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2021-08-25

Nova Scotia’s rural communities struggling to attract mental health providers

Incentivizing Mental Health Providers to Offer Travelling Services  

I hung up my phone after a long call with a clinic manager in a rural Nova Scotia community. She called to ask if I knew of any psychiatrists who would be available to work in her community one day a week. She pleaded, “We are desperate to find someone who can help. Our young people are suffering. There must be someone who wants to see the beach.”  

Unfortunately, I did not know a physician who would be willing to drive 500 kilometers to see a patient...and the ocean waves, as magnificent as they are.  

Rising Wait Lists in Rural Communities  

Rural and remote communities in Canada face unique challenges in providing access to quality mental health services...Where services do exist, they are frequently stretched thin, with long wait lists, high turnover rates, and poor communications infrastructures. [1]  

When services are not available in a community, people are often left with no choice but to travel long distances to get help they need. Even then, people are not guaranteed an appointment.  

Wait times to see a psychiatrist in Halifax, the province’s capital city, can range from five to eight months. By the time a patient gets seen, their conditions have often worsened.  

Three of Virtual Hallway’s founders - also practicing psychiatrists - made it their mission to find a solution. 

Connecting Care through Interprofessional Phone Consultation  

The Mental Health Commissioner of Canada suggests the following best practices: 

  1. Using technology 
  1. Supporting primary care providers  
  1. Improving care coordination [1]  

Virtual Hallway incorporates all three through a platform where primary care providers can book rapid phone consultations with specialists to get answers for their patients.  

This process eliminates waiting, saves time, and is impartial to distance.  

Not all health concerns can be addressed by a phone call, but more than 35% of referrals [2] are appropriate for an interprofessional phone consultation. For patients with more complex cases who do require a face-to-face visit, Virtual Hallway is a resource to support their ongoing care while they wait to be seen.  

Increasing Access   

Even though I could not recommend one psychiatrist who would be willing to travel such lengthy distances for work, I could offer the practitioners in the rural clinic access to four psychiatrists through Virtual Hallway.  

Our hope is that specialist input earlier on in a course of illness will streamline a person’s treatment and optimize their care.  

This is our mission: to create more efficient and accessible healthcare for everyone.  

References  

[1] Mental Health Commision of Canada. (2017). Rural and remote mental health in Canada: Evidence brief on best and promising practices. Health Canada. Retrieved from https://www.mentalhealthcommission.ca/sites/default/files/2020-05/Rural_remote_mental_health_evidence_brief_eng.pdf  

[2] Keely, E., Liddy, C. (2019). Transforming the specialist referral and consultation process in Canada. CMAJ, 191(15), E408-E409. https://doi.org/10.1503/cmaj.181550  

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