Vanier Children’s Services wait times range from three months for intensive family therapy and for school-age kids, to up to eight months for children age six and younger.

Wait times for intake assessment for a mental health treatment program for 16- to 25-year-olds, the First Episode Mood and Anxiety Program, are running between eight to 10 weeks, with treatment delays up to three months.

On its website, the program says it’s facing growing numbers of youth seeking services.

“The stats are glaringly showing that children and youth mental health has been neglected,” said MPP Jeff Yurek, the Progressive Conservative health critic at Queen’s Park and the MPP for Elgin-Middlesex-London.

Despite the shortage of psychiatrists, Yurek said other things can be done to get kids needed treatment.

“We need to look at getting the supports in place,” he said. “These community-based organizations do a wonderful job if they’re able to meet the demand and we need to ensure they’re able to fulfil their mandates.”

Children’s Mental Health Ontario chief executive Kimberly Moran agrees.

Moran wants to see other health professionals — such as psychologists and social workers — deployed to work in a team with child and youth psychiatrists.

“We can redefine the role of psychiatrists to improve equitable access to mental health care,” she said.