Mental Health Waiting Lists: Destitute Regions In Need

Amqui, Louiseville, Laval, Longueuil: Several recent tragedies have tragically highlighted the psychological distress of part of the population. Unfortunately, many people willing to seek help find themselves at a closed door, as delays in some regions can be more than a year.

The data obtained by Le Journal shows that it takes patience to see a psychologist (psychologist, social worker, etc.) on the public network.

Adult area

Average waiting time for psychiatric care

Regions/facilities		Specific services1 (First line*)	Specialized services2 (Second row *)
01	Bas Saint Laurent	82 days	158 days
02	Saguenay–Lac Saint Jean	119 days	259 days
03	Capitale Nationale	16 days	205 days
04	Mauricie and Centre-du-Québec	25 days	54 days
05	Estrie	16 days	143 days
06	Montreal
	West Island	45 days	86 days
	Central West Island	23 days	67 days
	South Central Island	9 days	26 days
	North Island	14 days	20 days
	East Island	21 days	66 days
	DUDE	0	38 days
	MUHC	0	141 days
07	Outaouais	82 days	60 days
08	Abitibi-Témiscamingue	146 days	109 days
09	North Coast	86 days	175 days
10	Northern Quebec	152 days	99 days
11	Gaspésie-Îles-de-la-Madeleine
	Gaspesie	218 days	28 days
	Magdalen Islands	70 days	28 days
12	Chaudière-Appalaches	51 days	126 days
13	Laval	39 days	310 days
14	Lanaudière	71 days	58 days
15	Laurentians	8 days	371 days
16	Monterégie
	center	46 days	44 days
	East	56 days	126 days
	west	45 days	58 days
PROVINCE AVERAGE TIME		60 days	164 days

Source: Department of Health and Human Services

The patient data and average waiting times shown in the tool refer to waiting patients as of March 31, 2023.
Note: A user is considered waiting if he or she is assigned or registered in the Activity Center without any intervention at the time of the portrait.

* Officially the expressions of the 1st and 2nd lines are no longer used.

1 The specific service is general support for moderate and stabilized cases (lower impact and/or needs).
2 The specialized service provides access to more adapted resources for serious or more complex cases (increased impact and/or needs).

For example, an adult with dark thoughts will generally see a doctor in less than a month on the mainland, but had to wait 146 days in Abitibi as of March 31 (latest available data).

Youth component

Average waiting time for psychiatric care

Regions/facilities		Specific services1 (First line*)	Specialized services2 (Second row *)
01	Bas Saint Laurent	114 days	168 days
02	Saguenay–Lac Saint Jean	72 days	200 days
03	Capitale Nationale	132 days	116 days
04	Mauricie and Centre-du-Québec	114 days	171 days
05	Estrie	19 days	137 days
06	Montreal
	West Island	1 day	26 days
	Central West Island	102 days	259 days
	South Central Island	2 days	0
	North Island	24 days	132 days
	East Island	28 days	133 days
	MUHC	0	187 days
	CHU Sainte Justine	0	14 days
07	Outaouais	56 days	305 days
08	Abitibi-Témiscamingue	33 days	n/a
09	North Coast	321 days	482 days
10	Northern Quebec	218 days	167 days
11	Gaspésie-Îles-de-la-Madeleine
	Gaspesie	392 days	148 days
	Magdalen Islands	56 days	n/a
12	Chaudière-Appalaches	10 days	100 days
13	Laval	17 days	0
14	Lanaudiere	39 days	69 days
15	Laurentians	30 days	605 days
16	Monterégie
	center	10 days	23 days
	East	56 days	55 days
	west	47 days	85 days
Average waiting time in the province		106 days	289 days

Source: Department of Health and Human Services

* Officially the expressions of the 1st and 2nd lines are no longer used.

For a minor it takes more than four months in the Capitale-Nationale. This delay increases to 321 days on the north coast and 392 days on the Gaspé Peninsula.

Consequences of the pandemic

Not surprisingly, the pandemic has led to a significant increase in demand for mental health resources, observes Dr. Karine Gauthier, founder of the Coalition of Psychologists of the Quebec Public Network. “It was a huge stressor for everyone. A lot of isolation and adaptation was required of the population,” notes the psychologist.

