Coordination could go a long way

Last week I talked about the difficulties that exist across Canada in accessing psychiatric services. The realities of finding a suitable psychiatric referral in a timely manner are often frustratingly difficult.

The issue has been addressed by the Mental Health Commission – which has stated a need for some system of coordinating mental health services.

Here in Kelowna, coordination could go a long way toward helping patients access the services they need without the headache.

Right now we have the hospital, the mental health centre and many private practitioners all running their own programs and offering different services to patients. Individuals in private practice – such as psychiatrists, psychologists and counsellors – do not necessarily have any affiliation with the hospital or mental health centre. Not only is there no affiliation, but there is absolutely no coordination between private practitioners and the other components.

When programs or personnel change, those of us in private practice may only hear about it from patients – there is no official communication from the institutions. Likewise, the hospital and mental health centre currently have no way of knowing what other services are going on in the community at large.

Professionals in each setting see only their own reality depending on their patient population and none has the overall picture.

When a patient needs a referral, it is up to that person and his or her family physician to learn who is accepting referrals and what the wait times will be – this takes time, which many physicians simply don’t have enough of.

A different service delivery model or an additional one may be necessary to solve this problem.

For example, a psychiatric clinic with psychiatrists, psychologists, social workers and nurses who could see patients on a walk-in basis could go a long way. At this intake clinic, staff could do an initial assessment, initiate treatment and make appropriate referrals for ongoing support. The staff positions would likely have to be salaried and ideally the clinic would be a 24/7 operation to divert psychiatric patients from the emergency room at the hospital – of course it would need to have a close working relationship with not only the ER but inpatient psychiatric services and the mental health centre.

In order for a clinic like this to be effective in delivering services efficiently, it would need a minimal amount of bureaucracy – often a challenge in government funded services. From my long experience I think the taxpayer would get more bang for the buck if the funding for this type of clinic was made available through private clinics. It cannot be done with the current fee-for-service funding because there is no way to fund the other professionals who could take some of the work load off the psychiatrist. I think that in the long run it would be much cheaper than waiting for a crisis that necessitates hospitalization, or other expensive institutional interventions.

Whether a clinic such as this or some other system to coordinate mental health services, it is clear that something needs to be done to improve things both here and in many communities.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.