Treatment Wait Times in ‘Depression Capital’ Have Now Grown to one Year

By SHELLEY PAGE, The Ottawa Citizen June 3, 2012

The Royal Ottawa Mental Health Centre has committed to cutting the wait time for mood disorder treatment in half to six months.In Ottawa, the city that’s been diagnosed as the “depression capital of Canada,” the wait time to be assessed for a mood disorder at the city’s marquee mental health treatment centre has now grown to one year.

Dr. Raj Bhatla, chief of psychiatry at the Royal Ottawa Mental Health Centre, says there is an “urgent need” to cut the 12-month waiting list for people suffering from depression, bi-polar disorder and other related conditions.

The Royal Ottawa has committed to cutting the wait time in half to six months. But without new funding and with a shortage of psychiatrists, all the centre can do is “an internal rejigging” that will “cut into the ability” of psychiatrists to provide longer-term treatment, Dr. Bhatla said in an interview.

These revelations have caused concern.

“It’s unconscionable to deny people timely access to psychiatric assessment and care,” said Bill Wilkerson, co-founder of the Global Business and Economic Roundtable on Addiction and Mental Health.

“I happen to think that Dr. Bhatla is one of the most talented, progressive psychiatrists I know of anywhere. That is a very credible source. And I think this is an honest appraisal of the situation,” Wilkerson said in an interview.

“If the leadership of the Royal Ottawa, whose heart is as big as its scientific capabilities, is conceding wait lists are a problem then I think the government of Canada, as an employer, and the province of Ontario, as a provider of services, must wake up and pay attention.”

Meanwhile, Lianna Cousins, president of the Mood Disorders Mutual Support Group of Ottawa, said many of its members are affected by a critical shortage of psychiatrists at all area hospitals, either because they can’t get in to see one, or they only receive a short appointment “to refill a prescription.”

She said their support groups, which used to be attended by “a steady 12 people,” have grown so large — about 40 people a meeting — they have to split the groups. They come from all walks of life and professions, not just the public service.

“It’s everywhere,” she said.

But Wilkerson, who dubbed Ottawa Canada’s depression capital, said he believes a large number of the people waiting for psychiatric assessment come from the ranks of the federal government, Ottawa’s largest employer.

The statistics seem to support this view. In 2010, disability claims for mental health conditions by federal public servants spiked to an all-time high. Mental health conditions, led by depression and anxiety, were responsible for 47.3 per cent of all approved disability claims in 2010, the highest percentage in the history of the disability plan.

Wilkerson said people remain off work “any where from 50- to 200-per-cent longer than they need to be” because they don’t get the care they need, when they need it.

He accused the federal minister of health, Leona Aglukkaq, of “hypocrisy” for announcing the first National Mental Health Strategy without addressing chronic problems of lack of “timely access to practicing psychiatrists.”

Last month, the Mental Heath Commission of Canada called for an overhaul of a fractured and under-funded system and insisted that spending on mental health should increase from seven to nine per cent of total health spending over 10 years to $4 billion.

Among the commission’s 109 recommendations was a call for more screening for mental-health problems and suicide risk. The commission said the majority of 4,000 Canadians who die from suicide each year were confronting a mental health illness or problem.

Dr. Bhatla, meanwhile, said the Royal Ottawa has been inundated with referrals from family doctors who want their patients assessed by a psychiatrist. But Dr. Bhatla only has seven psychiatrists available to do assessments.

He said the Royal recently surveyed family doctors to see how best to deal with the long wait time.

They are “telling us they need help,” he said, adding, “I’m quite confident that family doctors prescribe more anti-depressants than psychiatrists.”

Even if the Royal Ottawa can’t offer a patient the “full range of services,” Dr. Bhatla said “we at least owe the family doctors good consultative services so treatment can begin” — even if the treatment is managed by the referring doctor as opposed to the psychiatrist.

Dr. Bhatla said this is part of an overall increase in need in Ottawa for mental health services.

Children and youth seeking help for a mental health issue have overwhelmed the resources at the Children’s Hospital of Eastern Ontario, where more than 1,400 children and youth are on a waiting list seeking outpatient help.

The demand from adults has been growing over the past three to four years as well, Dr. Bhatla said, likely because family doctors are more tuned in to the mental health needs of their patients.

“We haven’t created a demand, we have just unveiled a demand that has been there for a long time,” Dr. Bhatla said.

He added that people on the wait list are still receiving treatment from their primary caregiver.

“They are still getting treatment and may be on medication or getting supportive counselling.”

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