Demand for mental health service in Canada is climbing. So are wait times for specialists

After what her family endured, Christine Hodge says she sympathizes with Canadian families who cannot access essential medications and treatments for mental illness.

The Ottawa woman’s daughter, now 21, was diagnosed with Bipolar I disorder before the pandemic began; however, it took more than two years — and a lot of advocacy — to find a psychiatrist willing to take her on.

“This diagnosis, and all that that entails, was not able to get her a psychiatrist for over two years, which would be the bedrock of her treatment,” said Hodge. “If she wasn’t able to get there for over two years, then what the heck is available to other people who are less fortunate?”

In a Statistics Canada study released in 2021, almost one in five Canadians aged 12 and older reported that they needed some help with their mental health. About 45 per cent of respondents said they felt their needs were either unmet or only partially met.

And, according to the Canadian Institute for Health Information, wait times in some jurisdictions for community mental health counselling are longer for children and youth up to 18 years of age, compared to adults. For all ages, the average wait time across Canada is 22 days.

Even if the entire wait list was magically erased today, it wouldn’t take long for us to start falling behind again because we can’t even keep up with the ongoing demand.– Child and adolescent psychiatrist Tamara Hinz

Saskatchewan psychiatrist Dr. Tamara Hinz says the child and adolescent psychiatry waitlist in Saskatoon currently sits at more than 300 referrals, and the patient who’s been waiting the longest was referred back in January 2020.

Demand for mental health care service is up, according to Hinz, and so is the shortage of psychiatrists and psychologists, she said.

“We drive ourselves crazy sometimes trying to figure out how to reorganize or redistribute the services we provide,” Hinz said. “But at the end of the day, there’s just not enough pie there.”

“Every month we go further and further behind. We are getting more new referrals than what our practice group has the capacity to see. Even if the entire wait list was magically erased today, it wouldn’t take long for us to start falling behind again because we can’t even keep up with the ongoing demand.”

A big part of the problem, said Hinz, is that psychiatrists are covered by public funding, but psychologists typically aren’t — and the few spots that are publicly funded are snapped up quickly.

“That creates an additional backlog for our services because there are still certain parts of assessment and treatment that a psychologist can’t do compared to a psychiatrist.”

Hinz, who’s also an assistant psychiatry professor at the University of Saskatchewan, says it continually strikes her how long people are waiting to see mental health specialists and the effects that could be having on them.

“I met a teen boy who should be in Grade 11, and is enrolled in Grade 10 but not going, and has been sort of struggling with mental health symptoms and undertreated ADHD while on our waitlist for over two years.”

“We are constantly dealing with these kinds of scenarios where we look at all of this as time and opportunity wasted.”

Shortage of accessible and affordable psychologists

Dr. David Dozois says he’s advocating for Canadian psychologists to be covered under provincial and territorial health plans.

The professor of psychology at Western University says he believes mental health care should be universal, similar to physical health care.

“Psychologists are covered only as long as they’re in a government-funded hospital agency or clinic,” said Dozois. “If they’re not, then the cost of a psychologist is considered extraneous to the public health system.”

Either people pay to see psychologists with their own funds, he said, or they have an insurance plan through their employer.

Dozois says there’s a “tremendous shortage” of psychologists in Canada’s public hospital system because many are leaving for better pay in the private sector.

“There are often waiting lists, but certainly people can get to see a private practice psychologist much, much quicker than they can in the public system,” he said.

“If you have the [financial] resources, it results in an inequitable health-care system in many respects. In the public system, often people are waiting at least six months, often a year or 18 months.”

There are approximately 19,500 psychologists in Canada, according to Statistics Canada.

Unify access of mental health and addictions services

A B.C. psychiatrist says there also needs to be unification in mental health with addictions treatment in all provinces and territories.

Bill MacEwan, with Vancouver’s Downtown Community Court mental health team, said the people he sees need sites that will treat you for both, at the same time.

“If you don’t have that, they’ll never be able to help the individual at that moment they walk through the door,” he said. “You have to do what you can at that moment and then try and have a significant impact. In Ontario, I know some centres do that. There’s better systems out there. We don’t have to reinvent the wheel.”

When dealing with someone with psychosis or bipolar disorder or depression, MacEwan said the biggest obstacle is also managing their drug use and preventing them from overdosing. The two often go hand-in-hand, he said.

Hodge said her family was fortunate to eventually land a psychiatrist and get her daughter on a stabilizing mixture of medications.

She called her daughter’s psychologist in tears asking for assistance, said Hodge.

Hodge said she told him, “‘She’s about to start not coming to you because the psychological help you’re providing is not really helping all that much.'”

“He then reached out throughout his network and landed us a psychiatrist willing to take her on, based on his words. That’s what it took.”

Hodge said her family is incredibly lucky and that her daughter “dodged a bullet.”

“She’s doing so great and she’s worked really, really, really hard because she has the cornerstone of the proper drugs.”