Washington D.C, Aug. 22 : A recent study has revealed that access to psychiatric care has not seen any significant improvement despite increasing the supply of psychiatrists in Canada.
The study conducted by the Centre for Addiction and Mental Health and the Institute for Clinical Evaluative Sciences found the demand for services continues to outpace supply despite a 17 percent increase in the number of practicing psychiatrists between 2003 and 2013.
Paul Kurdyak, the lead author, said: "When it comes to psychiatric care in Ontario, we cannot maintain the status quo." Adding, "We know our system isn't meeting existing demand.
We need to rethink how psychiatrists can integrate more efficiently within the broader mental health care system to provide better access to care." The researchers evaluated changes in demographic, geographic and practice patterns of all clinically active psychiatrists between 2003 and 2013.
In particular, the study identified two emerging demographic trends that the authors say will lead to further mental health care shortages if nothing is done to radically change how psychiatrists in Ontario practice.
Firstly, many psychiatrists operating in rural areas of the province are nearing retirement. "This is worrisome because these older practitioners are seeing high volumes of patients in areas with very low psychiatrist supply, and few younger psychiatrists are moving to these areas," said Kurdyak, who also noted that the regional per capita distribution of psychiatrists is troubling.
"For example, the Toronto Central Local Health Integration Network (LHIN) has the highest number of psychiatrists, at 61 psychiatrists per 100,000 people compared to just 4 per 100,000 in the Central West LHIN - a 15-fold difference.
So what happens when these rural psychiatrists retire?" he pointed. Second, the data showed that more women have entered the field of psychiatry in the last decade, and they attend their patients more frequently.
The researchers highlighted this finding is a hint towards the need for more thoughtful planning and policy development.
"Having more female psychiatrists in the system is a welcome change, correcting the imbalance of male psychiatrists in the Ontario workforce," said Kurdyak.
Adding, "The key is to look at these demographic trends in the context of the growing gap between the number of patients who need care and the capacity of all psychiatrists to help meet that need." The current research, however, did not evaluate the quality of care provided or patient outcomes.
"We have an opportunity here to rethink the entire system. Instead of simply calling for more psychiatrists, we need to redefine the role of all psychiatrists with a view to maximizing equitable access to evidence-based mental health care," said Kurdyak.
The authors point to other publicly-funded jurisdictions such as the United Kingdom and Australia that have successfully improved access to care by integrating the services of psychologists and social workers into publicly funded systems to provide evidence-based therapy, with psychiatrists adopting the role of specialist consultants.
"The bottom line is that without major changes in how we practice, patients' ability to access psychiatric care in Ontario will not improve," added Kurdyak.
The study was published in the Canadian Journal of Psychiatry..