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Demand outstripping resources at mental-health clinics for veterans: documents

May 7, 2018 | 3:45 PM

OTTAWA — Demand for service has been outstripping the resources available to a network of mental-health clinics set up across the country to help veterans with post-traumatic stress disorder and other psychological trauma, an internal government report suggests.

As a result, the report warns, many veterans in places like Quebec City, Vancouver and Edmonton have been forced to wait longer before seeing a mental-health specialist or psychiatrist, despite the importance of timely intervention.

The wait-time challenge is separate from the backlog of 29,000 requests for disability benefits at Veterans Affairs Canada, and follows a previous warning from the federal auditor general about former soldiers facing long waits for badly needed mental-health services.

Veterans Affairs acknowledged Monday the challenges posed by mental-health services, which it hopes to address by hiring more staff, expanding existing clinics and opening new satellite offices.

“In cases where clients require urgent psychiatric expertise,” added department spokesman Marc Lescoutre, “they are prioritized to ensure timely access to treatment.”

But the report also says Veterans Affairs is reviewing its own standards and could accept longer wait times as the norm, even though “shorter delays minimize client distress and are critical to optimizing positive mental health outcomes.”

That has raised alarm bells for at least one veterans’ advocate, who says the answer isn’t making veterans wait longer to access mental-health services.

“There is a need that exists across the country for OSI support, and we feel it too,” said Scott Maxwell of Wounded Warriors Canada, which offers various mental-health programs such as service dogs to veterans.

“But at the end of the day, everybody wants to see veterans have access to the OSI support they deserve and need. That’s got to be the goal.”

The internal report, obtained through the Access to Information Act, was produced in January and examined performance at 10 of the department’s Operational Stress Injury (OSI) clinics during 2016-17, the most recent year for which data was available.

First established in 2002, the clinics are now located in most major cities across Canada and include a team of psychiatrists, psychologists, social workers and other specialized mental-health professionals.

Each clinic is designed to assess and treat the mental-health needs of veterans as well as serving military personnel and RCMP members through one-on-one therapy and group sessions.

Getting through the door didn’t appear to be much of a problem, the report suggests: the majority of veterans received their first clinical visit within 15 days of a referral, at which time they were assessed for risk and any specialized treatment.

Accessing specialized and psychiatric treatment, however, was a more drawn-out affair for many veterans.

Only 27 per cent who needed specialized treatment without a psychiatrist were seen within 30 days of a referral, the report said — well below the department’s target of 80 per cent.

While the results were better for psychiatric treatment — 56 per cent of veterans were seen within 60 days — it also fell short of the 80 per cent target. Actual wait times varied considerably, depending where the clinic was located.

Veterans in Winnipeg and Ottawa, for example, could expect speedy access to a psychiatrist while those in Edmonton, Montreal and Vancouver, in particular, could expect to wait much longer.

The report specifically blamed an “unprecedented growth in new referrals” for the difficulties, which it pegged at 42 per cent over the previous year, saying the influx “is impacting the network’s ability to meet service standards.”

Veterans Affairs is planning to open a new satellite clinic in Kingston, Ont., and expand the OSI clinic in London, Ont., Lescoutre said, in addition to setting aside money to hire more mental-health workers.

“The department and the network of OSI clinics are also working together to review clinic processes in an effort to improve efficiencies,” he added.

More than once, the report indicates that Veterans Affairs is reviewing its service standards “to determine if they are appropriate.”

“If service standard was lowered to 60 business days the standard would be met 56 per cent of the time,” the report says of the 30-day target for specialized treatment without a psychiatrist.

Veterans Affairs Minister Seamus O’Regan marked Monday’s start to Mental Health Week by announcing a partnership with the Royal Ottawa Hospital to research PTSD in veterans.

— Follow @leeberthiaume on Twitter.

Lee Berthiaume, The Canadian Press