Chatham woman wants to know why 'most vulnerable' are waiting for care as hospital recovers from cyberattack

Having just started a new antidepressant medication, Chatham-Kent resident Lynn McKerracher is worried about her health now that a check-in appointment with her psychiatrist has been delayed more than two weeks due to a ransomware attack that has impacted several southwestern Ontario hospitals.

McKerracher, who has bipolar depression, anxiety and seasonal affective disorder, said she has been seeing a psychiatrist every four to six weeks for nearly 20 years. She said her doctor prescribes her medication and monitors her mood, as it can easily shift. 

The 51-year-old said she had an appointment booked with her psychiatrist for Nov. 9 to check in after she was prescribed to take another antidepressant in combination with one she's already on. But days before the appointment, McKerracher said, her psychiatrist's office, which is part of the Chatham-Kent Health Alliance (CKHA), told her she couldn't be seen because computers are still down from the ransomware attack. 

She said she even asked for a phone call check-in, but that was also denied. More than two weeks later, McKerracher said, her appointment still hasn't been rescheduled. The last time she saw her psychiatrist was Oct. 4. 

"It's been hard 'cause I worry a lot — that's part of my illness," said McKerracher, who has been on disability and stopped working in 2012 as a result of her diagnosis. 

"And I have no idea when I'm going to get a phone call and how long it's going to take for me to see my psychiatrist." 

Hospital says staff doing their best amid stress

CKHA is one of five hospitals trying to recover from the Oct. 23 ransomware attack.

In a text message, CKHA spokesperson Fannie Vavoulis said the hospital can't get into health details due to patient confidentiality. 

Vavoulis noted that due to the impact on systems, doctors might not be able to access a patient's records or medical history, their current medication list, reports from other doctors involved in that person's care and pre-operation assessments. 

While some systems are working, Vavoulis said they are "slower than usual and require extra time."

Some doctors might cancel appointments if they feel it's not safe to continue due to a lack of critical information, but Vavoulis said doctors will "do their best to reschedule as quickly as possible if this is required." 

"We want to emphasize to our patients that our physicians and front-line staff are under greater than normal stress due to these unusual circumstances and are responding with incredible resolve. We ask the public for their understanding during this time," reads part of the statement. 

The hospitals' IT provider, TransForm, has been rebuilding the system from scratch and expects to have hospitals mostly back online by mid-December. 

But in the meantime, patients like McKerracher say they're being ignored by the system. 

"The most vulnerable in the community are relying on [CKHA's] services and we're not getting that help that we need," said McKerracher, who also uses supports from the Canadian Mental Health Association's Lambton-Kent branch. 

"It matters that it's psychiatric care, it matters that it's cancer treatments ... how long is this going to be before we get that help?"

McKerracher worries that others in the community aren't getting the timely care that they need. 

The CMHA's Lambton-Kent branch declined to comment on how it's supporting patients in the community during this time or additional resources people can access.

Delays can have 'negative impact'

Windsor psychologist Cory Saunders said the longer mental health patients wait for supports, the more their symptoms can be exacerbated. 

"Certainly any delay in service can have a negative impact," Saunders said. 

"One of the good things we know is that people who are currently waiting for service actually are likely to have better outcomes than people who are not able to access service ... but at the same time we know the longer you spend waiting, the more that your symptoms are likely to potentially become worse." 

Gail Robinson, a University of Toronto psychiatry professor, said in an emailed comment that when starting a new antidepressant, she would want to check in with a patient at two weeks to reassure them, as often they won't feel a change for three or more weeks. 

Robinson is also a psychiatrist at Sunnybrook Hospital in Toronto. 

She said that in the first week of prescribing a new medication, she makes herself available for a phone call with patients as they could have a bad reaction. 

And when it comes to bipolar disorder, Robinson said, she checks in weekly with any new medication use as it can "cause a switch into mania." Mania is defined as a period of one week or longer where someone could experience symptoms like increased or fast talking, a decreased need for sleep, racing thoughts and physical agitation. 

As for available resources to help people who are struggling, Saunders said there are crisis lines, but when it comes to a psychiatrist or psychologist, the "system is already stretched pretty thin," so it could still take weeks or months for someone to be seen by another health-care professional. 

Little research on cyberattack impact on Canada's health system

An analysis article published in the Canadian Medical Association Journal (CMAJ) last week noted that since 2015, there have been at least 14 attacks targeting Canadian health information systems. This number is an underrepresentation as some attacks may go unreported and it doesn't include the most recent incident in southwestern Ontario. 

University of Toronto researcher Vinyas Harish, who co-authored the analysis, said there isn't much information available as to how these attacks impact Canada's health-care system, so the article had to draw on data from other countries.

The article says that based on a 2021 international survey of health IT decision-makers, the average cost of a ransomware attack is $1.27 million US. 

"One of our major takeaways is that cyberattacks can occur, privacy breaches, financial harm of course, but [the attack] also directly threaten[s] patient safety and the functioning of the health system," he said. 

The article also suggests that Canada look at having Sector Coordinating Councils (SCCs), as the U.S. does. These councils collaborate with the government and help establish voluntary practices around cybersecurity. 

Research from the United Kingdom that was published in September from the Frontiers in Digital Health journal noted that cyberattacks can possibly trigger or exacerbate issues like anxiety, insomnia, trauma, paranoia, substance use or suicidal behaviours in people with mental health issues. 

It reports that not only is access to service disrupted, but it's harmful when a person's mental health details are also exposed online. 

CBC News reached out to TransForm for an update on its recovery process, but it has declined to comment.