To address mental health waiting lists, Quebec's Minister of Social Services, Lionel Calment, plans to expand access to psychologists at CLSCs and introduce walk-in services.
Speaking at the National Mental Health and Forensic Psychiatric Services Director's Day on Friday, Carmant reiterated his desire to expand mental health services at mental health centers and make them available by walk-in.
In an interview with The Canadian Press, Carmant said the company has a one-year plan for “areas and facilities” where it wants to launch CLSC service.
“What we want to do in government is bring services closer to our citizens' living environments and communities,” he said.
He praised the work of the Aire ouverte program, which provides mental health services to young people between the ages of 12 and 25.
Quebec has allocated $40 million to establish open air centres in each of the province's municipalities.
“We're seeing a decline in waiting lists among young people, but that's not yet the case for adults,” Carmant said. “What's missing for adults is access to walk-in services. We're going to start doing that at CLSC, and that's the next step.”
Dr Christine Grew, president of the Association of Psychologists, believes rolling out more mental health services to CLSCs is a good strategy because they are one of the first places people turn to when they are in trouble.
“CLSCs are the most accessible so redeploying people there is a great idea because the sooner they are consulted the more we can prevent things from getting worse or becoming complicated,” she said.
She believes walk-in services could also be beneficial for residents as they would allow for psychoeducation, answer patients' questions and remove barriers to accessing services.
“For example, if someone is experiencing symptoms of depression and it is treated promptly, it can prevent more severe depression.
“This means treatment takes longer, people stop working and have to visit the hospital,” Grew said. “If we could treat common illnesses sooner, people would get more out of life and be less ill.”
However, she stressed that the issue must be treated by the right person, and for that to happen, patients' needs must be properly assessed and the services they require must be provided at the CLSC.
Grew noted that 40 percent of GP consultations are for common mental health issues, and having access to CLSC psychologists could ease congestion in GP clinics. But the question is whether there are enough staff.
Shortage of psychologists in public institutions
“Obviously if you want to provide services you need staff, but I think the intention is there,” Grew said.
However, in the public network, very few psychologists work in CLSCs, with more working in “second or third line” services.
Currently, of Quebec's 9,300 psychologists, approximately 6,000 work in clinical services, of which 2,050 are part of the public network, of which 520 are part of the CLSC.
Not all CLSCs have psychologists on-site.
Calmant acknowledged that “big challenges” lie ahead.
“The new generation and the post-pandemic generation are more willing to step up for mental health issues, and I think that's a good thing,” he said. “But we need to address the increased demand for services and innovate how we deliver them.”
He noted that the government has recently expanded mental health services to include social workers, sex therapists, exercise physiologists and counselling counsellors.
Grew warned against poaching psychologists from other departments to staff the CLSC.
“Putting them more on the front line should not take away from more specialised services,” she said. “For example, putting psychologists on the front line who work with cancer patients and cardiac patients and provide the psychological therapy services that people need would be dangerous. In other words, we should not take from others and pay for others.”
The interest in private practice is primarily driven by salary and working conditions.
Grew stressed he had tried to improve pay conditions but did not comment on whether that had been enough.
She said the situation is still nowhere near comparable to the private sector.
This report was first published in French on June 21, 2024 by The Canadian Press.
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