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Government to increase P.E.I. psychiatry complement from 15 to 21

PC MLA James Aylward in the P.E.I. Legislature June 2019.
Health Minister James Aylward in the P.E.I. Legislature in June 2019. - Mitch MacDonald

Health Minister James Aylward has ordered the complement of psychiatrists on P.E.I. to be expanded from 15 to close to 21.

The minister announced this measure in the legislature after being asked about a backlog of over 1,000 patients who, as of May, had not seen a psychiatrist, despite being referred by a family doctor. The backlog was first reported in The Guardian on the same day.

“This headline that was in The Guardian today, it was shocking, it was unacceptable,” Aylward told the legislature.

“I’ve asked the committee on physician resource planning to look at increasing the complement of psychiatrists here on P.E.I. as much as 5.8.”

Aylward had suggested to The Guardian that the backlog was partly due to a shortage of psychiatrists, as well as a practice of incorrectly triaging patients, due to out-of-date practices.

Health P.E.I. does not know how many of these patients may have been seen by another allied health professional, such as a counsellor or psychologist. 

RECRUITING CHALLENGES

The increase in psychiatry complement may pose recruiting challenges for the Island. The current complement of 15 has not been filled for several years. Currently, only 11.7 are seeing patients, due to leaves of absence, according to Health P.E.I.

“Is your department tracking the number of psychiatric referrals that have been mis-triaged and, if so, will you share this information?” Green MLA Trish Altass asked Aylward during question period on Tuesday.

“What we’ve instructed the family physicians to do is actually go back and re-interview any referrals that they may have had to psychiatry to see where they’re at now, to see if they’ve actually successfully found services or psychiatry or otherwise and then to re-triage them,” Aylward said in response.

It remains unclear why the backlog is so high. Some have suggested family doctors are using psychiatry referrals as a catch-all for individuals who are experiencing various mental health-related issues. Psychiatrists can prescribe medication, but many may simply need access to counselling or access to a psychologist instead. 

Health professionals interviewed by The Guardian have also suggested there is often a rivalry between clinicians such as psychiatrists and other health professionals, such as psychologists, social workers or counsellors. This lack of collaboration between the professions may be playing into the backlog as much as the lack of psychiatrists.

Others said the practice of “pulling” psychiatrists to work in-patient shifts at the Queen Elizabeth Hospital, for which a shift premium is often paid, may have contributed to fewer psychiatrists tending to outpatient referrals.

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