Saskatchewan’s “gateway to the north” has no more working child psychiatrists, a fact which raises concerns about patient care in a region that already struggles to access mental health services. Prince Albert lost its only two psychiatrists trained to treat children and youth in the past year after Dr. Mohammed Hussain died of a heart attack in October at age 79. Former Victoria Hospital Chief of Staff Dr. Louis Poulin worked alongside Hussain for 30 years. According to Poulin, Hussain took on difficult child psychiatry cases from around the province and Alberta, never complaining of his heavy workload. The only other child and youth psychiatrist working in Prince Albert, Dr. James Holmlund, retired late this spring resulting in the temporary closure of Victoria Hospital’s inpatient unit. Until the Saskatchewan Health Authority can recruit new child psychiatrists to practice in Prince Albert, children and youth needing inpatient care are being sent to Saskatoon. Prince Albert serves as a “hub” for a large part of the province’s north, where a series of reports over the past decade have frequently flagged issues accessing timely mental health support.
“And as soon as possible, we need a plan to reopen that unit. Families are stressed and kids are far from home. Patients are waiting too long in the ER and there is pressure to discharge them too soon. Our kids deserve better,” said Dr. Tamara Hinz, a Saskatoon child psychiatrist. “Prior to the closure,” Hinz continued, “our precious few beds were spread evenly between PA, Saskatoon, and Regina – 10 each. Can you imagine the outcry if, say, cardiac bed capacity was reduced by 1/3 overnight? Trying to absorb twice the number of kids that we normally care for has been taxing.” Another Saskatoon child psychiatrist, Dr. Madhav Sarda has added his voice to the cry. “I was running at 100 per cent of what I could give before all of this,” he said. “We all cate deeply about this province and the kids here and we do what we have to do to kind of get by, but it feels draining and it’s exhausting and you feel you don’t know if it’s going to get better because there isn’t a clear solution on the horizon.” Sarda believes the situation could remain grim for years before the appropriate number of psychiatrists are in place. “I think we’d like to assume that if you need care, you’ll get care, but what we see a lot of in mental health, of course, is if care isn’t readily available, people just don’t get care and they suffer in silence or it can lead to loss of life, the suicide crisis that we already have in the north,” he stated. The Saskatchewan Health Authority is said to be actively recruiting child and youth psychiatrists for Prince Albert, but the process can be a challenging one. Frequently the decision to move to a new city, a new community, has to be a family decision not just an individual physician’s. Brett Enns, executive director of primary health care for the north and northeast regions of the province, believes that while the search is on for four child and youth psychiatrists in Prince Albert, it is doubtful that they will be able to recruit all four at once, but should be able to recruit one or two within the next few months to a year.
The shortage of Child Psychiatrists has been a long-standing issue, with concerns about the supply of child psychiatristsdating back to 2016. In 2017, the wait time to see a child psychiatrist was two years in Saskatoon. Dr. Hinz identified many issues facing children and youth with mental health needs. “We need more beds. Recruiting child psychiatrists is no joke – almost everywhere is short staffed and PA will have to be able to make attractive offers to be competitive. You also can’t bring in just one; the workload is massive and one poor soul would burnout instantly.” In 2019, there were 16 child and adolescent psychiatrists working in Saskatchewan: Eight in Saskatoon, six in Regina and two in Prince Albert. Dr. Anna Felstrom, head of the University of Saskatchewan’s child and adolescent psychiatry division estimates a province with a population of upwards of one million people needs between 35 and 40 such specialists. “The longer and more entrenched a thought becomes or a behaviour becomes, the harder it is to fix it,” Felstrom said. An additional child and adolescent psychiatrist was reportedly hired to work in Saskatoon beginning in December of 2019, but this did nothing to address the need in Prince Albert and the north. Prince Albert serves as a “hub” for a large part of the province’s north serving children and youth from as close as Domremy. A 2018 provincial auditor’s report on the region found 80 per cent of child and youth patients with mild to moderate illness waited more than 20 days to access services in the former Prince Albert-Parkland Health Region during a period when there were two child psychiatrists on staff. Hinz said the closure has magnified existing gaps in the provincial mental health care system. "We were making do with what we had, but even before this closure there were a lot of struggles and gaps in care," she said. "Even before that we struggled with not enough child psychiatrists, not enough publicly funded mental health therapists or psychologists."
A shortage of psychiatrists in Saskatchewan is nothing new. A 2020 Globe and Mail analysis found Saskatchewan had only 9.3 psychiatrists per 100,000 people, the second-lowest among provinces. There are presently 13 openings for psychiatrists across the province, as posted to the Saskdocs web page. According to the Canadian Institute for Health Information (CIHI), Saskatchewan’s mental health hospitalization rate for children and youth is the second highest of all the provinces (not including the Territories) and Saskatchewan is tied for last place in numbers of psychiatrists treating children and youth. The number of children and youth hospitalized for mental health in Saskatchewan has doubled in the last decade, the highest rate of growth in the country. Hinz said youth are admitted to hospital for mental health reasons such as serious thoughts of suicide, suicide attempts, psychosis, mania or eating disorders. Data from the CIHI’s Care for Children and Youth with Mental Disorders – Data Tables shows that on average the rate of hospitalizations for children and youth in the Prince Albert district and the northern reaches of the province in 2017-2018 was 16 per 1000.
"I would give them an F [on recruitment]. We have a closed inpatient unit in one of the province's larger cities that serves as a hub," NDP Mental Health and Addictions Critic Danielle Chartier said. She pointed to the suicide crisis among youth in the north. Last December, Saskatchewan's provincial auditor's report found suicide rates in the northwest region of the province exceeded the provincial average by nearly 50 per cent. Northern community members say mental health workers of all kinds are needed but that psychiatrists are especially important because they can prescribe and manage medications for conditions like substance use disorders.
In late August, Prince Albert Northcote MLA Nicole Rancourt wrote to the Minister of Health to address this unacceptable service disruption; however, she has yet to receive a response.
