The Epidemic within the Pandemic: The Mental Health Crisis in Northern Ontario

The Epidemic within the Pandemic: The Mental Health Crisis in Northern Ontario
The pandemic continues to amplify the critical shortage in mental health providers in Northern Ontario. Currently there is an estimated shortage of 40 psychiatrists in Northern Ontario. As the number of mental health patients surges during the pandemic, NOSM looks to innovative practice models and approaches to meet their needs. 

Well before the pandemic, the Canadian Mental Health Association reported that Northern Ontarians self-report higher rates of depression. Northern Ontarians face multiple health disparities which are increasingly acute with regards to mental health and are avoidable, yet related to systemic social inequalities and part of a legacy of a shortage of health services and health practitioners.

Also prior to the pandemic, the youth suicide rate among Indigenous populations was estimated to be six times higher than non-Indigenous populations, according to Statistics Canada—estimates that are expected to increase. An already fragile mental health picture has only worsened due to the challenges of the pandemic. Canada was already in the midst of a mental health crisis prior to COVID-19. The pandemic has both magnified and added to this crisis and highlighted how crucial mental health promotion and care are to our overall well-being.

Delivering timely, and critical mental health care with extremely limited resources requires a creative, transformative approach. St. Joseph’s Care Group (SJCG) in Thunder Bay sees an opportunity to strengthen its Collaborative Care model of practice—a “model of mental health care designed to improve access and reduce wait times for specialist mental health services. The model, which places clients at the center of their care, was developed in partnership with family physicians and local family health teams,” SJCG reports. 

Dr. Jack Haggarty, Section Chair of Psychiatry at NOSM, practises in Thunder Bay and is Senior Medical Director (Chief) of Psychiatry at St. Joseph’s Care Group. He and Drs. Katalin Gyomorey, Katie Anderson, and Paul Mulzer are consulting psychiatrists providing collaborative care at sites including Fort William Clinic, Anishnawbe Mushkiki and Norwest Clinic and several others, serving over 30 family physicians and nurse practitioners and 40,000 patients.

This Collaborative Care model in Thunder Bay and District continues to contribute to research. Past findings show that patients in Collaborative Care show significant, sustained improvement in mental and physical functioning; increased access to care and decreased demand on existing mental health services as well as reduced wait times.

According to SJCG, Collaborative Care improves access to psychiatry beginning with consultation with family physicians to ease the load on the mental health-care system while improving the ability of primary care staff to provide mental health services to their patients. Primary-care providers benefit by having timely access to consultations, direct and indirect service and education from a psychiatrist and mental health nurses. With a psychiatrist and mental health nurse working directly with family physicians, several direct pathways improve access to mental health services, including external referrals.

Early in the pandemic, SJCG was invited by the Sioux Lookout First Nations Authority to enhance its access to psychiatry through the use of OTN video links.

It’s a model that dovetails well with the pandemic response highlighted in the Northern Ontario mental health and addiction COVID-19 innovations reported by the Centre for Addiction and Mental Health (CAMH): “Northern mental health and addiction service providers built new pathways, created new service options, worked through barriers alongside community partners and found ways to maintain and build connection with clients/patients.” The increased use of virtual care paired with coordinated collaborative approaches are helping.

Dr. Zoe Michano-Furlotte, NOSM alumna (MD 2016), who is entering her final year of psychiatry residency in Thunder Bay, points out that the need for the province to ramp up increased funding and psychiatric care. There is also room to grow out-patient services and outreach to patients in rural, remote communities.

People are more isolated than ever and access to mental health services has been hindered due to lockdowns, cancelled programming, closed public buildings and staff burnout. Limited access to therapy and treatment centres has led to cases of substance withdrawal syndrome in some communities under lockdown and an increase in the number and severity of violent incidents in others. 

We are dealing with a dual pandemic, with the opioid crisis on top of COVID-19. Mental wellness teams and (addictions) treatment centres have already shifted services to virtual platforms, but the shift is hampered by poor connectivity and accessibility to technology as well as limitations in workforce capacity related to both reliable and culturally relevant services. Investments in connectivity, infrastructure, technology, sustained access to virtual care and human resources must happen more immediately. NOSM is advocating for remedies for these inequities.

Dr. Verma spoke about the rise of mental health issues during the pandemic. More support is needed in Northern Ontario. Listen to the full news item and panel discussion at CP24 News.

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