An article
published in today's edition of
The Chronicle Herald:
By David Jackson, Provincial Reporter
Health Minister Maureen MacDonald [pictured] said Tuesday her department’s focus on swine flu has delayed a new deal for metro-area psychiatrists.
Half a dozen doctors were at Province House to draw attention to the department missing an Oct. 31 deadline for an agreement.
Dr. Nick Delva, the Capital district health authority’s chief of psychiatry and the head of Dalhousie medical school’s psychiatry department, said he thinks a deal could get done in a week to 10 days.
But with the biggest immunization program in provincial history underway, that’s not a time frame Ms. MacDonald is looking at.
"I think it’s pretty clear what I’m looking at in the next 10 days, and it’s not sitting down and doing collective bargaining, sadly," said Ms. MacDonald, who has been under opposition fire for the government’s handling of the H1N1 vaccine rollout.
"We will get to this issue as soon as we can, but we are dealing with a public health emergency in the province, and that’s where our focus has to be for the time being."
The psychiatrists had a memorandum of understanding with the previous government and Doctors Nova Scotia to get an agreement, called an academic funding plan, done by the end of October. The last one expired more than three years ago.
Dr. Delva said the new arrangement would add about $3 million in annual costs to about a $20-million budget. That covered 70 full-time-equivalent positions at 1,840 hours each per year, but Dr. Delva said psychiatrists have done a lot of work for free.
"We were providing far, far more hours (of) clinical work and far more hours (of) academic work than this," he said. "We did it for free for a number of years, and it was an unsustainable situation."
Aileen Brunet, a forensic psychiatrist and president of the Nova Scotia Psychiatric Association, said doctors won’t support the province’s new mental health court until an agreement is done.
The court starts sitting Thursday, with four cases scheduled. The Justice Department plans to pay for a private psychiatrist, if necessary, before an agreement is finalized. Dr. Brunet said psychiatrists would never withdraw services they are already providing, but they won’t be offering new ones until the deal is in place.
Premier Darrell Dexter said in question period that he expects a new deal to be done soon.
Liberal Leader Stephen McNeil said the Dexter government doesn’t seem to have a plan for mental health services.
"Clearly, what happened here today is the premier said one thing on the floor of the House, and the minister said something quite different outside. They’re not on the same page. Who’s telling the truth?"
Also see:Psychiatrists threaten to skip mental health court
An article
published in today's edition of
The Chronicle Herald:
Programs to help youth are in crisis, even worse for adults, doctors say
By Eva Hoare, Staff Reporter
The mental health system serving Nova Scotia’s young people is in crisis, say health care advocates who are holding a news conference in Halifax today to demand action on the province’s failing mental health program.
On average, three kids per day landed at the IWK Health Centre’s emergency department in 2008 suffering from severe mental health symptoms, and it took six to 12 months for a young person to get an initial consultation with a psychiatrist, a psychiatrist involved in the system said recently.
But those numbers could get worse if something isn’t done to recruit and retain more psychiatrists, the advocates said.
"It’s particularly acute for child psychiatry," said Dr. Aileen Brunet, a consultant to the IWK’s Youth Justice Service.
Dr. Brunet is also a forensic psychiatrist with the East Coast Forensic Hospital and president of the Nova Scotia Psychiatric Association.
About 70 full-time and 20 part-time psychiatrists, who mostly work in the Halifax Regional Municipality under an academic funding agreement with the Health Department, have been working without a contract since April 1, 2008.
Before that they were on "repeated interim agreements" — each a year in length — since 2006, said Dr. Brunet.
She’s worried a proper mental health strategy won’t be developed without a longer-term contract.
"We can’t hire new people, so we can’t reduce wait times," she said.
The picture is even worse for adults suffering from mental illness; their numbers at emergency departments double those of youth, the advocates said.
However, some good news did occur this past week when the psychiatrist group signed a memorandum of understanding with the province and a new deadline for a contract was set for this October, said Dr. Nick Delva [pictured], the head of Dalhousie University’s psychiatry department.
"I think we’d be happy with any current contract," Dr. Delva said in an interview Thursday. "The problem with us is that we’ve had no contract since April 1, 2008. We do need to keep ahead of these things and not get so far behind."
He said it’s imperative that a mental health strategy be developed for the province.
"I think mental health has been underfunded," Dr. Delva said, noting the amount set aside in Nova Scotia is lower than the national average.
More community-based mental health centres are needed. If they existed more mental health care beds could be freed up in hospitals, Dr. Delva added.
"We see a real need for a real recruitment and retention strategy for psychiatrists from the Department of Health," said Wendy Ackerley, director of resource development for Laing House.
The house helps people, aged 16-30, living with mental problems.
"Youth with mental illness have a need for support at times. Those times are very critical," she said, before adding that more systems must be put in place to help young people before they land in emergency rooms.
Andy Cox, who’s on the board of Laing House and the Mental Health Commission of Canada, added his voice to the cries for a provincial mental health strategy.
"One in five Nova Scotians experience mental illness and youth (numbers) are even greater than that," said Mr. Cox. "We have a mental health system that just needs help."
New Brunswick has followed the federal government’s lead, implementing its own plan, said Mr. Cox, also a patient advocate for the IWK’s mental health and addictions department.
A proper plan would include a campaign to destigmatize the illness among Nova Scotia’s youth, emphasizing the need to attract, retain and shorten wait times, he said.
"I would say mental health is in crisis; across the country, but especially youth mental health," Mr. Cox said.
Linda Smith, executive director of Mental Health, Children’s Services and Addiction Treatment for Nova Scotia, acknowledged the amount set aside for mental health is still low; running at about 3.5 per cent of the provincial budget. But she said spending has increased by 63 per cent over the past eight years.
"Is that enough? . . . We would always like to have more," she said in a recent interview.
Wait times are longer "than we would like," she said, but she believes that stems more from a shortage of psychologists and other mental health professionals rather than psychiatrists alone.
Also see:Politicians’ mental health ideas criticized
