Canadian mental health resources?
July 9, 2020 2:36 PM Subscribe
A family member is living in Canada currently and going through a depressive mental breakdown. He tried reaching out for help from a GP, but described the experience as a total failure. What can he and the family do if money isn't much of an object?
T is the classic depressive genius, non-neurotypical in some ways (somewhere between autism and inattentive ADHD), dealing with executive dysfunction, general negative thoughts and now suicidal ideation (quote: "If I kill myself, it won't be for several months yet"). None of his family is in Canada at the moment, he hasn't connected with work colleagues well and quarantine/WFH hit him very hard. His English is good, but isn't his first language.
He went to a GP today and got told that all the GP can prescribe are "herbal pills" while the soonest possible psychiatric consult is several weeks away. (I'm getting all of this third-hand from T, so it might be filtered through his negative attitude.) T refuses to even try the pills because in his opinion herbal things can't be effective. He also refuses to go to a hospital because "things aren't that bad". Some family members are on the verge of calling up Canadian police and reporting his suicidal intent.
Is there any way he can access psychiatric care privately or otherwise faster than a month from now? He's in the greater Toronto area.
Additionally, if anyone can recommend support forums for depressed people in academia whose mental issues are affecting their jobs, that would be something else I can clobber T with. He's convinced he's a uniquely horrible failure, the poor git.
(We're looking into Skype therapy in his first language, probably CBT to start with, but he's incoherent enough that he probably needs meds first.)
T is the classic depressive genius, non-neurotypical in some ways (somewhere between autism and inattentive ADHD), dealing with executive dysfunction, general negative thoughts and now suicidal ideation (quote: "If I kill myself, it won't be for several months yet"). None of his family is in Canada at the moment, he hasn't connected with work colleagues well and quarantine/WFH hit him very hard. His English is good, but isn't his first language.
He went to a GP today and got told that all the GP can prescribe are "herbal pills" while the soonest possible psychiatric consult is several weeks away. (I'm getting all of this third-hand from T, so it might be filtered through his negative attitude.) T refuses to even try the pills because in his opinion herbal things can't be effective. He also refuses to go to a hospital because "things aren't that bad". Some family members are on the verge of calling up Canadian police and reporting his suicidal intent.
Is there any way he can access psychiatric care privately or otherwise faster than a month from now? He's in the greater Toronto area.
Additionally, if anyone can recommend support forums for depressed people in academia whose mental issues are affecting their jobs, that would be something else I can clobber T with. He's convinced he's a uniquely horrible failure, the poor git.
(We're looking into Skype therapy in his first language, probably CBT to start with, but he's incoherent enough that he probably needs meds first.)
Health care is run by the Provinces in Canada. So knowing where he is will help significantly: intake routes into the mental health system will vary by region (and also by health authority).
posted by Sauter Vaguely at 3:18 PM on July 9, 2020
posted by Sauter Vaguely at 3:18 PM on July 9, 2020
OP mentioned that the family member is the greater Toronto area.
posted by Juniper Toast at 3:21 PM on July 9, 2020 [2 favorites]
posted by Juniper Toast at 3:21 PM on July 9, 2020 [2 favorites]
If it's being paid for out of pocket, I don’t know if any barriers to contacting a Psychiatrist (has to be a psychiatrist for medication) in Toronto and booking an appointment. Many therapist are seeing clients remotely right now, so it'll likely be over Skype and if talk therapy is important, setting up a session with somebody from his home country ASAP might be a better alternative.