Since then, despite significant investment, Quebec has failed to reduce the mental health waiting list.

“Studies show that such events have an impact over several years,” observes Dr. Gauthier.

On the supply side, Quebec has difficulty attracting and retaining doctoral students in psychology. “About 25% will go into the public network and almost half of that percentage will leave in the first two years to open private practices,” says the president of the Order of Psychologists of Quebec, Dr. Christine Grou.

“For me this is worrying. We need both services, but we cannot replace one with the other,” she adds.

Stress factors

In Chicoutimi, Valérie Maltais is faced daily with the lack of resources for vulnerable clients who end up in the Saguenay offices of the Canadian Mental Health Association.

In addition to the pandemic, she cites several stressors to explain the growing demand. “The housing shortage, the rise in prices, it is certain that this has an impact,” says the organization’s general director.

She gives the example of a woman working for minimum wage who was recently evicted from her home and was unable to find a new place to live. “We are seeing a lot of fear and uncertainty increasing almost everywhere,” notes Ms. Maltais.

At the parents’ expense

In the Laurentians, even access to private services has become virtually impossible, observes Jessica Kimpton, a social worker at the relatives in Saint-Jérôme.

“Parents are discouraged, they no longer know where to go”

– Jessica Kimpton, social worker at the organization Lahalte des Closes based in Saint-Jérôme

Photo MARTIN ALARIE / LE JOURNAL DE MONTRÉAL

“Deinstitutionalization has put a strain on families,” complains the woman who accompanied the parents of the young Émile Martineau, who tragically died at the age of 20 after struggling with mental health problems. (See other text)

In his region, a young person has to wait almost 20 months before being treated for specialist treatment.

Even as adults, children often remain in the care of their parents. In her practice, Ms. Kimpton regularly sees people in their 70s and 80s who prefer to keep their sick, aggressive children at home.

“The family says to themselves: If I don’t keep it, the person will go out on the street,” she explains.

Psychologists are leaving the public network in favor of the private sector, where salaries and working conditions are more attractive.

The report presented last spring by former minister Hélène David on training in psychology and mental health is categorical: everyone involved agrees that there is a shortage of psychologists in the public network and that this appears to be increasing.

In addition, the numbers of the Order of Psychologists speak for themselves. The number of private members increased by 806 between 2011 and 2021, while it decreased by 313 in the public sector.

There was no data on private practices for 2022 and 2023, but the public network lost 349 additional psychologists during this period.

Number of vacancies for psychologists

Quebec University Hospital 5
CISSS of the islands 4
CISSS Côte-Nord 16
CIUSSS de l’Est-de-l’Île-de-Montréal 25
CIUSSS South Central Montreal Island 12
CISSS Bas Saint Laurent 8th
CHU Ste-Justine 5

Source: Responses to Access to Information Requests.
*As of August 2023.

Overall, 47% of the order’s 9,222 members practice privately, compared to 20% in the health network. Teaching or supervising others.

Salary and working conditions

“Surveys of psychologists show that the reason why they choose the private sector is, firstly, the salary problems and secondly, the lack of professional autonomy,” notes the founder of the Coalition of Psychologists of the Quebec Public Network, Dr. Karine Gauthier.

According to his organization, the overall pay gap between the public and private sectors is 44.3%. The coalition therefore supports the establishment of a union consisting exclusively of psychologists in order to carry out the salary catch-up process.

“It has a snowball effect. “If the psychologist only has half as many colleagues and all the workload and pressure is on her, there is a greater chance that she will leave,” emphasizes Dr. Karine Gauthier, herself a psychologist in a hospital environment.

The president of the Order of Psychologists of Quebec also deplores the lack of professional autonomy granted to psychologists in hospitals. In addition, the public network has “become much worse” in recent years, so that skilled workers lack resources, explains Dr. Christine Grou.

schools and hospitals

This harsh reality is reflected in the number of job vacancies, both in health and education.

According to the David report, the Department of Health needs to recruit almost 1,000 psychologists within five years “to maintain an adequate service in the public network”. In schools, around 17% of positions were vacant during the committee’s work.

However, as some groups interviewed by Hélène David noted, this is an artificial shortage caused by migration to the private sector. In fact, there are a large number of psychologists in Quebec, almost half of all professions in Canada.

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