New faces are the norm at P.E.I.'s mental health walk-in clinics
Still barriers to seeking help, especially for men
In the year and a half since the mental health walk-in clinics have been open, there's a trend among the people using them that is encouraging to staff — many of them are new clients, meaning they haven't accessed community mental health services in the past.
Of the clients who accessed services in Prince County between July 2016 and December 7, 2017, 70 per cent of those recorded were new clients, according to data from Health PEI.
For Bruce Davison, manager of Community Mental Health and Addictions West, it shows the walk-in clinics have fewer barriers than less immediate services like ongoing therapy, which has a waiting list.
"Some of the barriers have to do with the nature of mental health problems. If you think of depression or anxiety — one of the things that people talk about the most is a lack of motivation," he said.
"Calling about an appointment wouldn't be a big deal when they're feeling better, but it may be a great effort when they're experiencing that kind of difficulty."
The mental health walk-in clinic in Summerside has been running for about a year and a half, and new clinics have been added in Elmsdale, O'Leary, Lennox Island and Charlottetown, as well as one for students at Westisle High School.
Davison said the trends he's seeing in western P.E.I. are consistent with what the two clinics in Charlottetown are seeing.
Reasons for not getting help can be gendered
The barriers to getting help can be particularly difficult to overcome for men, especially those over 50.
"Many men were raised with a limited emotional vocabulary," he said, adding many of the men they've seen at the walk-in clinics have cited that, as well as the stigma they feel around their mental health, as barriers to getting help
"We're going to be a long time yet bridging that gap to men that have been taught to think of themselves as invincible and that to show a need for help is to show weakness."
He said middle age is often considered risky for men's mental health — and research shows the risk of suicide spikes at that time.
"It tends to be a time when sometimes we have complications with our physical health that we haven't experienced before, the relationships with children or with spouses change significantly — and it presents its own problems, in all of those facets," he said.
Clinics seeing more women than men
But despite the low-barrier nature of the walk-in clinics, Davison said there are still challenges around getting men in the door.
The numbers around gender distribution among clients at the walk-in clinics mirrors that of those seeking all of the services offered at Community Mental Health West, including ongoing therapy services — with more women showing up than men.
"We're encouraged no matter who is coming in the door to access service," said Davison.
And he added that, like men, there are some reasons experienced by women that can prevent them from reaching out for help when they need it.
"Some services have not been delivered in the past in a way that's really aware of traditional sexism, of traditional oppression, and we're still dealing with the legacy of that," he said of one of the reasons women can be reluctant to seek services.
Client feedback positive
He said at the walk-in clinics, clients are given a minimal amount of intake paperwork — a single sheet of paper asking them for contact information, what they're experiencing, whether they have any medical conditions or medications, if they have suicidal thoughts and about the other community supports they might be using.
He said there are also short wait times, and often people are able to get in to see someone within minutes. Most of the clients, he said, present with anxiety, depression and mood disorders.
After their visit each client is handed a satisfaction survey, and Davison said strong results in the surveys show people feel the clinics have helped them.
Between March and December last year, 67 per cent of clients across the province responded that almost all of their concerns had been addressed and an additional 30 per cent said most of their concerns had been addressed, 76 per cent responded "yes definitely" when asked if that day's session was helpful to them, and 85 per cent responded "yes definitely" when asked if they would recommend the clinic to others.
No replacement for ER, doctor's office, or ongoing therapy
While Davison is excited by the results the walk-in clinics have seen, the clinics also have limitations.
Clients meet with a social worker or a registered nurse, but don't have direct access to a physician or a psychiatrist. It also isn't meant to be a substitute for a physician's referral. While the therapists at the walk-in clinics can make recommendations and further referrals, Davison said people should still speak to their family doctor if they believe they need a referral to ongoing therapy.
While the clinics help people who are in distress, it's not a crisis service, he said.
"So we tell people that for example if someone who comes in for an appointment is suicidal, we will do our best to address that with them, but we are limited by our ability to make a safety plan with them that doesn't require the kind of supports that would be available at an acute care emergency room," he said.
"Depending on the circumstances, so that's certainly fair clinical ground for us to engage them in a therapeutic discussion with a registered social worker, or a registered nurse, but if we're unable to make a safety plan with them they may still have to access an emergency room or their doctors offices."
And the walk-in clinics don't replace ongoing therapy either. While people are welcome to return for another session, Davison said there's no guarantee they'll be meeting with the same therapist.
This story is part of an ongoing project CBC P.E.I. is doing on mental health services in the province. You can share your experiences with us here.
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