If he takes an emotional dip and NEEDS to see an actual human , he could go to the CAMH at College and Spadina. They have an 24/7 emergency room for assessment and if warranted, can set him up with an on-site therapist (or whatever the COVID situation allows). I don't know if they will supply meds though. There's a self-referral number to call also.
posted by bonobothegreat at 3:44 PM on July 9, 2020 [2 favorites]
If he takes an emotional dip and NEEDS to see an actual human , he could go to the CAMH at College and Spadina. They have an 24/7 emergency room for assessment and if warranted, can set him up with an on-site therapist (or whatever the COVID situation allows). I don't know if they will supply meds though. There's a self-referral number to call also.
posted by bonobothegreat at 3:44 PM on July 9, 2020 [2 favorites]
I came in to suggest CAMH. Toronto’s Mental Health plan is here as well.
posted by warriorqueen at 4:22 PM on July 9, 2020
posted by warriorqueen at 4:22 PM on July 9, 2020
The GP should be able to prescribe a variety of medications... the bit about only herbal remedies feels off (given what I know of others experiences with the Ontario system)
posted by walkinginsunshine at 6:41 PM on July 9, 2020 [4 favorites]
posted by walkinginsunshine at 6:41 PM on July 9, 2020 [4 favorites]
Yeah, "herbal pills" aren't a thing from a real Ontario doctor.
CAMH is the provincial centre of services for mental health in Ontario. It lists Crisis Resources. Do you know which municipality he's in? Most of these resources won't work outside their area.
Actual in-person consultations may be very limited. The hospitals I work with in the GTA are closed even for family visitors.
posted by scruss at 7:37 PM on July 9, 2020 [2 favorites]
CAMH is the provincial centre of services for mental health in Ontario. It lists Crisis Resources. Do you know which municipality he's in? Most of these resources won't work outside their area.
Actual in-person consultations may be very limited. The hospitals I work with in the GTA are closed even for family visitors.
posted by scruss at 7:37 PM on July 9, 2020 [2 favorites]
3rding about the herbal remedies.
posted by bonobothegreat at 7:41 PM on July 9, 2020
posted by bonobothegreat at 7:41 PM on July 9, 2020
If it's being paid for out of pocket, I don’t know if any barriers to contacting a Psychiatrist (has to be a psychiatrist for medication) in Toronto and booking an appointment.
It is against the law in Ontario for a doctor to bill for insured services. In other words, psychiatric care is covered by government health insurance (is an insured service), a psychiatrist cannot bill a patient for this.
I am beyond shocked that a doctor prescribed herbal pills. It is not true that this is all a gp can do and I'm surprised an actual MD doctor would even do this, give that MDs are usually science-oriented, I would think/hope. I called my family doctor 2 weeks ago and asked her to put me on anti-depressants and I had the pills in my hands later that day and my need is not as great as your friend's. It definitely does not have to by a psychiatrist to prescribe medication. His family doctor should be able to do it.
Anyway, though he cannot pay out of pocket for a psychiatrist, he can pay for other kinds of therapists. They cannot provide medication. However, if they believe that medication should be considered, they can provide a detailed history to a family doctor to support a prescription if the doctor is apparently some kind of weirdo. And of course he can contact CAMH. CAMH also has an emergency room.
Not to be alarmist, but three people have died in Canada recently after police were called to do wellness checks or crisis intervention due to mental illness. That's obviously not the USUAL outcome of a wellness check, but this just isn't police services' area of expertise.
posted by If only I had a penguin... at 8:18 PM on July 9, 2020 [4 favorites]
It is against the law in Ontario for a doctor to bill for insured services. In other words, psychiatric care is covered by government health insurance (is an insured service), a psychiatrist cannot bill a patient for this.
I am beyond shocked that a doctor prescribed herbal pills. It is not true that this is all a gp can do and I'm surprised an actual MD doctor would even do this, give that MDs are usually science-oriented, I would think/hope. I called my family doctor 2 weeks ago and asked her to put me on anti-depressants and I had the pills in my hands later that day and my need is not as great as your friend's. It definitely does not have to by a psychiatrist to prescribe medication. His family doctor should be able to do it.
Anyway, though he cannot pay out of pocket for a psychiatrist, he can pay for other kinds of therapists. They cannot provide medication. However, if they believe that medication should be considered, they can provide a detailed history to a family doctor to support a prescription if the doctor is apparently some kind of weirdo. And of course he can contact CAMH. CAMH also has an emergency room.
