The Mauricie-et-du-Centre-du-Québec Integrated University Health and Social Services Center (CIUSSS MCQ), like the entire public network, is losing its expertise in psychology and the bleeding continues. Those who remain must deal with increasingly heavy cases and the pressure to act quickly. A particularly worrying combination that doctors and their helpless patients observe.
Exasperated to the point of resigning
A psychologist with 12 years of experience in CIUSSS MCQ confided in Radio-Canada. The one we will call Julie to preserve her anonymity resigned recently. She denounces the inflexibility of her employer and practices focused on speed and not on the well-being of patients.
« Psychotherapy is not something that is done with a cane. I think the system is in a hurry: rush to get results, rush to treat people, rush to get them out too. »
Julie sees her colleagues leaving the public network one after the other, some with more than 20 years of experience. It’s because they no longer have the impression that their expertise is recognized or respected by the bosses. Often a few more sessions can make all the difference in a patient’s life, but psychologists in the public system have less and less leeway to pursue treatment or take a different approach, she says.
: “just organize yourself so that clients with eating disorders eat and then they will be referred to other services because the waiting lists are too long in psychology”.”,”text” :”I have colleagues who have been asked: “just organize yourself so that clients with eating disorders eat and then they will be referred to other services because the waiting lists are too long in psychology”.”}}”>I have colleagues who have been asked: “just organize yourself so that clients with eating disorders eat and then they will be referred to other services because the waiting lists are too long in psychology”.
A situation ethically and deontologically very difficult
for her and her colleagues.
Waiting lists are getting longer and cases are getting worse
Julie realizes that the needs are more pressing than ever and that the waiting lists are overflowing. When a patient arrives in his office, he has often waited more than a year, sometimes two years.
During this time, their symptoms worsen. The mental health problem crystallizes if the person does not have help
explains Julie, who reminds us that an eating disorder can lead to death and that people with a personality disorder can go as far as suicide.
She also notes a loss of patient confidence over time. When they finally get called, they no longer want the services.
In the circumstances, it is not surprising that the emergency room is overflowing, according to her. Unfortunately, urgency cannot work miracles.
Result : young people use more drugs, more drugs also to appease themselves
.
The region, a “mental health desert”, according to doctors
The Mauricie Federation of General Practitioners is also concerned about the non-access
to psychologists in the public network.
The president of the Federation, Dr. Pierre Martin, does not remember a single one of his patients who had access to a psychologist in the public. He describes the region as sanity desert
. He notes a chronic consumption of drugs in many patients who take them younger and younger and for longer and longer periods.
The pediatrician who practices in the Mauricie Karina Poliquin also regularly comes up against the limits of the public network, but also more and more of the waiting lists in the private sector when she tries to obtain help for her young patients.
« It’s like someone who has a broken arm: if they are told to wait two years before having an operation or a cast, that’s definitely unacceptable, but it’s a reality with which we have to juggle [dans le domaine de la santé mentale]. »
Dr. Poliquin tries to compensate by multiplying the appointments with children who suffer from mental health problems, sometimes up to twice a month. She often has no choice but to prescribe medication to soothe their suffering until they can have access to a psychologist.
Ministerial standards are respected, says the CIUSSS
Impossible to know how long you have to wait in Mauricie and Centre-du-Québec to see a psychologist in the public health network. THE CIUSSS MCQ refuses to pass on the information and talks instead about treatment programs, self-care, interdisciplinary teams and 30-day targets for service initiation.
The senior advisor for the management of the mental health and addiction program CIUSSS MCQMarie-Pierre Milot, affirms that the exodus of psychologists is a constant concern, but specifies that ministerial standards are respected.
Despite everything, thanks to the various professionals involved, such as social workers, psychoeducators, human relations officers and nurses, CIUSSS MCQwe respect the waiting times”,”text”:”at the CIUSSS MCQ, we respect the waiting times”}}”>au CIUSSS MCQwe respect the waiting timesshe insists.
The senior advisor indicates that a start of treatment is quickly offered to people who are directed to the mental health access counter to identify their problems and equip them. If there is a wait that exceeds 30 days, we relaunch them, we reassess their symptoms
argues Ms. Milot.
« It’s like a funnel principle: if we refer users who don’t need psychotherapy to other types of services, then that makes room for people who really need of psychotherapy. »
As for the positions of psychologists, they are the subject of a continuous posting, according to her. The vacancies are there, we are just waiting for people to want to take them, says Ms. Milot. That’s why we fill our vacancies with other types of professionals while waiting for psychologists.
Marie-Pierre Milot, a social worker by training, is surprised to hear Julie’s complaints. These people have the opportunity to express themselves to their manager
she says.
The person who is in the office with the psychologist is as important as the person who is on the waiting list and eager to see a psychologist.
A alarming situation everywhere
according to the Order of Psychologists of Quebec
The situation is alarming throughout the province and it compromises the quality of services to the population
insists the president of the Order of Psychologists of Quebec, Dr. Christine Grou.
In Mauricie and the Center–du-Québec, as in the other regions, about a quarter of psychologists work in the public network. According to her, they represented a third of the profession ten years ago.
Psychologists who have accumulated an average of 8 or 9 years of university studies, including a compulsory doctorate, leave the network for the private sector mainly for two reasons, namely salaries and working conditions.
« What we don’t treat often gets worse and more complex and what we don’t treat costs so much more, not just financially, humanly and socially. »
Dr. Christine Grou, psychologist and president of the Order of Psychologists of Quebec (File photo)
Photo: Order of Psychologists of Quebec
There is a limit to not allowing psychologists to continue care or to treat, she protests. It’s called the revolving door syndrome, which means they go out quickly, but they come back quickly too.
Fight to do your job
Julie, who is still on the job for a few more weeks, feels like she has to constantly fight to keep doing her job.
Before all these changes, I helped young people whose lives changed later
, she remembers. It is precisely to have the chance to see her patients evolve that she has devoted herself every day for 12 years.
She worries about the most vulnerable in society who cannot afford to go to the private sector or who have severe mental health problems.
Three times more services provided, according to the Ministry of Health
It is not easy to have a clear portrait of the waiting lists and vacant positions in the province. A compilation by the Coalition of Psychologists of the Quebec Public Network reports 123 departures in 2021-2022 in health, social services and in the education sector, i.e. 5 times more than the previous year.
By e-mail, a spokesperson for the Ministry of Health and Social Services of Quebec (MSSS) affirms that the ministry does not use data concerning the number of posts
nor the name of vacant jobs
.
He adds that in 2021-2022, three times as many people received mental health services in Quebec and underlines the exceptional work of the speakers
.
The network employs more than 2,000 psychologists and there should be 300 to 1,000 more within 5 years, according to this spokesperson.