Health P.E.I. has reduced the backlog of individuals waiting to see a psychiatrist by over 80 per cent, but the recent departure of two psychiatrists from Unit 9 could lengthen wait times for remaining patients.
The reduction in the waitlist occurred after a concerted effort on the part of mental health and addictions staff at Health P.E.I.
As of November, 206 patients remained of a backlog of more than 1,000 who had been referred to a psychiatrist by a physician. Last July, a Guardian story revealed over 770 of the unbooked referrals were logged at the Richmond Centre in Charlottetown while over 230 were logged at the Montague mental health walk-in clinic.
A statement by Health P.E.I. said staff has since determined 212 of the individuals no longer required an appointment with a psychiatrist. A further 670 have been re-triaged and have had an appointment booked. A further 206 remain unbooked.
But Health P.E.I. CEO Denise Lewis Fleming said the recent departures at Unit 9 could cause delays for the remaining 206 patients.
"It's going to have a short-term impact because it will make it more challenging to book out the remaining appointments," Lewis Fleming said.
Lewis-Fleming said Unit 9, a 20-bed psychiatry unit that is a cornerstone of mental health services in Charlottetown, will be staffed by a locum until Jan. 16. But, while work continues to recruit a replacement, out-patient psychiatrists may be asked to fill shifts.
"Our psychiatry group has also met and are having conversations about how they can support to ensure in-patient service continues on Unit 9, at least in a short-term basis. So that care is available for patients," Lewis Fleming said.
Lewis Fleming added telepsychiatry services will be available to patients seeking mental health care.
According to internal documents obtained by The Guardian through a Freedom of Information request, the backlog of 1,088 unbooked referrals had accumulated with no standardized plan or process for assigning to a physician.
The backlog was highlighted as early as March 12, 2019, in a report by Health P.E.I.’s ethics committee. The report noted access to psychiatric services varied across P.E.I.
“Some sites are reviewing/triaging the referrals and offering mental health services while others are storing the referrals awaiting the provision of psychiatry services,” the report noted.
“Some staff are experiencing moral distress as they are aware of the referral and are concerned for the well being of the client and family.”
In a May letter circulated to physicians, Dr. Heather Keizer, P.E.I.’s chief of mental health and addictions services, said coverage of in-patient shifts at hospitals like QEH by out-patient psychiatrists has not improved wait times.
“This circumstance has been exacerbated, over time, by a former practice of ‘pulling’ the outpatient psychiatrists to cover the inpatient units on a regular basis,” Keizer wrote.
In May, Health P.E.I. contracted a health-care consultant to manage the backlog and follow-up with referring physicians. The process for referrals was revamped, removing other mental health professionals such as psychologists, social workers or nurses from the process.
All adult and child referrals for a booking with a psychiatrist now bypass the Richmond Centre and go to the Department of Psychiatry at the Hillsborough Hospital.
Appointments will then be assigned by Keizer and sent back to the Richmond Centre for booking.
Lewis-Fleming noted the new referral process is no different than practices used for referrals to other specialists.
She said exit interviews are planned with “a number of psychiatrists that have left over the past year” in order to determine why they left and how retention can be improved.