Not to be alarmist, but three people have died in Canada recently after police were called to do wellness checks or crisis intervention due to mental illness. That's obviously not the USUAL outcome of a wellness check, but this just isn't police services' area of expertise.
posted by If only I had a penguin... at 8:18 PM on July 9, 2020 [4 favorites]
Oh, I just saw you wanted Skype therapy. This place advertised in my FB feed and I sent it to a friend, though I don't know if she's tried it: telecbt. ca . Now supposedly their therapy is covered by OHIP (i.e. the government) because it's with MDs (note it doesn't say they're psychiatrists). These MDs are supposedly accepting new clients now.
Also, there aren't that MANY MDs, so I kind of wonder if it's not a scam: You request an MD and you can't get an appointment with one because they're booked solid so then they say "well, if you'd like to pay we can offer you an appointment with one of these other therapists." Huh...I just looked and there are even fewer non-MDs. Maybe they take people off the list when they have as many patients as they can handle?
posted by If only I had a penguin... at 8:28 PM on July 9, 2020
Also, there aren't that MANY MDs, so I kind of wonder if it's not a scam: You request an MD and you can't get an appointment with one because they're booked solid so then they say "well, if you'd like to pay we can offer you an appointment with one of these other therapists." Huh...I just looked and there are even fewer non-MDs. Maybe they take people off the list when they have as many patients as they can handle?
posted by If only I had a penguin... at 8:28 PM on July 9, 2020
Bonobothegreat outlined the quickest way to get help in Toronto in normal times - but be aware, CAMH has been absolutely slammed since COVID. If your friend has a confirmed appointment in a few weeks, that might still be faster. Also (in normal times) the waiting area is, well it’s the ER for a psych hospital. Other people’s issues might be triggering, and of course everyone’s waiting and in active distress so it might be jarring (and he might have to put up with it and *stay there* for many hours to get help...)
Mount Sinai and Sunnybrook aren’t shabby for mental health, actually. The waiting areas are usually calmer, as well. Of course they will be under COVID protocols.
I would not waste time on the mental health care available in hospitals in Mississauga, in case that’s where he is. Can’t speak to the rest of the GTA.
posted by cotton dress sock at 10:15 PM on July 9, 2020
Mount Sinai and Sunnybrook aren’t shabby for mental health, actually. The waiting areas are usually calmer, as well. Of course they will be under COVID protocols.
I would not waste time on the mental health care available in hospitals in Mississauga, in case that’s where he is. Can’t speak to the rest of the GTA.
posted by cotton dress sock at 10:15 PM on July 9, 2020
Also yes psychiatrists are paid through OHIP, and there’s nowhere near enough of them, so wait lists are super long and appointments are months out at the best of times. There’s no way to pay to get to the front of the line.
I found this resource, which is interesting. No idea about these particular practitioners. Usually psychiatrists don’t do therapy, they assess and prescribe and leave therapy to other types of mental health professionals. These doctors do not claim to be psychiatrists AFAICT (though they may well be, they may be distinguishing themselves from what psychiatrists usually do... So it’s unclear what kind of training or background they have. Any GP can bill for therapy through OHIP.)
https://www.mdpac.ca/Public/Physician_Psychotherapists_Accepting_Patients.html
If you’re worried about your friend having a bad experience with another doctor and that putting him off,
You can search for psychiatrists through the college directory
https://www.cpso.on.ca/
And see what people say on rating sites
https://www.ratemds.com/on/toronto/
And call their offices to see who’s taking patients soon... then your friend could go to a walk in and get a referral to a particular psychiatrist. Would take time as well...
