Mid-June the youngest member of the legislative assembly, Cory Deagle, challenged his own PC party’s Minister of Health, James Alyward. Mr Deagle took issue with the lopsided walk-in mental health clinic hours of service, which are concentrated in Charlottetown and Summerside.
“We deserve the same amount of hours at our mental health walk-in clinics in Kings and Prince County,” said Mr Deagle, adding mental health concerns can affect anyone at any hour of the day and rural Islanders deserve equal access to mental health care as those who live in the Island’s urban centres.
Since the clinics reopened from a shutdown caused by COVID-19, provincial walk-in mental health clinics have been offering 28 hours of service in Charlottetown, 16 hours in Summerside, six hours in O’Leary and four hours in Montague.
“The state of mental health for Islanders is paramount. We need to ensure they are served,” Mr Alyward said in the house.
Mr Alyward noted that telehealth services, virtual care and other options had been implemented throughout the pandemic for this reason.
Dr Heather Keizer, who oversees mental health and addictions services Island-wide, said the hours allotted to each walk-in clinic location are based on demand.
“The idea is really not to provide less services to Montague or O’Leary. It’s really based on the numbers. There is a lot of demand in Charlottetown,” she said, adding that 70 per cent of demand for mental health and addictions services is seen in Charlottetown.
Over the past three months, 17 patients made use of the walk-in mental health clinic in Montague which has been open Thursdays from 4 to 8 pm.
These numbers weren’t far off in 2019, when COVID-19 wasn’t a factor. April through June that year, 24 people utilized the service in Montage.
In O’Leary 30 people used the clinic during this time period in 2019 and 12 in 2020. Meanwhile 220 used the service in Charlottetown in 2019 and 130 used it this year. In Summerside 73 used the service in April through June in 2019 and 75 during the same period in 2020.
Dr Keizer said the hours were intended to compliment the regular clinic hours and be useful to seasonal workers who might not be able to make it in to a regular clinic for a first contact meeting and orientation during open hours.
“Our staff has been working very, very hard, they are fairly stretched. We need to be cautious with how we place staff. If we get seven visits in a month we need to look at that. How we can make the best use of our skilled staff and provide services to the community,” she said.
Dr Keizer explained that walk-in mental health clinics are not intended to offer urgent care or to circumvent the regular process of obtaining referrals or prescriptions.
“At that clinic we have mental health workers, we do not have a psychiatrist or a family doctor at that clinic.”
The role of the walk-in clinic is to serve as an interim for example, if someone’s therapist isn’t available the patient can talk to a health care professional. If someone isn’t sure what their next step within the mental health care system should be, walk-in clinic staff can provide orientation.
“The patient walks in, has a single appointment, is given an assessment and is helped to work through their next steps,” Dr Keizer said.
“Do they need to be referred on to get a therapist? Do they need to go to their family doctor to get a prescription for that sort of thing? So it’s really about helping the patient get some clarity about navigating the system.”
Since the Island’s health care system has implemented virtual care options, Dr Keizer is rethinking how Islanders can be best accommodated.
She said there are some elements of her practice that would be very difficult to administer through telehealth or virtual care such as diagnostic assessments. But she has been surprised by how well telehealth and virtual care options have worked over the past few months.
As for the care provided at walk-in mental health clinics being shifted completely to telehealth or virtual care, Dr Keizer chose not to comment.