PEI struggling to recruit psychiatrists

Suicidal patients could be turned away from the emergency room without receiving treatment due to the province’s psychiatrist shortage, says P.E.I’s chief of mental health and addictions.

Heather Keizer spoke to the standing committee for health and wellness Oct. 3 about the government’s plan to get back to a full complement of 15 psychiatrists. There are 9.5 full-time equivalent working on the Island now.

“It’s conceivable” a suicidal patient could be discharged from the ER without seeing a psychiatrist, Keizer said.

“We should have 15 psychiatrists on call in our emergency room. We have 4.7.”

That means there are now ER shifts with no psychiatric coverage. In the meantime, video conference sessions with off-Island psychiatrists are being used and ER physicians are “well-trained” in suicide risk assessments, Keizer said.

Mental health advocate Sarah Stewart-Clark said she was “very startled” to learn the extent of the shortage.

“I think we’ve all been working from this number (11) that was provided by the province.”

Part of the problem is, during past shortages, the province hired some psychiatrists who were less than suitable, Keizer said.

“Those who have exited have done so in response to a performance review.”

The province has been very accommodating to potential candidates, Henderson said, but that isn’t enough when contending with larger jurisdictions for psychiatrists, he added.

“We have to be more competitive than we are.”

Keizer has been busy interviewing candidates to fill P.E.I.’s recommended complement of 15 psychiatrists, with a focus on Canadian schools.

Committee chair Jordan Brown suggested the government should reach out to Islanders during their first four years of medical school and persuade them to specialize in psychiatry.

Visa issues have delayed the arrival of psychiatrist Dr. Mahesh Nachnani. Henderson told The Guardian on Sept. 3 Nachnani had already been practising on P.E.I. for two weeks.

When she worked in a similar-sized jurisdiction in Ontario, the region had six psychiatrists for a population of 150,000, Keizer said.

“The burden of illness was less. Since I moved here, I’ve seen more severe, more illness, more regularly.”

Mental health expert Todd Leader, who is consulting with Health P.E.I., said he used a work-around situation during a shortage in the South Shore Health Authority in Nova Scotia.

Psychiatrists spent some time each week taking consultation calls from family doctors to allow them to make informed medication decisions.

“It worked great and the doctors’ competence increased over time while we kept working on the psychiatry recruitment challenge.”

Although she approves of the suggested solutions, Stewart-Clark said it will take more than words to restore faith in the provincial government and its handling of mental health. 

“I think, after the past year, people have lost trust in our health minister and in Health P.E.I. to manage our mental health system. That trust has to be built back up and it can only be built back up by action.”