Sask. auditor finds mental health care demands outpace resources

Saskatchewan’s provincial auditor Judy Ferguson found that demand for mental health services in the former Prince Albert Parkland Health Region is outpacing resources.

“They’re not keeping up with the demand on a number of different fronts. I don’t have the answer for you and that is why we’re calling for that comprehensive reassessment,” Ferguson said.

Direct on the ground challenges involve access to brief and social detox centres. These short-term facilities are designed for people who need a place to sober up. From 2015 to 2017, the centre has routinely served over 3,000 clients. However, the refusal rate has grown from 570 clients to 2,510, a 44 per cent refusal rate.

The report also notes that that same time period saw a 20 per cent climb in demand for mental health outpatient services. In 2015-16, there were 49,456 visits. The next year, 2016-17, saw 60,334 visits. The report found that an unspecified number of these patients came from outside the region.

In order to better address this, Ferguson recommended establishing more care options outside Prince Albert.

Accessing a psychiatrist, both for adults and children, is shown to be a lengthy process. In 2017, 89 per cent of adults with mild to moderate illness severity levels were not able to see a psychiatrist within 30 days. People with very severe illness levels were able to see a psychiatrist within the targeted timeframe 89 per cent of the time.

For children, 80 per cent with moderate illness severity were unable to see a psychiatrist within 20 days.

“When we see 80 per cent of young people not being seen within 20 days we have a second independent officer saying that young people are literally dying on the wait list to see mental health supports,” deputy NDP leader Carla Beck said.

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On March 31, 2017 the region had three psychiatrist vacancies. Currently, a child psychiatrist is the only vacancy. Brett Enns said there have been significant recruitment challenges due to the specialized nature of the job.

Complicating matters further, a growing number of patients are missing appointments.

“Up to 39 per cent not showing up for appointments, people are waiting around. Is there a way that you can get people to those appointments to make sure that they’re coming,” Ferguson said.

The Saskatchewan Health Authority’s (SHA) executive director of primary health care northeast Brett Enns said they do call absentee patients in addition to other follow-up provisions.

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The report also recommends the SHA work with the Ministry of Social Services to help those who need it find supported living spaces.

That’s a strategy the SHA is employing not just in Prince Albert, but across the province.

“What services are out there to match the needs of the clients as they’re coming in? Not every client requires a one-to-one counselling session,” Enns said.

“In fact lots of clients would benefit and do benefit from the internet based cognitive therapy program.”

On top of the care recommendations, the auditor made a key administrative recommendation. She called for a provincial integrated mental health record system to record services provided.

“Even the file thing sounds like a knit, but it’s really not. When an individual goes for services they have to repeat their story,” Ferguson said. “If an inpatient tells their story they have to retell their story on the outpatient. That wastes precious time and resources, and it’s hard on the individual in terms of that continuity of care.”

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There are positive steps. Ferguson is encouraged by new privacy legislation that allows different branches of government to share appropriate personal information as long as there are pre-existing agreements.

Enns added that additional work is being done in the SHA on this front.

The auditor said that solving the mental health and addictions care issues can’t be solved through more money alone, and requires a societal shift. She acknowledged that the province is currently in the middle of a ten-year mental health strategy and there will be much more work to do.

“In reality, it’s going to be chipping away at this. The issue is huge and it’s not going to be solved overnight, but they need to take concrete steps to improve,” Ferguson said.

On Thursday afternoon, Enns said they were still reviewing the auditor’s recommendations. He is also hopeful some of the new $11.4 million dedicated to mental health services can help close service gaps.

In 2016-17, the former Prince Albert health region spent $13.2 million on mental health.