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Patients redirected to psychiatrists, counsellors upon ‘reorganization’ of mental health care

University of Ottawa Health Services (UOHS) cut its two on-staff psychologists in what it has called a “reorganization” of mental health services offered by the organization, the Fulcrum has learned.

The mental health team consists of counsellors, psychiatrists, and up until January, two part-time psychologists. Those positions were dropped in early December, and the two psychologists worked their last day on Jan. 13.

Christopher Fisher, executive director of the UOHS, said the positions were cut in order to eliminate the “middle ground” between the counsellors and the psychiatrists. The team’s four counsellors handle the “lion’s share” of patient care, he said, while the psychiatrists are assigned to patients who require more complex treatment.

“The psychologists were a small component of an otherwise larger team in terms of their capacity to see patients, in volume and complexity,” he said.

The psychologists had about 24 patients at the time of their dismissal. Fisher said those patients have been reassigned to another member of the mental health team — either bumped up to a psychiatrist or moved over to a counsellor — or referred back to their family physician for continued follow-up.

However, one student said he felt “abandoned” after his appointments were dropped without much notice or explanation. The student, who asked not to be named, had been seeing one of the psychologists since 2012. He had two appointments scheduled in the new year, but received a call in December informing him those appointments had been cancelled.

When he visited the office on Nicholas Street, he said he was greeted by a receptionist who, as the student walked in, seemed equally confused and upset about the news and was “complaining to her coworkers” about having to turn away patients.

The student said that no matter the underlying reasons for the change, the fact that there was a sudden change at all is what’s troubling to him.

“It’s jeopardizing to my care,” he said. “In terms of the future success of a patient, causing a disruption is like pouring gasoline on fire. To do this at the beginning of a semester without giving me proper time to at least find someone. It’s disastrous.”

The student said he had not been reassigned to a new mental health professional.

He said he’s concerned because counsellors are unable to provide the same mental health treatment and doctor-patient continuity as his psychologist, and that visiting a private practice psychologist would mean commuting further to a clinic and shelling out big bucks on each appointment, “which, for students, is impossible.”

Fisher said he hadn’t heard reports of there being any problems with the transition, but encouraged any patient with questions or concerns to bring them to the attention of the UOHS.

Executive members of the Student Federation of the University of Ottawa (SFUO) are concerned that the university community is seeing cuts in an area that’s crucial to the well-being of its students. Chris Hynes, vp university affairs of the SFUO, said that in terms of funding and support, Health Services should be doing more rather than less.

“When it comes to mental health and support services for students, this isn’t something where we should be scraping by,” said Hynes. “We’d like to see the administration support that enough so that cuts like these don’t have to happen.”

SFUO president Anne-Marie Roy underlined that “students’ mental health is a big deal.”

The Student Academic Success Service (SASS) deals with counselling services for students at the U of O who need help dealing with problems like stress, anxiety, and mild forms of depression. SASS counsellors will often refer students with more severe mental health problems to a general practitioner, who will then refer them to a psychologist or psychiatrist.

Murray Sang, director of SASS, said most students who come through will see a counsellor within 48 hours, continue seeing the counsellor for about five sessions, and then be on their way.

“The problem is that the complexity of the problems is rising. What happens is that we’re seeing more and more students that require greater intervention that we’re not equipped to deal with,” said Sang.

“We’re seeing more and more students with more and more complicated issues — things like severe anxiety, clinical depression — and those aren’t going to respond to five visits with one of our counsellors.”

But he noted the UOHS is “not there to replace the health care system,” which as a whole is afflicted with long waitlists and limited admittance. Fisher noted that wait times for mental health care at the U of O are much shorter than the standard in the province or the country, and particularly shorter than those of the average university health care system. Patient use of UOHS mental health services is capped at eight sessions per person in order to make sure care can be distributed among the many members of the community who may need it.

Sang said he wasn’t aware of the changes to the mental health services, though it is not common practice for the UOHS to report back to SASS.

According to Fisher, the UOHS team has a tentative plan to move forward with the reorganization, but he’s not at liberty to bring those plans forward until they’ve been confirmed with the Ministry of Health and Long-Term Care and can start being implemented.

“Until then,” he said, “we have more than adequate resources to meet the demands.”