A Dartmouth, N.S., clinic run by the Nova Scotia Health Authority that treats current and former military and RCMP members suffering from post-traumatic stress disorder has been operating for months without any psychologists.
“It’s missing a big piece of the puzzle that’s going to help an individual get as healthy as they can, as quickly as they can,” said Jeannette Kennedy, the president of the Association of Psychologists of Nova Scotia.
The shortage of psychologists at the operational stress injury clinic comes at a time when high-profile Mounties have recently gone public about their on-the-job acquired PTSD, and the challenges they faced obtaining mental-health treatment after identifying and disclosing their injury.
The Dartmouth clinic is funded by Veterans Affairs Canada. It is normally staffed by nurses, social workers, occupational therapists, psychologists, psychiatrists and family doctors.
In Nova Scotia, registered psychologists, psychiatrists and nurse practitioners are specially trained to diagnose PTSD, a complex mental-health condition that may develop after a traumatic, terrifying or dangerous experience, and recur even years later.
Kennedy said psychologists are trained to administer personality and IQ tests required to distinguish PTSD from other disorders and brain functioning impairments.
Her experience, she said, shows PTSD severity is related to symptoms persisting and worsening without diagnosis and intervention.
The vacancies at the clinic also come amid public scrutiny of the care provided to Armed Forces members with PTSD. A provincial fatality inquiry into the murder-suicide of an Afghanistan war veteran with PTSD and his family is examining whether Lionel Desmond had access to mental-health services.
The Dartmouth clinic is one of 11 across the country that offer “one-on-one therapy sessions and group sessions to address anxiety, insomnia, anger and other issues” that are symptoms of a mental-health disorder, said Veterans Affairs Canada.
Mounties do have the option of seeking the care of a private practice psychologist. In addition, the force has made peer support co-ordinators available, as well as online videos.
Kennedy, who worked for the military before moving into private practice, said the goal at the Canadian Armed Forces was to treat members “in-house” for streamlined, faster care. Members would be sent to outside psychologists at times of “overflow.”
She said another advantage to having a clinic staffed with psychologists is to provide advice to the employer about occupational risks that have been identified.
Start date for psychologists is ‘as soon as possible’
Since September, the provincial health authority has been searching for psychologists to fill the holes. It needs 3.2 full and part-time clinical psychologists, including a clinical team leader. According to a job posting, the successful candidate is required to begin “as soon as possible.”
The salary is up to $60 an hour. That’s viewed as roughly equivalent to the earnings by a psychologist in private practice who may have office overhead costs and no employer-paid benefits.
But the health authority’s requirement of a PhD excludes many of the province’s 550 registered psychologists because roughly half only have a master’s degree.
In Nova Scotia, whether a psychologist holds a PhD or a master’s degree, the scope of practice is the same. In other words, they can perform the same job.
The health authority declined an interview, but in an email, spokesperson Maureen Wheller said the clinic “is able to support its client population using an evidence-based approach.”
Most patients can expect a phone call within 14 days, and be seen by a psychiatrist within three months, she said.
“The lens of psychology is an important role on an inter-professional team. We are actively recruiting psychologists to provide their input and expertise,” Wheller wrote.
A 2018 survey of Nova Scotia psychologists found widespread job dissatisfaction within the public sector.
The questionnaire by the Association of Psychologists of Nova Scotia found that at least half of psychologists who left the public sector were unhappy with the number of staff, the availability of training and professional development, and the level of support from the employer. Forty per cent were concerned about the standard of care given to clients.
Wheller said the health authority conducts confidential exit interviews when someone leaves a job to learn about ways to better attract and retain people.
Besides a shortage of psychologists, another obstacle in RCMP members seeking help has to do with the clientele at the clinic, said a former member of the force. Of the clinic’s 188 patients, 160 are from the military, while 28 are RCMP members.
‘One size doesn’t fit all,’ says ex-Mountie
“Why would I want to go to a counselling session with 11 military guys there and only me? What’s going to become the topic of the session? It’s going to be the military,” said retired Staff Sgt. Murray Brown, who has PTSD. “One size doesn’t fit all.”
When Brown retired seven years ago, he held a job similar to that of being a union representative. He stays in touch with a large group of retired and serving Mounties.
“It seems almost everybody in my circle is affected by it [PTSD],” he said, adding he believes the condition is under-reported among officers.
PTSD numbers in the RCMP
According to data provided by the police force, PTSD is the second most-common reason for a disability pension being awarded, behind only hearing damage.
Among members on the job, nearly 1,800 — or almost eight per cent of the force — have a PTSD injury and are receiving a disability pension.
Brown said some Mounties choose not to disclose their psychological injury because of stigma, and it’s perceived to be a career-limiting move that can affect promotions and job security.
But Kennedy said with early treatment for trauma, members can perform their policing skills more effectively, take less time off work and be healthier at home.
The Mounties have promised to tackle the issue and are recruiting 14 psychologists nationally, with one based in Nova Scotia, to staff a new PTSD early detection and intervention program.
The force is also participating in a 10-year research study of cadets to investigate the effects that policing has on the mental health of Mounties.
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