posted by cotton dress sock at 10:38 PM on July 9, 2020
I found this resource, which is interesting. No idea about these particular practitioners. Usually psychiatrists don’t do therapy, they assess and prescribe and leave therapy to other types of mental health professionals. These doctors do not claim to be psychiatrists AFAICT (though they may well be, they may be distinguishing themselves from what psychiatrists usually do... So it’s unclear what kind of training or background they have. Any GP can bill for therapy through OHIP.)
https://www.mdpac.ca/Public/Physician_Psychotherapists_Accepting_Patients.html
If you’re worried about your friend having a bad experience with another doctor and that putting him off,
You can search for psychiatrists through the college directory
https://www.cpso.on.ca/
And see what people say on rating sites
https://www.ratemds.com/on/toronto/
And call their offices to see who’s taking patients soon... then your friend could go to a walk in and get a referral to a particular psychiatrist. Would take time as well...
posted by cotton dress sock at 10:38 PM on July 9, 2020
Response by poster: Thanks for all the resources! He's finally admitted to his mum that he only told the doctor he has "something not right with his head" with no further details, no wonder he didn't get any useful medication, so first order of business is to get him online therapy and psychiatrist appointments (thank heavens, our country's socialised medicine doesn't disallow paid care) to get him first-line diagnosis and coach him on what to say to the Canadian practitioners. He's feeling better today, thank heavens.
Still looking for academic depression support group recs, mind you.
posted by I claim sanctuary at 7:23 AM on July 10, 2020 [1 favorite]
Still looking for academic depression support group recs, mind you.
posted by I claim sanctuary at 7:23 AM on July 10, 2020 [1 favorite]
If he is affliated with a post-secondary institution, either as a student or employee, he should be accessing the schools mental health supports. (They all have them). They would give him support groups recommendations. A month ago my friend in a GTA university was able to get a same day appointment over the phone where they were (in their opinion, over-) prescribed medication immediately. The whole process took about three hours from the initial phone call and was completely covered by OHIP and the student benefit plan for the medication.
This comment comes from a place of caring - you have diagnosed him with depression, decided he needs to be immediately medicated, chosen CBT and support groups as the therapy modality, and are now coaching him on what to say to the medical professionals trying to get an idea of his insight into how he is doing. Oftentimes mental health breakdowns happen because the "support" person isn't listening to the person and is instead rushing into fix the problem in the way they have decided (you know the saying to that to a hammer everything looks like a nail...) That disempowerment of the individual is a major factor in depression. As someone who wants to support your relative, please get some professional support yourself in how you can be an empowering, not enabling, support.
I know suicidal ideation is scary - my husband had it for years and his daily conversations eventually gave me C-PTSD, but it was important to his eventual recovery that I was in therapy myself to learn how to support him, not take over his life or make his choices for him. It is a tough balance because you think "well, if only they did what I said, all their problems would be solved!" But that really does just make things worse, and their resistance will make you just push harder for poor choices.
posted by saucysault at 10:04 AM on July 10, 2020 [2 favorites]
This comment comes from a place of caring - you have diagnosed him with depression, decided he needs to be immediately medicated, chosen CBT and support groups as the therapy modality, and are now coaching him on what to say to the medical professionals trying to get an idea of his insight into how he is doing. Oftentimes mental health breakdowns happen because the "support" person isn't listening to the person and is instead rushing into fix the problem in the way they have decided (you know the saying to that to a hammer everything looks like a nail...) That disempowerment of the individual is a major factor in depression. As someone who wants to support your relative, please get some professional support yourself in how you can be an empowering, not enabling, support.
I know suicidal ideation is scary - my husband had it for years and his daily conversations eventually gave me C-PTSD, but it was important to his eventual recovery that I was in therapy myself to learn how to support him, not take over his life or make his choices for him. It is a tough balance because you think "well, if only they did what I said, all their problems would be solved!" But that really does just make things worse, and their resistance will make you just push harder for poor choices.
posted by saucysault at 10:04 AM on July 10, 2020 [2 favorites]
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posted by katra at 2:48 PM on July 9, 2020