Quebec social services minister wants to expand mental health services in clinics

Quebec Social Services Minister Lionel Carmant wants to increase mental health services in clinics in Quebec. (Christinne Muschi, The Canadian Press)

To tackle mental health waiting lists, Quebec Social Services Minister Lionel Carmant plans to expand access to psychologists in CLSCs and introduce walk-in services.

Speaking at the National Director of Mental Health and Forensic Psychiatry Services Day on Friday, Carmant reiterated his desire to expand mental health services in CLSCs and to have walk-in availability.

In an interview with The Canadian Press, Carmant said he had a one-year plan "of territories and establishments" where he wants to open CLSC services.

"Our government, what we want to do, is to bring services closer to citizens in their living environment, in their community," he said.

He praised the results of the Open Air (Aire ouverte) program, which offers mental health services to young people aged 12 to 25.

Quebec has earmarked $40 million to deploy an Open Air centre in each of the province's administrative regions.

"Among young people, we're seeing a reduction in waiting lists, but that's not yet the case for adults," said Carmant. "What's lacking among adults is access to walk-in services. We're going to start working on that in the CLSCs, those are the next steps."

Order of psychologists president Dr. Christine Grou believes it's a good strategy to deploy more mental health services in CLSCs, since they're one of the first places people turn to in times of need.

"CLSCs are the most accessible, so re-staffing them is an excellent idea, because the earlier the consultations, the more we can prevent things from getting worse and more complex," she said.

She believes that the walk-in service could also be beneficial for the population, as it enables psychological educations, answers patients' questions and removes barriers to service access.

For example, if someone is experiencing a depressive episode and it is treated quickly, it can prevent a more serious depression.

"And that will take longer to treat, precipitating a work stoppage and requiring hospital consultations," said Grou. "If we treat common disorders more quickly, people are going to be more functional and less ill."

She stressed, however, that the problem must be treated by the right person. To do this, the patient's needs must be properly assessed, and the services they require must be available at the CLSC.

Grou pointed out that access to psychologists in CLSCs could relieve overcrowding in family medical clinics, noting that 40 per cent of consultations with a family doctor are for common mental disorders. However, the problem lies in having enough staff.

Lack of psychologists in the public sector

"It's clear that if we want to offer services, we need staff, but I think the intention is there," said Grou.

However, there are few psychologists in the public network working in CLSCs, and more in "second- or third-line" services.

Currently, of the 9,300 psychologists in Quebec, around 6,000 practice in clinical services, and of these, 2,050 are in the public network, including 520 in CLSCs.

Not all CLSCs have a psychologist on site.

Carmant acknowledged that he has "major challenges" ahead of him.

"Because the new generations and the post-pandemic are raising their hands much more readily for mental health problems, and I see that as a good thing," he said. "However, we have to manage the increase in demand for services, and we have to innovate in the way we offer services."

He pointed out that his government recently extended mental health services to social workers, sex therapists, kinesiologists and guidance councillors.

Grou cautioned against taking psychologists away from other departments and putting them in CLSCs.

"If we put more of them on the front line, we shouldn't take away from more specialized services," she said. "The danger would be to say that we're going to take the psychologists who accompany oncology or cardiology patients, for example, and who offer psychotherapeutic services that people need, and we're going to bring them to the front line. We mustn't rob Peter to pay Paul, in other words."

The interest in private practice is mainly due to salary conditions and working conditions.

Grou emphasized that efforts had been made to improve salary conditions, but did not comment on whether this was sufficient.

She mentioned that conditions were still far from being comparable to the private sector.

This report by The Canadian Press was first published in French on June 21, 2024.

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