Prince Albert’s Child and Adolescent Mental Health and Psychiatry Unit is temporarily suspending admissions for the second time since 2020 due to an ongoing struggle to recruit and retain in-demand child and adolescent psychiatrists.
The Saskatchewan Health Authority calls it a temporary pause while it tries to recruit more.
In a news release on Tuesday, he said admissions to the unit were halted on July 18 because the resignation of the area’s only child and adolescent psychiatrist takes effect this Saturday.
The health authority also apologized for any stress or anxiety this may cause and said the goal is to reopen the unit to admissions as soon as possible.
The unit previously closed admissions in June 2020 for the same reason – lack of psychiatrists.
Andrew McLetchie, SHA’s vice president of integrated northern health, told reporters Wednesday afternoon that having a child psychiatrist is not enough to handle the demands for services needed in Prince Albert and northern populations qu he serves.
“The pressure on him as the sole provider just didn’t make the job attractive and one that could be sustained,” McLetchie said of the outgoing psychiatrist.
“Being a solitary psychiatrist is a difficult thing in a community with the demands of Prince Albert.”
He said a big part of SHA’s focus now is on creating a team environment and “winning conditions” for the recruitment of multiple child and adolescent psychiatrists to Prince Albert and making the position attractive.
Currently, there are two positions in Prince Albert, but McLetchie said there is discussion about increasing that number to three.
He said the SHA is also working on a broader support structure for psychiatrists who work in Prince Albert, including more dedicated support and more integrated teams on the ground who work with psychiatrists.
Saskatchewan. now up to 20 beds
Dr. Tamara Hinz, a child and adolescent psychiatrist from Saskatoon, said these temporary closures have really impacted Saskatchewan’s overall capacity, as Prince Albert once accounted for a third of it.
She said that when there were two child psychiatrists in Prince Albert, the unit there had 10 of the province’s 30 beds. But with just one psychiatrist, it had been reduced to five beds – and the province’s overall capacity had fallen to 25 beds. From now on, it will only be 20.
The outgoing child psychiatrist from Prince Albert also had to manage after-hours calls and an outpatient clinic, she said.
“It’s really an untenable task to assume all of this on one person,” she said.
“Ideally it’s probably at least a three-person job to have a sustainable rotation of specialists to cover acute care – that is, inpatient work and after-hours crises – and all the necessary follow-up with these patients.”
“And it’s really crucial to have colleagues to consult and to be able to support each other.”
“Pretty big ripple effect”
Now that the Prince Albert unit is temporarily closed, the bulk of these patients and this work are coming to Saskatoon and will impact many areas, she said.
Hinz said that means children are waiting longer in emergency departments, waiting for a bed.
That means children who come to the emergency room for other reasons may have to wait longer because there isn’t as much room for them, she said.
She said it also affected the pediatric inpatient unit at Jim Pattison Children’s Hospital.
Think it doesn’t affect you because you don’t have a child with mental health issues? This will impact all pediatric care in Saskatoon as these children are overflowing into @PattisonKids emergencies and hospitalization units. I wish I could say we have a great contingency plan, but we don’t.
“There’s this increased pressure to maybe feel like we need to release the kids sooner than we otherwise would – or not admit the kids we would otherwise have – when we know that beds are scarce,” she said.
“So it really has a pretty big ripple effect.”
Hinz said the Prince Albert unit serves youth in northern Saskatchewan dealing with mental health issues that cannot be managed in a community setting.
She said that, like in the other two units in the province, he would most often see children with very serious mood disorders, such as major depressive disorder, who present with security problems related to thoughts. self-harm or death.
Psychotic illnesses are another common presentation – which could stem from an illness like schizophrenia or drug use, noting that meth use in Saskatchewan has “exploded”.
Crystal meth is a very common cause of really agitated states like psychosis that require specialized inpatient treatment, she said.
She also said that during the pandemic she had seen a “really unfortunate explosion” of eating disorders, which can be life-threatening and can sometimes require very long hospital stays.
Outpatients will be affected
Dr. Madhav Sarda, another child and adolescent psychiatrist based in Saskatoon, is also concerned about the decline in the total number of beds in the province with the temporary loss of the Prince Albert unit.
“Thirty was already not enough. It was already a small number. We already did not have enough beds for the number we have in the province,” he said.
“So the first thing is that there just aren’t a lot of beds for children in crisis.”
He said the result is that they will not be able to provide the support for outpatients and children who are not at immediate acute risk because they are spending more time with more acute children.
“We are stressed and cannot provide these services as we would like,” he said.
“Our list of outpatients is growing.”
The case for higher pay
McLetchie, Hinz and Sarda agree that the high demand for child psychiatrists across the country is a big challenge.
Sarda says he doesn’t know if there is a province that has as many child psychiatrists as it would like.
Asked about the potential benefit of offering more income to help with recruitment, he said a higher salary alone would not be enough, but it would help.
“If you’re competing against every other place in the country, you have to make your point,” he said. “And money can be part of that.
“You’re going to have to fight to get people here, like everywhere else in this country there’s fighting.”
As it searches for replacement child psychiatrists for Prince Albert, the SHA said two emergency mental health beds will be maintained in the city to support children and youth awaiting emergency child and adolescent hospitalization in Saskatoon. or Regina.
He also said 17- and 18-year-olds requiring hospital care will be temporarily cared for in the adult unit in Prince Albert with one-on-one support.